Barriers to men's involvement in antenatal and postnatal care in Butula, western Kenya

Background: Men have a lot of influence on their partners' and children's health. However, studies have shown their involvement in antenatal care (ANC) and postnatal care (PNC) is relatively low owing to several factors. Aim: To explore the barriers to men's involvement in ANC and PNC in Butula sub-county, western Kenya. Setting: Butula sub-county, Busia county, western Kenya. Methods: A mixed methods study design, descriptive in nature, was used to collect both quantitative and qualitative data. A total of 96 men were selected to participate in the surveys. Also, four focus group discussions and four key informant interviews were conducted. Results: We found out that some men still participate in ANC and PNC despite the barriers. The perception that maternal health is a women's domain and existence of alternative traditional maternal services were key cultural barriers. The men's nature of work, low income and expenses incurred at ANC/PNC clinics were significant economic barriers. The lack of services targeting men, provider attitude, non-invitation to the clinic, time spent at the clinic and lack of privacy at the clinics were key facility-based barriers. Conclusion: A myriad of cultural, economic and health-facility barriers hinder men from active involvement in ANC and PNC. Awareness creation among men on ANC and PNC services and creating a client-friendly environment at the clinics is key in enhancing their involvement. This should be a concerted effort of all stake holders in maternal health services, as male involvement is a strong influencer to their partners' and children's health outcomes

Modeling the Probability of Giving Birth at Health Institutions among Pregnant Women Attending Antenatal Care in West Shewa Zone; Oromia; Ethiopia: a Cross Sectional Study

Background: Although ante natal care and institutional delivery is effective means for reducing maternal morbidity and mortality; the probability of giving birth at health institutions among ante natal care attendants has not been modeled in Ethiopia. Therefore; the objective of this study was to model predictors of giving birth at health institutions among expectant mothers following antenatal care. Methods: Facility based cross sectional study design was conducted among 322 consecutively selected mothers who were following ante natal care in two districts of West Shewa Zone; Oromia Regional State; Ethiopia. Participants were proportionally recruited from six health institutions. The data were analyzed using SPSS version 17.0. Multivariable logistic regression was employed to develop the prediction model. Results: The final regression model had good discrimination power (89.2); optimum sensitivity (89.0) and specificity (80.0) to predict the probability of giving birth at health institutions. Accordingly; self efficacy (beta=0.41); perceived barrier (beta=-0.31) and perceived susceptibility (beta=0.29) were significantly predicted the probability of giving birth at health institutions. Conclusion: The present study showed that logistic regression model has predicted the probability of giving birth at health institutions and identified significant predictors which health care providers should take into account in promotion of institutional delivery