International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria.
Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
PLoS One. 2020 Dec 10;15(12):e0243611. doi: 10.1371/journal.pone.0243611. eCollection 2020.
BACKGROUND: In much of sub-Saharan Africa, male partners play influential roles in women's access to maternal-child healthcare, including prevention of mother-to-child transmission of HIV services. We explored male partner perspectives on women's access to maternal-child healthcare in North-Central Nigeria. METHODS: Three focus groups were conducted with 30 men, purposefully-selected on the basis of being married, and rural or urban residence. Major themes explored were men's maternal-child health knowledge, gender power dynamics in women's access to healthcare, and peer support for pregnant and postpartum women. Data were manually analyzed using Grounded Theory, which involves constructing theories out of data collected, rather than applying pre-formed theories. RESULTS: Mean participant age was 48.3 years, with 36.7% aged <40 years, 46.7% between 41 and 60 years, and 16.6% over 60 years old. Religious affiliation was self-reported; 60% of participants were Muslim and 40% were Christian. There was consensus on the acceptability of maternal-child health services and their importance for optimal maternal-infant outcomes. Citing underlying patriarchal norms, participants acknowledged that men had more influence in family health decision-making than women. However, positive interpersonal couple relationships were thought to facilitate equitable decision-making among couples. Financial constraints, male-unfriendly clinics and poor healthcare worker attitudes were major barriers to women's access and male partner involvement. The provision of psychosocial and maternal peer support from trained women was deemed highly acceptable for both HIV-positive and HIV-negative women. CONCLUSIONS: Strategic engagement of community leaders, including traditional and religious leaders, is needed to address harmful norms and practices underlying gender inequity in health decision-making. Gender mainstreaming, where the needs and concerns of both men and women are considered, should be applied in maternal-child healthcare education and delivery. Clinic fee reductions or elimination can facilitate service access. Finally, professional organizations can do more to reinforce respectful maternity care among healthcare workers.
背景：在撒哈拉以南非洲的许多地区，男性伴侣在妇女获得母婴保健方面发挥着重要作用，包括预防艾滋病毒母婴传播服务。我们探讨了尼日利亚中北部男性对妇女获得母婴保健的看法。
方法：我们对 30 名男性进行了三次焦点小组讨论，这些男性是根据已婚、农村或城市居住情况有目的地选择的。主要探讨的主题是男性母婴健康知识、妇女获得医疗保健方面的性别权力动态以及对孕妇和产后妇女的同伴支持。使用扎根理论对手动分析数据，该理论涉及从收集的数据中构建理论，而不是应用预先形成的理论。
结果：参与者的平均年龄为 48.3 岁，其中 36.7%年龄<40 岁，46.7%年龄在 41-60 岁之间，16.6%年龄超过 60 岁。参与者的宗教信仰是自我报告的；60%的参与者是穆斯林，40%是基督教徒。与会者一致认为母婴保健服务是可以接受的，对母婴最佳结局很重要。与会者提到了潜在的家长制规范，承认男性在家庭健康决策方面比女性更有影响力。然而，人们认为良好的人际关系会促进夫妻之间的公平决策。经济拮据、对男性不友好的诊所和医护人员的不良态度是妇女获得医疗保健和男性伴侣参与的主要障碍。提供受过培训的妇女提供的心理社会和产妇同伴支持被认为对艾滋病毒阳性和阴性妇女都非常可接受。
结论：需要社区领导（包括传统和宗教领袖）进行战略接触，以解决健康决策中性别不平等背后的有害规范和做法。性别主流化，即考虑到男女双方的需求和关切，应应用于母婴保健教育和提供。降低或免除诊所费用可以促进服务的获取。最后，专业组织可以做更多的工作，在医护人员中加强尊重产妇护理。
BMC Pregnancy Childbirth. 2021-8-7
BMC Pregnancy Childbirth. 2018-12-14
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