“男性所不知之事会损害女性健康”：加纳男性参与孕产妇保健的障碍与机遇的定性研究
'What men don't know can hurt women's health': a qualitative study of the barriers to and opportunities for men's involvement in maternal healthcare in Ghana.
作者信息
Ganle John Kuumuori, Dery Isaac
机构信息
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana.
Institute of African and Gender Studies, University of Cape Town, Cape Town, South Africa.
出版信息
Reprod Health. 2015 Oct 10;12:93. doi: 10.1186/s12978-015-0083-y.
BACKGROUND
The importance of men's involvement in facilitating women's access to skilled maternal healthcare in patriarchal societies such as Ghana is increasingly being recognised. However, few studies have been conducted to examine men's involvement in issues of maternal healthcare, the barriers to men's involvement, and how best to actively involve men. The purpose of this paper is to explore the barriers to and opportunities for men's involvement in maternal healthcare in the Upper West Region of Ghana.
METHODS
Qualitative focus group discussions, in-depth interviews and key informant interviews were conducted with adult men and women aged 20-50 in a total of seven communities in two geographic districts and across urban and rural areas in the Upper West Region of Ghana. Attride-Stirling's thematic network analysis framework was used to analyse and present the qualitative data.
RESULTS
Findings suggest that although many men recognise the importance of skilled care during pregnancy and childbirth, and the benefits of their involvement, most did not actively involve themselves in issues of maternal healthcare unless complications set in during pregnancy or labour. Less than a quarter of male participants had ever accompanied their wives for antenatal care or postnatal care in a health facility. Four main barriers to men's involvement were identified: perceptions that pregnancy care is a female role while men are family providers; negative cultural beliefs such as the belief that men who accompany their wives to receive ANC services are being dominated by their wives; health services factors such as unfavourable opening hours of services, poor attitudes of healthcare providers such as maltreatment of women and their spouses and lack of space to accommodate male partners in health facilities; and the high cost associated with accompanying women to seek maternity care. Suggestions for addressing these barriers include community mobilisation programmes to promote greater male involvement, health education, effective leadership, and respectful and patient-centred care training for healthcare providers.
CONCLUSIONS
The findings in this paper highlight the need to address the barriers to men's involvement, engage men and women on issues of maternal health, and improve the healthcare systems - both in terms of facilities and attitudes of health staff - so that couples who wish to be together when accessing care can truly do so.
背景
在加纳等父权制社会中，男性参与促进女性获得熟练的孕产妇保健服务的重要性日益得到认可。然而，很少有研究探讨男性在孕产妇保健问题上的参与情况、男性参与的障碍以及如何最好地让男性积极参与。本文旨在探讨加纳上西部地区男性参与孕产妇保健的障碍和机会。
方法
在加纳上西部地区的两个地理区域、共七个社区（包括城市和农村地区），对20至50岁的成年男性和女性进行了定性焦点小组讨论、深入访谈和关键信息人访谈。采用阿特里德 - 斯特林的主题网络分析框架来分析和呈现定性数据。
结果
研究结果表明，尽管许多男性认识到孕期和分娩期间熟练护理的重要性以及他们参与的益处，但大多数男性除非在孕期或分娩时出现并发症，否则不会积极参与孕产妇保健问题。不到四分之一的男性参与者曾陪同妻子在医疗机构进行产前检查或产后护理。确定了男性参与的四个主要障碍：认为孕期护理是女性的角色，而男性是家庭供养者；消极的文化观念，如认为陪同妻子接受产前护理服务的男性受妻子支配；卫生服务因素，如服务开放时间不利、医护人员态度恶劣（如虐待妇女及其配偶）以及医疗机构缺乏容纳男性伴侣的空间；以及陪同女性寻求孕产妇护理的高昂成本。解决这些障碍的建议包括开展社区动员项目以促进男性更多参与、健康教育、有效领导以及对医护人员进行尊重和以患者为中心的护理培训。
结论
本文的研究结果凸显了有必要消除男性参与的障碍，让男性和女性就孕产妇健康问题进行参与，并改善医疗保健系统——包括设施和医护人员态度方面——以便希望在接受护理时在一起的夫妇能够真正做到。
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