Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia; Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Gent, Belgium; Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, VIC 3053, Australia.
Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia; The Antara Foundation, 26 Sultanpur Estate, Mandi Road, Mehrauli, New Delhi 110030, India.
Soc Sci Med. 2021 Dec;291:114475. doi: 10.1016/j.socscimed.2021.114475. Epub 2021 Oct 14.
Globally, there is growing awareness of the important contributions men can make as key stakeholders in maternal and newborn health (MNH), and increased investment in interventions designed to influence men's engagement to improve MNH outcomes. Interventions typically target men, women, couples or health providers, yet how these stakeholders perceive and experience interventions is not well understood and the fact that women may experience these interventions as disempowering has been identified as a major concern. This review aims to synthesise how women, men, and providers perceive and experience interventions designed to influence men's engagement in MNH, in order to identify perceived benefits and risks of participating in interventions, and other key factors affecting uptake of and adherence to interventions. We conducted a qualitative evidence synthesis based on a systematic search of the literature, analysing a purposive sample of 66 out of 144 included studies to enable rich synthesis. Women, men and providers report that interventions enable more and better care for women, newborns and men, and strengthen family relationships between the newborn, father and mother. At the same time, stakeholders report that poorly designed or implemented interventions carry risks of harm, including constraining some women's access to MNH services and compounding negative impacts of existing gender inequalities. Limited health system capacity to deliver men-friendly MNH services, and pervasive gender inequality, can limit the accessibility and acceptability of interventions. Sociodemographic factors, household needs, and peer networks can influence how men choose to support MNH, and may affect demand for and adherence to interventions. Overall, perceived benefits of interventions designed to influence men's engagement in MNH are compelling, reported risks of harm are likely manageable through careful implementation, and there is clear evidence of demand from women and men, and some providers, for increased opportunities and support for men to engage in MNH.
全球范围内，人们越来越意识到男性作为孕产妇和新生儿健康（MNH）的关键利益相关者可以做出重要贡献，并加大了对旨在影响男性参与以改善 MNH 结果的干预措施的投资。干预措施通常针对男性、女性、夫妇或卫生提供者，但这些利益相关者如何看待和体验干预措施尚不清楚，而且女性可能会将这些干预措施视为剥夺权力，这已被确定为一个主要问题。本综述旨在综合评估女性、男性和提供者如何看待和体验旨在影响男性参与 MNH 的干预措施，以确定参与干预措施的潜在益处和风险，以及影响干预措施的采用和坚持的其他关键因素。我们进行了一项基于文献系统检索的定性证据综合分析，对 144 项纳入研究中的 66 项进行了有针对性的抽样，以实现丰富的综合分析。女性、男性和提供者报告说，干预措施能够为女性、新生儿和男性提供更多更好的护理，并加强新生儿、父亲和母亲之间的家庭关系。与此同时，利益相关者报告说，设计或实施不当的干预措施存在潜在的风险，包括限制一些女性获得 MNH 服务，并加剧现有性别不平等的负面影响。有限的卫生系统能力提供对男性友好的 MNH 服务，以及普遍存在的性别不平等，可能会限制干预措施的可及性和可接受性。社会人口因素、家庭需求和同伴网络可能会影响男性选择支持 MNH 的方式，并可能影响对干预措施的需求和坚持。总的来说，旨在影响男性参与 MNH 的干预措施的潜在益处令人信服，据报道的风险是可以通过谨慎实施来管理的，而且女性和男性以及一些提供者对增加男性参与 MNH 的机会和支持有明显的需求。
