Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.
Parenting Research Centre, 232 Victoria Parade, East Melbourne, VIC, 3002, Australia.
BMC Pregnancy Childbirth. 2018 May 9;18(1):145. doi: 10.1186/s12884-018-1775-4.
Complications during pregnancy, childbirth and the postpartum period present a significant and complex public health problem in low income countries such as Ethiopia. One strategy endorsed by the World Health Organisation (WHO) to improve maternal and child health outcomes is to encourage male partner involvement in pregnancy care. This research aimed to explore the relationships between 1) male attendance at antenatal care and 2) socio-economic and women's empowerment factors and adherence to focused antenatal care guidelines among women receiving care in Ethiopia.
Secondary analysis of 2011 Ethiopian Demographic and Health Survey (DHS) data. A sub-sample of couples with a child aged 0-2 years old, for whom women attended at least one antenatal care (ANC) appointment was selected. Predictor variables on socio-economic position, demographic and women's empowerment factors, and male attendance at antenatal care were identified. Six outcome variables were constructed to indicate whether or not women: commenced ANC in the first trimester, attended at least four ANC appointments, received a urine test, received a blood test, were counselled on potential complications during pregnancy and met these focused antenatal care guidelines. Binary logistic regression was performed to estimate the relationship between the predictor and outcome variables.
After controlling for other factors, women whose partners attended ANC were significantly more likely to receive urine and blood tests and be counselled about pregnancy complications compared to women who attended alone. Male attendance was not associated with women commencing care in the first trimester or attending at least four appointments. Although more women whose male partners had attended appointments received all recommended components of ANC than those who attended alone, this association was not significant.
The results revealed some benefits and did not detect harms from including male partners in focused antenatal care. Including men may require changes to maternal healthcare systems and training of healthcare workers, to adopt 'father inclusive' practices. Given the limited research in this area, large population studies including the DHS routinely carried out in Ethiopia could enhance knowledge by including more detailed indicators of male involvement in pregnancy, maternal and child healthcare and early child development.
在埃塞俄比亚等低收入国家,妊娠、分娩和产后期间的并发症是一个重大且复杂的公共卫生问题。世界卫生组织(WHO)为改善母婴健康结果而支持的一项策略是鼓励男性伴侣参与妊娠保健。本研究旨在探索以下两者之间的关系:1)男性参加产前护理,以及 2)社会经济和妇女赋权因素与在埃塞俄比亚接受护理的妇女遵守重点产前护理指南之间的关系。
对 2011 年埃塞俄比亚人口与健康调查(DHS)数据进行二次分析。选择至少接受过一次产前护理(ANC)预约且有 0-2 岁儿童的夫妇的子样本。确定了社会经济地位、人口和妇女赋权因素以及男性参加产前护理的预测变量。构建了六个结果变量,以表明妇女是否:1)在孕早期开始 ANC,2)至少接受四次 ANC 预约,3)接受尿液检查,4)接受血液检查,5)接受关于妊娠期间潜在并发症的咨询,以及 6)符合这些重点产前护理指南。进行了二元逻辑回归分析,以估计预测变量与结果变量之间的关系。
在控制了其他因素后,与单独参加 ANC 的妇女相比,伴侣参加 ANC 的妇女更有可能接受尿液和血液检查,并接受关于妊娠并发症的咨询。男性的参与与妇女在孕早期开始护理或至少接受四次预约无关。尽管与单独参加 ANC 的妇女相比,更多伴侣参加过预约的妇女接受了所有推荐的 ANC 成分,但这种关联并不显著。
结果显示了一些益处,并且没有发现将男性伴侣纳入重点产前护理会带来危害。将男性纳入可能需要改变孕产妇保健系统和培训保健工作者,以采用“父亲包容”的做法。鉴于该领域的研究有限,包括埃塞俄比亚常规开展的 DHS 在内的大型人群研究可以通过纳入更多关于男性参与妊娠、孕产妇和儿童保健以及早期儿童发展的详细指标来增强知识。