“他无需在树下等待”:马拉维男性、女性及医护人员对男性伴侣参与预防母婴传播人类免疫缺陷病毒服务的看法

"He does not have to wait under a tree": perceptions of men, women and health care workers on male partner involvement in prevention of mother to child transmission of human immunodeficiency virus services in Malawi.

作者信息

Nyondo-Mipando Alinane L, Chimwaza Angela F, Muula Adamson S

机构信息

School of Public Health and Family Medicine, College of Medicine University of Malawi, Blantyre, Malawi.

Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.

出版信息

BMC Health Serv Res. 2018 Mar 20;18(1):187. doi: 10.1186/s12913-018-2999-8.

Abstract

BACKGROUND

The perception of male involvement (MI) in maternal child health services is multifaceted and differs among varying programs and populations. In the Prevention of Mother to Child Transmission (PMTCT) context, MI includes men's attendance at antenatal care (ANC) clinics, undertaking an HIV tests within the ANC and financial and psychological support. Contexualising the definition of MI is fundamental in the development of MI in PMTCT policy and interventions. The objective of this study was to explore the perceptions of men, women and health care workers on male partner involvement in PMTCT services in Malawi.

METHODS

A qualitative descriptive study was conducted at South Lunzu Health Centre (SLHC) in Blantyre, Malawi from December 2012 to January 2013. We conducted s Key Informant Interviews (KIIs) with 6 health care workers and moderated four Focus Group Discussions (FGDs) among 18 men and 17 pregnant women attending antenatal care at SLHC. We divided FGDs participants according to sex and age. We digitally recorded all FGDs and KIIs and simultaneously transcribed and translated verbatim into English. We employed thematic analysis to identify codes and themes.

RESULTS

Men and women described MI in PMTCT as either a) Positive participation or b) Negative participation. Positive participation included total involvement of the male partner in PMTCT interventions, reminding the spouse of clinic and treatment schedules, and resource provision. Health care workers described MI as either a) Involvement along the pregnancy continuum or b) Passive Involvement. Participants' preferred positive involvement of male partners.

CONCLUSIONS

There are multiple perceptions of MI in PMTCT with participants preferring positive involvement. There is a need to have a uniform description of MI in PMTCT to optimize development of strategies and interventions that accommodate and optimize MI in PMTCT. A uniform description will be useful in assessing a country's progress towards achieving MI in PMTCT goals.

摘要

背景

男性参与孕产妇保健服务的认知是多方面的,在不同项目和人群中存在差异。在预防母婴传播(PMTCT)背景下,男性参与包括男性到产前保健(ANC)诊所就诊、在ANC期间进行艾滋病毒检测以及提供经济和心理支持。在制定PMTCT政策和干预措施时,将男性参与的定义置于具体情境中至关重要。本研究的目的是探讨马拉维男性、女性和医护人员对男性伴侣参与PMTCT服务的看法。

方法

2012年12月至2013年1月,在马拉维布兰太尔的南伦祖健康中心(SLHC)进行了一项定性描述性研究。我们对6名医护人员进行了关键 informant访谈(KIIs),并在SLHC参加产前保健的18名男性和17名孕妇中主持了4次焦点小组讨论(FGDs)。我们根据性别和年龄对FGDs参与者进行了划分。我们对所有FGDs和KIIs进行了数字录音,并同时逐字转录和翻译成英语。我们采用主题分析来识别代码和主题。

结果

男性和女性将PMTCT中的男性参与描述为a)积极参与或b)消极参与。积极参与包括男性伴侣全面参与PMTCT干预措施、提醒配偶诊所和治疗时间表以及提供资源。医护人员将男性参与描述为a)在整个孕期的参与或b)被动参与。参与者更喜欢男性伴侣的积极参与。

结论

对于PMTCT中的男性参与存在多种认知,参与者更喜欢积极参与。有必要对PMTCT中的男性参与进行统一描述,以优化适应和优化PMTCT中男性参与的策略和干预措施的制定。统一描述将有助于评估一个国家在实现PMTCT目标中男性参与方面的进展。

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