坦桑尼亚达累斯萨拉姆市男性参与产前护理的现状及障碍：基于机构的混合方法研究。
Prevalence and barriers to male involvement in antenatal care in Dar es Salaam, Tanzania: A facility-based mixed-methods study.
机构信息
Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
出版信息
PLoS One. 2022 Aug 19;17(8):e0273316. doi: 10.1371/journal.pone.0273316. eCollection 2022.
BACKGROUND
Men have traditionally not been fully involved in reproductive health care of their partners, and yet, they play a crucial role in family decision-making and therefore crucial key players in preventing poor pregnancy outcomes. This study aimed to assess prevalence and determinants of male participation in maternal health care and explore male partners' perspective of their involvement in antenatal care at an urban tertiary referral facility.
METHODS
A mixed-methods study was conducted from October 2018 to January 2019 at Muhimbili National Hospital. A cross-sectional survey of 428 nursing mothers and two focus group discussions of male partners (n = 7 and n = 11) of women attending antenatal clinic and nursing mothers in the post-natal ward were performed. Using SPSS Ver. 23 (IBM, Chicago, IL), frequency distribution tables summarized demographic data and categories of male partners' involvement in antenatal care. Focus group discussions included male partners of age from 24 to 55 years at their first to fifth experience of pregnancy and childbirth. Interviews were audio-recorded, and then transcribed and coded. Thematic analysis was applied.
RESULTS
The prevalence of male involvement in antenatal care was 69%. More than two-thirds of nursing mothers received physical, psychological and financial support from partners (76%) and attended four or more antenatal visits (85%). Five themes of male perspective of their involvement in antenatal care were generated, including: a) cultural norms and gender roles, b) ignorance of reproductive health service, c) factors outside their control, d) couple interaction and conflicts, and e) institutional obstacles.
CONCLUSION
The prevalence of male partners' involvement in antenatal care was relatively high. Men's involvement in antenatal care depended on access to antenatal care education, standards of structure and process of antenatal service and how well their role was defined in the maternal health care system. Interactions and practice in society, employment sector and government health system should complement strategies to promote men's involvement in maternal health.
背景
男性传统上并未完全参与其伴侣的生殖健康护理，但他们在家庭决策中起着至关重要的作用，因此是预防不良妊娠结局的关键角色。本研究旨在评估男性参与孕产妇保健的流行情况和决定因素，并探讨男性伴侣在城市三级转诊机构产前保健中的参与情况。
方法
本混合方法研究于 2018 年 10 月至 2019 年 1 月在姆希比利国家医院进行。对 428 名哺乳期妇女进行横断面调查，并对在产前诊所就诊的女性及其产后病房的男性伴侣（n=7 和 n=11）进行了两次焦点小组讨论。使用 SPSS Ver. 23（IBM，芝加哥，IL），频率分布表总结了人口统计学数据和男性伴侣参与产前保健的分类。焦点小组讨论包括年龄在 24 至 55 岁之间的男性伴侣，他们处于第一次到第五次怀孕和分娩的经验阶段。访谈进行了录音，并进行了转录和编码。应用了主题分析。
结果
男性参与产前保健的比例为 69%。超过三分之二的哺乳期母亲得到了伴侣的身体、心理和经济支持（76%），并参加了 4 次或更多次产前检查（85%）。男性参与产前保健的观点产生了五个主题，包括：a）文化规范和性别角色，b）对生殖健康服务的无知，c）他们无法控制的因素，d）夫妻互动和冲突，以及 e）机构障碍。
结论
男性伴侣参与产前保健的比例相对较高。男性参与产前保健取决于获得产前保健教育、产前服务的结构和过程标准以及他们在孕产妇保健系统中的角色定义程度。社会、就业部门和政府卫生系统的互动和实践应补充促进男性参与孕产妇保健的策略。
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