Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh.
University of Edinburgh, Edinburgh, UK.
BMC Pregnancy Childbirth. 2020 Mar 18;20(1):169. doi: 10.1186/s12884-020-2854-x.
To improve the utilization of maternal and newborn health (MNH) care and to improve the quality of care, the World Health Organization (WHO) has strongly recommended men's involvement in pregnancy, childbirth, and after birth. In this article, we examine women's preferences for men's involvement in MNH care in rural Bangladesh and how this compares to husbands' reported involvement by women.
A cross-sectional household survey of 1367 women was administered in 2018 in the district of Brahmanbaria. Outcomes of interest included supporting self-care during pregnancy, participation in birth planning, presence during antenatal care, childbirth, and postnatal care, and participation in newborn care. Binary and multiple logistic regressions were done to understand the associations between the outcomes of interest and background characteristics.
Although women preferred a high level of involvement of their husbands in MNH care, husbands' reported involvement varied across different categories of involvement. However, women's preferences were closely associated with husbands' reported involvement. Around three-quarters of the women reported having been the primary decision makers or reported that they made the decisions jointly with their husbands. The likelihood of women reporting their husbands were actively involved in MNH care was 2.89 times higher when the women preferred their husbands to be involved in 3-4 aspects of MNH care. The likelihood increased to 3.65 times when the women preferred their husbands to be involved in 5-6 aspects. Similarly, the likelihood of husbands' reported active involvement was 1.43 times higher when they jointly participated in 1-2 categories of decision-making. The likelihood increased to 2.02 times when they jointly participated in all three categories.
The findings of our study suggest that women in rural Bangladesh do indeed desire to have their husbands involved in their care during pregnancy, birth and following birth. Moreover, their preferences were closely associated with husbands' reported involvement in MNH care; that is to say, when women wanted their husbands to be involved, they were more likely to do so. Programmes and initiatives should acknowledge this, recognizing the many ways in which men are already involved and further allow women's preferences to be realized by creating an enabling environment at home and in health facilities for husbands to participate in MNH care.
为了提高孕产妇和新生儿健康（MNH）服务的利用率并改善服务质量，世界卫生组织（WHO）强烈建议男性参与妊娠、分娩和产后照护。本文旨在探讨孟加拉国农村地区女性对男性参与 MNH 照护的偏好，并将其与女性报告的丈夫参与情况进行比较。
2018 年在婆罗门巴里亚区进行了一项针对 1367 名女性的横断面家庭调查。主要结局指标包括支持孕期自我护理、参与分娩计划、产前护理、分娩和产后护理、新生儿护理。采用二元和多项逻辑回归分析来了解感兴趣结局与背景特征之间的关联。
尽管女性希望丈夫高度参与 MNH 照护，但丈夫报告的参与情况在不同的参与类别中存在差异。然而，女性的偏好与丈夫报告的参与情况密切相关。约四分之三的女性表示自己是主要决策者，或报告她们与丈夫共同做出决策。当女性希望丈夫参与 MNH 照护的 3-4 个方面时，女性报告丈夫积极参与 MNH 照护的可能性是丈夫参与 1-2 个方面的 2.89 倍。当女性希望丈夫参与 5-6 个方面时，这种可能性增加到 3.65 倍。同样，当丈夫共同参与 1-2 个类别的决策时，丈夫报告的积极参与的可能性增加到 1.43 倍。当他们共同参与所有三个类别时，这种可能性增加到 2.02 倍。
本研究结果表明，孟加拉国农村地区的女性确实希望丈夫在妊娠、分娩和产后期间参与自己的照护。此外，她们的偏好与丈夫报告的 MNH 照护参与情况密切相关；也就是说，当女性希望丈夫参与时，他们更有可能参与。相关项目和倡议应该认识到这一点，承认男性已经以多种方式参与其中，并通过在家庭和医疗机构中创造一个有利的环境，让女性的偏好得到实现，进一步允许丈夫参与 MNH 照护。
