Lived experiences of couples in a relationship where one partner is diagnosed with a mental illness

Background: A partner with mental illness can be challenging in a couple's relationship. Mental illness brings about disintegration in the relationship because the partner without mental illness takes on more responsibilities than before. The partner without mental illness can be subjected to multiple risks, including stress and burden of care. The lived experiences of couples in a relationship where one partner is diagnosed with a mental illness is an under-researched area of mental health.Objectives: To explore and describe the lived experiences of couples in a relationship where one partner is diagnosed with a mental illness.Method: A qualitative, descriptive, exploratory and contextual research design was utilised. A purposive sampling method was used to sample participants for this study. Five couples, where one partner was diagnosed with a mental illness, participated in the study. Ten in-depth, individual, phenomenological interviews were conducted to provide rich descriptions of the couples' experiences. Data were analysed using thematic analysis. An independent coder assisted with the data analysis. A consensus discussion was held between the independent coder and the interviewing researcher to agree on the identified themes.Results: Four themes with categories emerged from the data analysis: couples experienced changed social roles in their relationship, emotional upheaval was experienced by the individual partners in the couple relationship, interpersonal distance was experienced in the couple's relationship and a changed relationship with the self was experienced by the individual partners in the couple relationship.Conclusion: The results concluded that couples experienced that the presence of mental illness in their relationship adversely affects the relationship, thus emphasising the need to empower the couples dealing with challenges of being in a relationship where one partner is diagnosed with a mental illness

Involving male partners in maternity care in Burkina Faso: a randomized controlled trial

To determine whether an intervention to involve the male partners of pregnant women in maternity care influenced care-seeking, healthy breastfeeding and contraceptive practices after childbirth in urban Burkina Faso. Methods:In a non-blinded, multicentre, parallel-group, superiority trial, 1144 women were assigned by simple randomization to two study arms: 583 entered the intervention arm and 561 entered the control arm. All women were cohabiting with a male partner and had a low-risk pregnancy. Recruitment took place at 20 to 36 weeks' gestation at five primary health centres in Bobo-Dioulasso. The intervention comprised three educational sessions: (i) an interactive group session during pregnancy with male partners only, to discuss their role; (ii) a counselling session during pregnancy for individual couples; and (iii) a postnatal couple counselling session. The control group received routine care only. We followed up participants at 3 and 8 months postpartum.Findings:The follow-up rate was over 96% at both times. In the intervention arm, 74% (432/583) of couples or men attended at least two study sessions. Attendance at two or more outpatient postnatal care consultations was more frequent in the intervention than the control group (risk difference, RD: 11.7%; 95% confidence interval, CI: 6.0 to 17.5), as was exclusive breastfeeding 3 months postpartum (RD: 11.4%; 95% CI: 5.8 to 17.2) and effective modern contraception use 8 months postpartum (RD: 6.4%; 95% CI: 0.5 to 12.3). Conclusion:Involving men as supportive partners in maternity care was associated with better adherence to recommended healthy practices after childbirth

Male Partners' Involvement in Prevention of Mother-to-Child HIV Transmission in Africa: A Systematic Review

In sub-Saharan Africa (SSA); male partners are rarely present during prevention of mother-to-child transmission (PMTCT) services. This systematic review aims to synthesize; from a male perspective; male partners' perceived roles; barriers and enablers of their involvement in PMTCT; and highlights persisting gaps. We carried out a systematic search of papers published between 2002 and 2013 in eng on Google Scholar and PubMed using the following terms: men; male partners; husbands; couples; involvement; participation; Antenatal Care (ANC); PMTCT; SSA countries; HIV Voluntary Counseling and Testing and disclosure. A total of 28 qualitative and quantitative original studies from 10 SSA countries were included. Men's perceived role was addressed in 28% (8/28) of the studies. Their role to provide money for ANC/PMTCT fees was stated in 62.5% (5/8) of the studies. For other men; the financial responsibilities seemed to be used as an excuse for not participating. Barriers were cited in 85.7% (24/28) of the studies and included socioeconomic factors; gender role; cultural beliefs; male unfriendly ANC/PMTCT services and providers' abusive attitudes toward men. About 64% (18/28) of the studies reported enablers such as: older age; higher education; being employed; trustful monogamous marriages and providers' politeness. In conclusion; comprehensive PMTCT policies that are socially and culturally sensitive to both women and men need to be developed

Determinants of unmet need for modern contraception andreasons for non-use among married women in rural areas of Burkina Faso

Burkina-Faso (TFR=6.0) is among the top-ten high fertility countries world-wide and CPR (15) among women is low. This study examined the factors associated with non-use of modern contraception among married women residing in the rural areas of Burkina-Faso. The study used 2010 Burkina Faso Demographic and Health Survey data-set and focussed on married women aged 15-49 years (n=7;191). Chi-square and logistic regression techniques were used for the analysis (a=5). Mean number of living children was significantly higher among women who have UNMC (3.92) than those with met need (3.01). Modern CPR and UNMC among married women was 12.7 and 40.7 respectively. The multivariate analysis reveals that being married more than once increases the likelihood of UNMC (OR=1.304; C.I=1.0821.571; p0.05). Husbands' approval of FP is a protective factor of UNMC (OR

Aspects epidemiologiques et etiologiques des couples infertiles a Abidjan

Objectif : Ce travail avait pour objectifs d'identifier les caracteristiques sociodemographiques des couples infertiles et de preciser les principales etiologies. Methode : Nous avons mene une etude retrospective descriptive portant sur 210 couples consultant pour infertilite dans les services de gynecologie du CHU de Treichville et d'une clinique privee de la place durant la periode 1er fevrier 2013 au 30 septembre 2014 (20 mois). Resultats. La prevalence de l'infertilite etait de 14;03%. L'age moyen etait de 34;31 ans chez les femmes et de 43;2 ans chez les hommes. La majorite des patientes avait atteint au moins le niveau d'etude secondaire (77;1%). Les couples residant hors d'Abidjan etaient de 15%; et les differentes couches socio-economiques etaient touchees par l'infertilite. La duree moyenne de vie commune des couples etait de 6;9 ans avec une duree moyenne d'infertilite de 6;3 ans. L'infertilite etait en general de type secondaire; touchant aussi bien les femmes (41%) que les hommes (30%). Les etiologies chez les femmes etaient d'origine uterine (47;06%); hormonale (22;79%) et tubo peritoneale (17;65%). Chez l'homme les troubles du sperme etaient domines par l'oligoasthenospermie (69;91%) d'etiologie generalement infectieuse. Conclusion. l'infertilite etait frequente dans nos services; touchant aussi bien les femmes que les hommes

Discovery of, and response to husbands' HIV positive status: the groaning voices of Vhavenda women

Many couples find themselves in situations that are difficult to understand when there is discordance concerning HIV infection. This situation warrants a lot of questions that do not have answers and for many people it leaves them with ambivalent feelings towards the spouse. The present study was conducted to explore the emotions that women experience when the husband tests HIV positive. Semi-structured interviews were conducted with six (age range: 36 to 42 years; mean age: 38.0 years; ethnicity: Venda; marital status: married) purposively selected women who consulted for psychological intervention needed to care for their sick husbands. Data were analysed using thematic content analysis. The results of this study indicated that the women went through different emotions and they had reacted differently to the news depending on other circumstances in their marriage. It is therefore recommended that support groups for these women be established to offer them an opportunity to share their experiences and feelings

Factors Affecting Fertility Decisions of Married Men and Women Living with HIV in South Wollo Zone; Northeast Ethiopia

Background: In a setting with high HIV prevalence and high fertility rates; addressing fertility issues of People Living with HIV/AIDS (PLWHA) is crucial. However; understanding of the factors associated with fertility decisions of PLWHA in Ethiopia is remarkably low. Objective: The study was conducted to assess factors associated with fertility decisions of PLWHA in South Wollo Zone; Northeast Ethiopia. Methods: The study was conducted from February 1 to March 30; 2008 using cross-sectional design. Quantitative data were collected from a sample of 458 men and 458 women using structured questionnaire. Qualitative data were also collected from six health care providers. Logistic regression was used to analyze the quantitative data. Results: The study showed that 18.3of currently married PLWHA have decided to have a child. The factors found to be independently associated with current decision to have a child were higher family income [OR (95CI) = 2.29 (1.23; 4.26)]; partner's decision to have a child [OR (95CI) = 36.4 (17.0; 77.5)]; having knowledge on PMTCT [OR (95CI) = 2.26 (1.44; 3.54)] and having partner with negative HIV test result [OR (95CI) = 0.408 (0.219; 0.759)]. During in-depth interview the health care providers indicated the fertility related counseling service to be low. Conclusion: In spite of the fact that significant proportion of married PLWHA had decided to have a child; the fertility related counseling service is low. Improving fertility related counseling services to enable clients make informed fertility decision is mandatory. The factors identified to be associated with fertility decision could be of major importance and as such should be investigated further. [Ethiop. J. Health Dev.2010;24(3):214-220]

The Dilemma of Safe Sex and Having Children: Challenges Facing HIV Sero-Discordant Couples in Uganda

Background: Sixty percent of new HIV infections in Uganda occur in stable relationships between HIV discordant couples. Given the importance of fertility in Uganda; we hypothesized that unsafe sexual practices may be used to found a family/replace a dead child. Thus; we explored sexual practices to understand to what extent these are influenced by the desire to have children and the implications for HIV transmission among discordant couples. Methods: A cross-sectional survey of 114 HIV discordant couples in Kampala; and in-depth interviews with 15 purposively selected couples. Quantitative data were analysed using STATA. Multivariate logistic regression analysis done to identify factors associated with consistent condom use. Thematic content analysis of qualitative data was done using NVIVO 2. Results: Participants wanting children and those with multiple sexual partners were less likely to use condoms (Adj OR 0.51; and 0.36 respectively). Three of the five types of sexual practices used by couples do not allow pregnancy to occur. Main reasons for wanting a child included: ensuring lineage continuity and posterity; securing relationships and pressure from relatives to reproduce. Challenges included: risk of HIV transmission to partner and child; lack of negotiating power for safer sex; failure of health systems to offer safe methods of reproduction. Conclusions: HIV sero-discordant couples with strong desire for childbearing have a dilemma of risking HIV infection or infecting their spouse. Some risk transmission of HIV infection to reproduce. We need to address gender issues; risky behaviour and reproductive health services for HIV sero-discordant couples

Sexual Risk Reduction among Zambian Couples

Zambia has over 1 million HIV infections nation wide and an urban prevalence rate of 23This study compared the impact of male involvement in multiple and single session risk reduction interventions among inconsistent condom users in Zambia and the role of serostatus among HIV-seropositive and serodiscordant couples. Couples (N=392) were randomised into intervention arms. Among inconsistent condom users at baseline (N=83); condom use increased in both conditions and this increase was maintained over a 12- month period. At 12 months; seronegative men in the multiple session condition increased sexual barrier (male and female condoms) use in comparison with those in the single session condition (F=16.13; p=0.001) while seropositive individuals increased sexual barrier use regardless of condition. Results illustrate the importance of both single and multiple session risk reduction counselling among seronegative men in serodiscordant couples in Zambia; and highlight the differing perception of risk between seropositive and serodiscordant persons

Qualitative study on maternal referrals in rural Tanzania: Decision making and acceptance of referral advice

The aim of this study was to describe perceptions of maternal referrals in a rural district in Tanzania. Focus group discussions (FGDs) with health workers and community members, stratified by age and gender, were conducted. The FGDs revealed that husbands and relatives are the decision makers in maternal referrals, whereas the women had limited influence, especially on emergency referrals. The process in deciding to seek referral care is envisaged within community perception of seriousness of the condition, difficulty to access and cost involved in transport, living expenses at the hospital, and perceived quality of care at facility level. The hospitals were seen as providing acceptable quality of care, whereas, the health centres had lower quality than expected. To improve maternal referral compliance and reduce perinatal and maternal morbidity and mortality, community views of existing referral guidelines, poverty reduction, women's empowerment and male involvement in maternal care are necessary. (Afr J Reprod Health 2008; 12[2]:120-131)

Pattern of contraceptives choice among the married women attending the family planning clinic of a tertiary health institution

Background: Rampant population growth is the most fundamental problem of our times. It affects adversely the advancement of nations and the wellbeing of all peoples. The fertility rate in Nigeria remains high at a national average of about 5.2 children per woman. When a woman effectively uses a modern method of contraceptive she is less likely to be exposed to the hazards of grand multiparity; and also unlikely to resort to dangerous illegal abortion. Method: This is a retrospective study; a review of the records of the family planning clinic of Ladoke Akintola University of Technology Teaching Hospital; Osogbo was undertaken. These were new clients coming for the first time to the family planning clinic of the institution from January; 2001 to December 2006. Result: A total of 1355 married women were coming for the first time to the family planning clinic within the study period; and their age range between 18 and 51 years with a mean of 33.5+6.1 years. 170 (12.5) were Para 1; Para 2-4 were 855 (63.1); while Para 5 and above were 330 (24.4). The clients source of information about family planning was: family planning clinic personnel 1039 (76.7); media (print and electronic) 152 (11.2); friends and relatives 127 (9.4); and community health workers 37 (2.7). Intrauterine contraceptive device was the most chosen method by the clients 1011 (74.6); while condom was the least chosen 3 (0.2); 264 (19.5); and 77 (5.7) clients chose injectables and pills; respectively. Conclusion: An increase in the level of knowledge on modern contraceptive methods through mass and interpersonal communications could be one of the key strategies to increase the utilization rate of modern contraceptive methods