Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria.
Department of Community Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Nigeria.
PLoS One. 2023 Mar 30;18(3):e0282469. doi: 10.1371/journal.pone.0282469. eCollection 2023.
High maternal death is attributable to developing countries' health systems and sociocultural factors This study assessed the effect of participatory-action research on males' perception and practice towards maternity care and safe motherhood in rural southeast Nigeria.
A pre-post-intervention study design was employed to study 396 male partners of pregnant women selected through cluster sampling in rural communities in southeast Nigeria. Males' perceptions and practices towards maternity care and safe motherhood were assessed using an interviewer-administered five-point Likert scale questionnaire. A community-participatory intervention was implemented comprising advocacy, and training of community volunteers, who then educated male partners of pregnant women on safe motherhood and facilitated emergency saving and transport schemes. A post-intervention assessment was conducted six months later, using the same questionnaire. Good perception and good practices were determined by mean scores >3.0. Continuous variables were summarised using mean and standard deviation, and categorical variables using frequencies and proportions. A comparison of the mean scores pre- and post-intervention mean scores were compared, and the mean difference was determined using paired T-test. Statistical significance was set at a p-value <0.05.
The perception that male partners should accompany pregnant women for antenatal care had the least mean score at the pre-intervention stage, 1.92 (0.83). However, the mean score increased for most variables after the intervention (p<0.05). The mean score for maternity care practices increased post-intervention for accompanying pregnant women to antenatal care, facility delivery, and helping with household chores (p<0.001), with a composite mean difference of 0.36 (p<0.001). Birth preparedness/complication readiness practices-saving money, identifying transport, skilled providers, health facilities, blood donors and preparing birth kits, were good, with a composite mean score that increased from 3.68(0.99) at pre-intervention to 4.47(0.82) at post-intervention (p<0.001).
Males' perceptions and practices towards safe motherhood improved after the intervention. This highlights that a community-participatory strategy can enhance males' involvement in maternal health and should be explored. Male partners accompanying pregnant women to clinics should be advocated for inclusion in maternal health policy. Government should integrate community health influencers/promoters into the healthcare systems to help in the provision of health services.
高孕产妇死亡率归因于发展中国家的卫生系统和社会文化因素。本研究评估了参与式行动研究对尼日利亚东南部农村男性对产妇保健和安全孕产认知和实践的影响。
本研究采用前后干预研究设计，通过整群抽样选择了尼日利亚东南部农村社区的 396 名孕妇的男性伴侣。使用经过访谈者管理的五点李克特量表问卷评估男性对产妇保健和安全孕产的认知和实践。实施了一项社区参与式干预，包括宣传和培训社区志愿者，他们然后向孕妇的男性伴侣进行安全孕产教育，并促进紧急储蓄和运输计划。六个月后，使用相同的问卷进行了干预后评估。良好的认知和良好的实践是通过平均得分>3.0 来确定的。连续变量用平均值和标准差表示，分类变量用频率和比例表示。比较了干预前后的平均得分，并使用配对 t 检验确定平均差异。统计学意义设定为 p 值<0.05。
男性伴侣应该陪伴孕妇进行产前护理的认知在干预前阶段的平均得分最低，为 1.92（0.83）。然而，大多数变量的平均得分在干预后增加（p<0.05）。干预后，陪伴孕妇进行产前护理、在医疗机构分娩和帮助家务的产妇保健实践的平均得分增加（p<0.001），综合平均差异为 0.36（p<0.001）。生育准备/并发症准备实践-储蓄、确定交通、熟练提供者、卫生设施、献血者和准备生育包，表现良好，综合平均得分从干预前的 3.68（0.99）增加到干预后的 4.47（0.82）（p<0.001）。
干预后，男性对安全孕产的认知和实践有所改善。这表明，社区参与策略可以增强男性对产妇保健的参与，应该加以探索。应该倡导让孕妇的男性伴侣陪同她们去诊所，将其纳入产妇保健政策。政府应将社区卫生影响者/促进者纳入医疗保健系统，以帮助提供卫生服务。
