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社区视角:坦桑尼亚中部社区中男性参与产妇护理的潜在障碍探讨。

Community perspectives: An exploration of potential barriers to men's involvement in maternity care in a central Tanzanian community.

机构信息

Department of Public Health, School of Medicine, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.

Department of Education, Faculty of Humanities and Education, Saint John's University of Tanzania, Dodoma, Tanzania.

出版信息

PLoS One. 2020 May 21;15(5):e0232939. doi: 10.1371/journal.pone.0232939. eCollection 2020.

DOI:10.1371/journal.pone.0232939
PMID:32437360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7241761/
Abstract

BACKGROUND

Male involvement in maternal health has been linked to positive health outcomes for women and children, as they control household resources and make significant decisions, which influence maternal health. Despite of the important role they have in maternal health care, their actual involvement remains low. The objective of this study was to explore community perspectives on potential barriers to men's involvement in maternity care in central Tanzania.

METHODS

Qualitative research methods were used in data collection. We conducted 32 focus group discussions (16 FGDs with men and 16 FGDs with women) and 34 in-depth interviews with community leaders, village health workers and health care providers. Interview guides were used to guide the focus group discussions and in-depth interviews. The interviews and discussions were audio recorded, transcribed and translated into English and imported into QSR NVivo 9 software for thematic analysis. Three themes emerged from the data; men's maternity care involvement indicators, benefits of men's involvement in maternity health care services and barriers to men's involvement in maternity health care services.

RESULTS

Both men and women participants acknowledged the importance of men's involvement in maternity health care services, even though few men actually got involved. Identified benefits of men's involvement in maternity health care services include: Learning any risk factors directly from the health care providers and getting prepared in addressing them; and reinforcing adherence to instruction received from the health care provider as family protectors and guardians. Barriers to men's involvement in maternity health care services are systemic; starting from the family, health care and culture-specific gender norms for maternity related behaviour as well as healthcare facilities structural constrains inhibiting implementation of couple-friendly maternity health care services.

CONCLUSIONS

Men's involvement in maternity care is influenced by culture-specific maternity-related gender norms. This situation is compounded by the conditions of deprivation that deny women access to resources with which they could find alternative support during pregnancy. Moreover, structures meant for maternal health care services lack privacy, thus inhibiting male partners' presence in the delivery room. Intervention to increase men's involvement in maternity care should address individual and systemic barriers to men's involvement.

摘要

背景

男性参与产妇保健与妇女和儿童的健康结果呈正相关,因为他们控制家庭资源并做出重大决策,从而影响产妇健康。尽管他们在产妇保健中发挥着重要作用,但他们的实际参与程度仍然很低。本研究的目的是探讨坦桑尼亚中部社区对男性参与产妇保健的潜在障碍的看法。

方法

采用定性研究方法收集数据。我们进行了 32 次焦点小组讨论(16 次男性焦点小组讨论和 16 次女性焦点小组讨论)和 34 次深入访谈,访谈对象包括社区领导、乡村卫生工作者和医疗保健提供者。访谈指南用于指导焦点小组讨论和深入访谈。访谈和讨论均进行了录音、转录并翻译成英文,然后导入 QSR NVivo 9 软件进行主题分析。从数据中得出了三个主题;男性参与产妇保健的指标、男性参与产妇保健服务的益处以及男性参与产妇保健服务的障碍。

结果

男性和女性参与者都承认男性参与产妇保健服务的重要性,尽管很少有男性真正参与。男性参与产妇保健服务的益处包括:直接从医疗保健提供者那里了解任何风险因素并做好应对准备;作为家庭保护者和监护人,加强对医疗保健提供者所提供指导的遵守。男性参与产妇保健服务的障碍是系统性的;从家庭、医疗保健和文化特定的性别规范开始,这些规范与产妇相关的行为有关,以及医疗保健设施结构限制了夫妇友好型产妇保健服务的实施。

结论

男性参与产妇保健受到特定于文化的与产妇相关的性别规范的影响。这种情况因剥夺条件而加剧,剥夺条件使妇女无法获得资源,使她们在怀孕期间无法获得替代支持。此外,用于产妇保健服务的结构缺乏隐私,从而抑制了男性伴侣在产房的存在。为增加男性参与产妇保健而进行的干预应解决男性参与的个人和系统性障碍。

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