Kalisa Richard, Malande Oliver Ombeva
Department of Obstetrics and Gynecology, Ruhengeri Hospital, Musanze, Rwanda; Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University, Amsterdam, The Netherlands.
Department of Pediatrics, Faculty of Health Sciences, Egerton University, Nakuru, Kenya.
Pan Afr Med J. 2016 Oct 17;25:91. doi: 10.11604/pamj.2016.25.91.9710. eCollection 2016.
Birth preparedness and complication readiness (BP/CR) promotes timely access to skilled maternal and neonatal services, active preparation and decision-making for seeking health care to prevent any adverse outcomes. The aim was to assess level of male partner (MP) involvement in the birth plan, the attitude of the women towards maternal care and factors associated with BP/CR among obstetric referrals in rural Rwanda.
This was a cross-sectional study among 350 pregnant women who were admitted as referrals at Ruhengeri hospital, between July 2015 and November 2015. Data was collected on socio-demographics, level of MP's participation in maternal health care and domestic activities, women's attitude towards involvement of men in maternal care and BP/CR. Any woman who arranged to have a birth companion, made a plan of where to deliver from, received health education on pregnancy and childbirth complications, saved money in case of pregnancy complication and had attended antenatal care (ANC) at least 4 times, was deemed as having made a birth plan.
The mean age was 27.7 years, while mean age of the spouse was 31.3 years. Majority of the women (n=193; 55.1%) and their spouse (n=208; 59.4%) had completed primary education. Men's role was found to be mainly in the area of financial support. The level of men ANC attendance was low (n=103; 29.4%), while 78 (22.3%) women were accompanied to the labor ward. However, there was a strong opposition to the physical presence of MP in the labor room (n=178; 50.9%). The main reason cited by women opposing MP presence is that it is against their culture for a man to witness the delivery of a baby. On multivariable analysis, maternal education level of secondary or higher adjusted odds ratio [AOR] 1.4 95% CI (1.8-2.6), formal occupation of spouse, AOR 2.4 95% CI (1.4-4.2) and personnel checked during ANC being community health worker AOR 2.2, 95% CI; (1.3-3.7) were associated with being well prepared.
Male involvement in pregnancy and antenatal care is low. To increase men involvement in birth plan addressing cultural barriers and refraining care-givers and health facility policies towards family delivery is paramount.
生育准备和并发症应对（BP/CR）有助于及时获得熟练的孕产妇和新生儿服务，积极做好寻求医疗保健的准备并做出决策，以预防任何不良后果。目的是评估卢旺达农村地区产科转诊病例中男性伴侣（MP）参与生育计划的程度、女性对孕产妇护理的态度以及与BP/CR相关的因素。
这是一项横断面研究，研究对象为2015年7月至2015年11月期间在鲁亨盖里医院作为转诊患者入院的350名孕妇。收集了社会人口统计学数据、男性伴侣参与孕产妇保健和家庭活动的程度、女性对男性参与孕产妇护理和BP/CR的态度。任何安排了分娩陪伴者、制定了分娩地点计划、接受过妊娠和分娩并发症健康教育、为应对妊娠并发症存钱且至少参加过4次产前检查（ANC）的女性，都被视为制定了生育计划。
平均年龄为27.7岁，配偶的平均年龄为31.3岁。大多数女性（n = 193；55.1%）及其配偶（n = 208；59.4%）完成了小学教育。发现男性的作用主要在经济支持方面。男性参加ANC的比例较低（n = 103；29.4%），而78名（22.3%）女性在分娩时有人陪同。然而，女性强烈反对男性伴侣在产房出现（n = 178；50.9%）。反对男性伴侣在场的女性给出的主要原因是，男性目睹婴儿出生违背她们的文化。多变量分析显示，中等及以上教育水平的孕产妇调整优势比[AOR]为1.4，95%置信区间（1.8 - 2.6），配偶有正式职业，AOR为2.4，95%置信区间（1.4 - 4.2），以及在ANC期间接受检查的人员为社区卫生工作者，AOR为2.2，95%置信区间（1.3 - 3.7），均与准备充分相关。
男性对妊娠和产前护理的参与度较低。为提高男性对生育计划的参与度，消除文化障碍以及规范护理人员和医疗机构针对家庭分娩的政策至关重要。
