Turinawe Emmanueil Benon, Rwemisisi Jude T, Musinguzi Laban K, de Groot Marije, Muhangi Denis, de Vries Daniel H, Mafigiri David K, Katamba Achilles, Parker Nadine, Pool Robert
University of Amsterdam, Amsterdam, The Netherlands.
Makerere University, Kampala, Uganda.
Reprod Health. 2016 Mar 12;13:24. doi: 10.1186/s12978-016-0147-7.
Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization's Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context.
This study employed ethnographic methods including participant observation, which took place in the process of everyday life activities of the respondents within the community; 12 focus group discussions, and 12 in-depth interviews with community members and key informants. Participants in this study were purposively selected to include TBAs, men, opinion leaders like village chairmen, and other key informants who had knowledge about the configuration of maternity services in the community. Data analysis was done inductively through an iterative process in which transcribed data was read to identify themes and codes were assigned to those themes.
Contrary to the thinking that TBA services are utilized by women only, we found that men actively seek the services of TBAs and utilize them for their wives' healthcare within the community. TBAs in turn sensitize men using both cultural and biomedical health knowledge, and become allies with women in influencing men to provide resources needed for maternity care.
In this study area, men trust and have confidence in TBAs; closer collaboration with TBAs may provide a suitable platform through which communities can be sensitized and men actively brought on board in promoting maternal health services for women in rural communities.
自1994年国际人口与发展会议以来，男性参与生殖健康问题一直被倡导为改善母婴健康结果的一种手段，但迄今为止，医疗服务提供者未能成功让男性参与孕期护理，尤其是在大多数服务不足人群居住的农村和偏远地区。为了加强社区对孕产妇护理的参与，对传统助产士进行了培训并配备了设备，以确保更好的护理和快速转诊。1997年，世界卫生组织安全孕产倡议出台后，人们的热情从传统助产士转向了其他方面。然而，在许多发展中国家，尤其是农村地区，传统助产士仍然发挥着重要作用。本研究探讨了在乌干达农村背景下，男性与传统助产士在塑造孕产妇保健方面的互动。
本研究采用了人种志方法，包括参与观察，即在社区内受访者的日常生活活动过程中进行观察；12次焦点小组讨论，以及对社区成员和关键信息提供者进行12次深入访谈。本研究的参与者是有目的地挑选出来的，包括传统助产士、男性、村长等意见领袖，以及其他了解社区孕产妇服务配置的关键信息提供者。数据分析通过一个迭代过程进行归纳，在这个过程中，阅读转录的数据以识别主题，并为这些主题分配代码。
与认为只有女性使用传统助产士服务的想法相反，我们发现男性积极寻求传统助产士的服务，并在社区内将其用于妻子的医疗保健。传统助产士反过来利用文化和生物医学健康知识使男性敏感起来，并在影响男性提供孕产妇护理所需资源方面与女性成为盟友。
在本研究地区，男性信任并对传统助产士有信心；与传统助产士更密切的合作可能提供一个合适的平台，通过这个平台可以提高社区的认识，并让男性积极参与到促进农村社区妇女孕产妇健康服务中来。
