Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Université de Montréal School of Public Health, Montréal, QC, Canada.
Soc Sci Med. 2021 Oct;287:114363. doi: 10.1016/j.socscimed.2021.114363. Epub 2021 Sep 2.
Engaging men and increasing their involvement as partners and parents can improve child health and development. Despite the increasing global evidence and advocacy around father involvement and caregiving, there remain few father-inclusive interventions for promoting early child health, especially within primary health systems in low- and middle-income countries. In this study, we explored community perspectives regarding fathers' roles in early child health services during the first three years of life to identify the barriers and facilitators to father involvement in Monapo District in northern, rural Mozambique. A qualitative sub-study was embedded within a qualitative intervention implementation evaluation conducted in October-November 2020. In-depth interviews were conducted with 36 caregivers, 15 health facility providers, 12 community health providers, 4 government officials, and 7 non-governmental partner organizations. Data were analyzed using inductive thematic content analysis. Results revealed that fathers were generally uninvolved in early child healthcare services. Primary barriers to fathers' involvement included the absence of fathers in many households; opportunity costs associated with fathers' accompanying children to health facilities; long waiting times at facilities; negative health provider attitudes towards fathers; and patriarchal gender norms. Respondents also highlighted facilitators of father involvement, which included fathers' broader engagement with their child at home; fathers' desires to support their partners; parental awareness about the importance of father involvement in child healthcare; and community outreach and sensitization campaigns targeting fathers directly. Our study highlights opportunities for enhancing the focus, design, and delivery of child health services so that they are more inclusive and responsive to fathers. Future research should assess the feasibility, acceptability, and effectiveness of father-focused child health interventions on caregiving and early child health and development outcomes. These strategies should holistically address not only individual and household factors, but also broader structural and sociocultural determinants at the health system and community levels.
让男性参与并增强其作为伴侣和家长的角色，可以改善儿童的健康和发育。尽管全球范围内越来越多的证据和倡导表明父亲的参与和育儿至关重要，但在促进儿童早期健康方面，尤其是在中低收入国家的初级卫生系统中，仍然很少有包含父亲的干预措施。在这项研究中，我们探讨了社区对父亲在生命头三年中参与儿童早期健康服务的看法，以确定在莫桑比克北部农村莫阿波区父亲参与的障碍和促进因素。一项定性子研究嵌入在 2020 年 10 月至 11 月进行的定性干预实施评估中。我们对 36 名照顾者、15 名卫生机构提供者、12 名社区卫生提供者、4 名政府官员和 7 个非政府合作伙伴组织进行了深入访谈。使用归纳主题内容分析对数据进行了分析。结果表明，父亲通常不参与儿童早期保健服务。父亲参与的主要障碍包括：许多家庭中没有父亲；父亲陪同孩子去医疗机构的机会成本；医疗机构的候诊时间长；卫生提供者对父亲的负面态度；以及父权制性别规范。受访者还强调了促进父亲参与的因素，其中包括父亲在家中更广泛地参与照顾孩子；父亲支持伴侣的愿望；父母对父亲参与儿童保健的重要性的认识；以及直接针对父亲的社区外展和宣传活动。我们的研究强调了增强儿童保健服务的重点、设计和提供的机会，使这些服务更加包容和响应父亲的需求。未来的研究应评估以父亲为重点的儿童保健干预措施在照顾和儿童早期健康和发育结果方面的可行性、可接受性和有效性。这些策略应全面解决不仅是个人和家庭因素，还有卫生系统和社区层面更广泛的结构性和社会文化决定因素。
