Davis Jessica, Vyankandondera Joseph, Luchters Stanley, Simon David, Holmes Wendy
Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.
Reprod Health. 2016 Jul 16;13(1):81. doi: 10.1186/s12978-016-0184-2.
The importance of involving men in reproductive, maternal and child health programs is increasingly recognised globally. In the Pacific region, most maternal and child health services do not actively engage expectant fathers and fathers of young children and few studies have been conducted on the challenges, benefits and opportunities for involving fathers. This study explores the attitudes and beliefs of maternal and child health policymakers and practitioners regarding the benefits, challenges, risks and approaches to increasing men's involvement in maternal and child health education and clinical services in the Pacific.
In-depth interviews were conducted with 17 senior maternal and child health policymakers and practitioners, including participants from five countries (Cook Island, Fiji, Papua New Guinea, Solomon Island, and Vanuatu) and four regional organisations in the Pacific. Qualitative data generated were analysed thematically.
Policymakers and practitioners reported that greater men's involvement would result in a range of benefits for maternal and child health, primarily through greater access to services and interventions for women and children. Perceived challenges to greater father involvement included sociocultural norms, difficulty engaging couples before first pregnancy, the physical layout of clinics, and health worker workloads and attitudes. Participants also suggested a range of strategies for increasing men's involvement, including engaging boys and men early in the life-cycle, in community and clinic settings, and making health services more father-friendly through changes to clinic spaces and health worker recruitment and training.
These findings suggest that increasing men's involvement in maternal and child health services in the Pacific will require initiatives to engage men in community and clinic settings, engage boys and men of all ages, and improve health infrastructure and service delivery to include men. Our findings also suggest that while most maternal and child health officials consulted perceived many benefits of engaging fathers, perceived challenges to doing so may prevent the development of policies that explicitly direct health providers to routinely include fathers in maternal and child health services. Pilot studies assessing feasibility and acceptability of context-appropriate strategies for engaging fathers will be useful in addressing concerns regarding challenges to engaging fathers.
全球越来越认识到男性参与生殖、孕产妇和儿童健康项目的重要性。在太平洋地区，大多数孕产妇和儿童健康服务并未积极让准父亲和幼儿的父亲参与进来，并且关于让父亲参与的挑战、益处和机会的研究很少。本研究探讨了孕产妇和儿童健康政策制定者及从业者对于男性参与太平洋地区孕产妇和儿童健康教育及临床服务的益处、挑战、风险和方法的态度与看法。
对17名高级孕产妇和儿童健康政策制定者及从业者进行了深入访谈，其中包括来自五个国家（库克群岛、斐济、巴布亚新几内亚、所罗门群岛和瓦努阿图）以及太平洋地区四个区域组织的参与者。对生成的定性数据进行了主题分析。
政策制定者和从业者报告称，男性更多地参与将为孕产妇和儿童健康带来一系列益处，主要是通过让妇女和儿童有更多机会获得服务和干预措施。他们认为让父亲更多参与面临的挑战包括社会文化规范、在首次怀孕前让夫妻参与存在困难、诊所的布局、卫生工作者的工作量和态度。参与者还提出了一系列增加男性参与的策略，包括在生命周期早期、在社区和诊所环境中让男孩和男性参与，以及通过改变诊所空间以及卫生工作者的招聘和培训，使卫生服务对父亲更友好。
这些研究结果表明，要增加男性在太平洋地区孕产妇和儿童健康服务中的参与度，需要采取举措让男性在社区和诊所环境中参与进来，让各年龄段的男孩和男性参与进来，并改善卫生基础设施和服务提供以纳入男性。我们的研究结果还表明，虽然大多数接受咨询的孕产妇和儿童健康官员认为让父亲参与有许多益处，但这样做所面临的可感知挑战可能会阻碍制定明确指示卫生服务提供者将父亲常规纳入孕产妇和儿童健康服务的政策。评估适合具体情况的让父亲参与的策略的可行性和可接受性的试点研究，将有助于解决有关让父亲参与的挑战的担忧。
