Dumbaugh Mari, Tawiah-Agyemang Charlotte, Manu Alexander, ten Asbroek Guus Ha, Kirkwood Betty, Hill Zelee
Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, UK.
BMC Pregnancy Childbirth. 2014 Aug 12;14:269. doi: 10.1186/1471-2393-14-269.
Male involvement in various health practices is recognized as an important factor in improving maternal and child health outcomes. Male involvement interventions involve men in a variety of ways, at varying levels of inclusion and use a range of outcome measures. There is little agreement on how male involvement should be measured and some authors contend that male involvement may actually be detrimental to women's empowerment and autonomy. Few studies explore the realities, perceptions, determinants and efficacy of male involvement in newborn care, especially in African contexts.
Birth narratives of recent mothers (n = 25), in-depth interviews with recent fathers (n = 12) and two focus group discussions with fathers (n = 22) were conducted during the formative research phase of a community-based newborn care trial. Secondary analysis of this qualitative data identified emergent themes and established overall associations related to male involvement, newborn care and household roles in a rural African setting.
Data revealed that gender dictates many of the perceptions and politics surrounding newborn care in this context. The influence of mother-in-laws and generational power dynamics were also identified as significant. Women alone perform almost all tasks related to newborn care whereas men take on the traditional responsibilities of economic providers and decision makers, especially concerning their wives' and children's health. Most men were interested in being more involved in newborn care but identified barriers to increased involvement, many of which related to gendered and generational divisions of labour and space.
Men defined involvement in a variety of ways, even if they were not physically involved in carrying out newborn care tasks. Some participant comments revealed potential risks of increasing male involvement suggesting that male involvement alone should not be an outcome in future interventions. Rather, the effect of male involvement on women's autonomy, the dynamics of senior women's influence and power and the real impact on health outcomes should be considered in intervention design and implementation. Any male involvement intervention should integrate a detailed understanding of context and strategies to include men in maternal and child health should be mutually empowering for both women and men.
男性参与各种健康活动被认为是改善母婴健康结果的一个重要因素。男性参与干预措施以多种方式让男性参与其中,参与程度各不相同,并使用一系列结果指标。对于如何衡量男性参与程度,人们几乎没有达成共识,一些作者认为男性参与实际上可能对女性的赋权和自主权有害。很少有研究探讨男性参与新生儿护理的现实情况、观念、决定因素和效果,尤其是在非洲背景下。
在一项基于社区的新生儿护理试验的形成性研究阶段,对近期分娩的母亲(n = 25)进行了分娩叙事,对近期分娩的父亲(n = 12)进行了深入访谈,并与父亲进行了两次焦点小组讨论(n = 22)。对这些定性数据进行二次分析,确定了新出现的主题,并建立了与非洲农村地区男性参与、新生儿护理和家庭角色相关的总体关联。
数据显示,在这种情况下,性别决定了许多围绕新生儿护理的观念和政治因素。岳母的影响和代际权力动态也被认为是重要因素。几乎所有与新生儿护理相关的任务都由女性独自完成,而男性承担经济支柱和决策者的传统责任,特别是在涉及妻子和孩子的健康问题上。大多数男性有兴趣更多地参与新生儿护理,但指出了增加参与的障碍,其中许多与性别和代际劳动分工及空间划分有关。
男性以多种方式定义参与,即使他们没有实际参与执行新生儿护理任务。一些参与者的评论揭示了增加男性参与的潜在风险,这表明仅男性参与不应成为未来干预措施的一个结果。相反,在干预设计和实施中,应考虑男性参与对女性自主权的影响、老年女性影响力和权力的动态变化以及对健康结果的实际影响。任何男性参与干预措施都应全面了解具体情况,并采用相互赋权的策略让男性参与母婴健康事务,使男女双方都能从中受益。