Changes in Men’s Knowledge & Attitudes Following Health Education on their Role in Preventing Maternal Deaths: An Exploratory Survey in a Nigerian Community
Keywords:Maternal mortality, reproductive health, male involvement, health education, Nigeria, Africa
AbstractBackground: In developing countries, men are sometimes stereotypically perceived as uninterested in maternal health, but their reproductive health roles have been widely recognized. Some studies have suggested that effective communication with men on safe motherhood can yield behavior changes capable of reducing maternal deaths. Aim: This study’s objective was to study the impact of an educational session on the knowledge and attitudes of married men regarding maternal deaths. Design: Men were interviewed before the intervention and then participated in a joint educational session on safe motherhood. Follow-up interviews took place three months after the intervention. Results: 141 randomly selected men enrolled in the study; 122 completed both interviews. After the session, men were more likely to recognize a danger sign of pregnancy and delivery, but there was no increase in their willingness to participate in making the local hospital better for maternal healthcare. Mean composite scores increased significantly. Conclusions: Married men have moderate knowledge about maternal deaths and are potentially educable regarding their prevention. Further controlled intervention programs and studies are recommended.
Chipeta EK, Chimwaza W, Kalilani-Phiri L. Contraceptive knowledge, beliefs and attitudes in rural Malawi: misinformation, misbeliefs and misperceptions. Malawi Med J 2010; 22:38-41.
Green CP, Cohen SI. Belhadj-el Ghouayel H. Male involvement in reproductive health, including family planning and sexual health. New York: UNFPA, 1995.
Nzioka C. Research on men and its implications on policy and programme development in reproductive health. In: Programming for male involvement in Reproductive Health. Report of the meeting of WHO Regional Advisors in Reproductive Health. Sept. 5-7, 2001, Washington D.C., USA, 2001.
Olawoye JE, Omololu FO, Aderinto Y, Adeyefa I, Adeyemo D, Osotimehin B. Social construction of manhood in Nigeria: implications for male responsibility in reproductive health. Afr Popul Stud 2005; 19:1-20.
Doedens W, Burns K. Challenges to reproductive health in emergencies. WHO Health Emergencies Newsl 2001. URL: http://www.who.int/hac/about/7099.pdf Accessed Dec 29, 2012.
Gaikwad VS, Murthy TSM, Sudeepa DA. Qualitative study on men’s involvement in reproductive health of women among auto-rickshaw drivers in Bangalore Rural. Online J Health Allied Sci 2012. URL: http://www.ojhas.org/issue41/2012-1-3.pdf Accessed Oct 8, 2012.
Greene ME, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S. Involving men in reproductive health: contributions to development. Paper prepared for the United Nations Millennium Project. New York: Millennium Development Project. 2006. URL: http://www.unmillenniumproject.org/documents/Greene_et_al-final.pdf Accessed Dec 31, 2012.
Agadjanian V. Men’s talk about ‘‘women’s matters’’: gender, communication, and contraception in urban Mozambique. Gender & Society 2002; 16:194-215.
Nanjala M, Wamalwa D. Determinants of male partner involvement in promoting deliveries by skilled attendants in Busia, Kenya. Global J Health Sci 2012; 4:60-7.
Nkuoh G N, Meyer DJ, Tih PM, Nkfusai J. Barriers to men’s participation in antenatal and prevention of mother-to-child HIV transmission care in Cameroon, Africa. J Midwifery Womens Health 2010; 55:363-9.
Adeleye OA, Chiwuzie J. He does his own and walks away: perceptions about male attitudes and practices regarding safe motherhood in Ekiadolor, southern Nigeria. Afr J Reprod Health 2007; 11:76-89.
Adeleye OA, Aldoory L, Parakoyi DB. Using local culture and gender roles to improve male involvement in maternal health in southern Nigeria. J Health Commun 2011; 16:1122–35.
Osubor KM, Fatusi AO, Chiwuzie JC. Maternal health-seeking behaviour and associated factors in a rural Nigerian community. Matern Child Health J 2006; 10:159-69.
Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH. Birth preparedness, complication readiness and fathers’ participation in maternity care in a northern Nigerian community. Afr J Reprod Health 2010; 14:21-32.
Odimegwu CO, Adewuyi AA, Odebiyi T, Aina B, Adesina Y, Olatubara O, et al. Men’s role in emergency obstetric care in Osun State of Nigeria. Afr J Reprod Health 2005; 9:59-71.
Association for Reproductive and Family Health. Women’s reproductive health, empowerment and male involvement: findings from seven states of Nigeria. Ibadan: Association for Reproductive and Family Health; 1998.
Kululanga LI, Sundby J, Chirwa E, Malata A, Maluwa A. Barriers to husbands’ involvement in maternal health care in a rural setting in Malawi: a qualitative study. J Res in Nurs Midwifery 2012. URL: http://www.interesjournals.org/JRNM. Accessed Oct 8, 2012.
Kululanga LI, Sundby J, Malata A, Chirwa E. Male involvement in maternity health care in Malawi. Afr J Reprod Health 2012; 6:145-57.
Carter MW. 'Because He Loves Me': Husbands' involvement in maternal health in Guatemala. Cult, Health Sex 2002; 4:259-79.
Walston N. Challenges and opportunities for male involvement in reproductive health in Cambodia USAID; 2005. URL: http://www.policyproject.com/pubs/countryreports/MaleInvolv_Cam.pdf Accessed Oct 8, 2012.
Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med 1994;38: 1091-110.
Prevention of Maternal Mortality Network. About the PMM Network. Int J Gynecol Obstet 1997; 59(Suppl. 2):3-6.
Maine D. Safe motherhood programs: options and issues. New York: Columbia University, Center for Population and Family Health, 1991.
Gummi FB, Hassan M, Shehu D, Audu, L. Community education to encourage use of emergency obstetric services, Kebbi State, Nigeria. Int J Gynecol Obstet 1997; 59(Suppl. 2):191-200.
Shehu D, Ikeh AT, Kuna MJ. Mobilizing transport for obstetric emergencies in northwestern Nigeria. Int J Gynecol Obstet 1997; 59(Suppl. 2):173-80.
Association for Reproductive and Family Health. Changes in Women’s Reproductive Health and Male Involvement in Nigeria: Post Evaluation: 1996 - 1998. Ibadan: Association for Reproductive and Family Health; 1998.
Orisaremi TC, Alubo O. Gender and the reproductive rights of Tarok women in central Nigeria. Afr J Reprod Health 2012; 16:83-96.
National Centre for Women Development. A compilation of the constitution, national and state statutes and regulations, local government bye-laws, customary laws and religious laws, policies and practices, and court decisions relating to the statuses of women and children, applicable in Nigeria. Abuja: National Centre for Women Development; 2005.
Monjok E, Smesny A, Ekabua JE, Essien EJ. Contraceptive practices in Nigeria: literature review and recommendation for future policy decisions. Open Access J Contracept 2010. URL: http://www.dovepress.com/contraceptive-practices-in-nigeria-literature-review-and-recommendatio-peer-reviewed-article-OAJC. Accessed Mar 30, 2011.
Ijadunola MY, AbionaTC, Ijadunola KT, Afolabi OT, Esimai OA, OlaOlorun FM. Male involvement in family planning decision making in Ile-Ife, Osun State, Nigeria. Afr J Reprod Health 2010; 14:45-52.
Oyediran KA, Ishola GP, Feyisetan BJ. Factors affecting ever-married men’s contraceptive use and knowledge in Nigeria. J Biosoc Sci 2002; 34:497-510.
National Population Commission of Nigeria, ICF Macro. Nigeria Demographic and Health Survey 2013. Abuja: National Population Commission and Calverton, Maryland: ICF Macro, 2014.
National Population Commission of Nigeria. National policy on population for sustainable development. Abuja: National Population Commission; 2004.
Ibrahim MS, Sufiyan MB, Idris SH, et al. Effect of a behavioral intervention on male involvement in birth preparedness in a rural community in Northern Nigerian. Ann Nig Med 2014; 8:20-7.
Soubeiga D, Gauvin L, Hatem M Johri M. Birth preparedness and complication readiness (BPCR) interventions to reduce maternal and neonatal mortality in developing countries: systematic review and meta-analysis. BMC Pregnancy Childbirth 2014. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234142/pdf/1471-2393-14-129.pdf Accessed Dec 22, 2014.
Rosner B. Fundamentals of biostatistics. 3rd ed. Belmont (US): Thompson, 2006, 275.
World Health Organization. Maternal, newborn, child and adolescent health. URL: http://www.who.int/maternal_child_adolescent/en/ Accessed Jan 4, 2015.
Ayuba II, Gani O. Outcome of teenage pregnancy in the Niger Delta of Nigeria. Ethiop J Health Sci 2012; 22:45-50.
Iklaki CU, Inaku JU, Ekabua JE, Ekanem EI, Udo AE. Perinatal outcome in unbooked teenage pregnancies in the University of Calabar Teaching Hospital, Calabar, Nigeria. ISRN Obstet Gynecol 2012. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316960/pdf/ISRN.OBGYN2012-246983.pdf Accessed Feb 20, 2012.
Braine T. Adolescent pregnancy: a culturally complex issue. Bull World Health Organ 2009; 87:410–1.
Okpere EE, Okogbenin SA. Age and reproductive outcome. In: Okpere EE (Ed). Clinical obstetrics. 2nd ed. Benin City, Nigeria: University of Benin Press, 2011, 398-402.
Mairiga AG, Kullima AA, Bako B, Kolo MA. Sociocultural factors influencing decision-making related to fertility among the Kanuri tribe of north-eastern Nigeria. Afr J Prim Health Care Fam Med 2010. URL: http://www.phcfm.org/index.php/phcfm/article/download/94/70 Accessed Jun 1, 2010.
Khalifa MA. Attitudes of urban Sudanese men towards family planning. Stud Fam Plann 1988; 19:236-43.
Mbizvo MT, Adamchak DJ. Family planning knowledge, attitudes and practices of men in Zimbabwe. Stud Fam Plann 1991; 22:31-8.
Ezeh AC, Seroussi M, Raggers H. Men’s fertility, contraceptive use and reproductive preference. Demographic and Health Surveys. Comparative Studies No. 18. Calverton, MD: Macro International; 1996.
Omo-Aghoja, LO., Omo-Aghoja VW, Aghoja CO, Okonofua FE, Aghedo O, Umeri C, et al. Factors associated with the knowledge, practice and perceptions of contraception in rural southern Nigeria. Ghana Med J 2009; 43:115-21.
Alemayehu M, Belachew T, Tilahun T. Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia. BMC Pregnancy Childbirth 2012. URL: http://www.biomedcentral.com/1471-2393/12/6. Accessed Jan 26, 2013.
Bhatta DN. Involvement of males in antenatal care, birth preparedness, exclusive breast feeding and immunizations for children in Kathmandu, Nepal. BMC Pregnancy Childbirth 2013.
URL: http://www.biomedcentral.com/1471-2393/13/14 Accessed Dec 22, 2014.
Adeyemi AB, Aina OI, Eniola OA, Adewuyi AA, Adesina FA. The effect of an educational intervention programme on reproductive health decision-making among couples in south west Nigeria. Trop J Obstet Gynaecol 2005; 22:27–32.
Miller K, Zulu EM, Watkins SC. Husband-wife survey responses in Malawi. Stud Fam Plann 2001; 32:161-74.
Cleland JG, Ndugwa RP, Zulu EM. Family planning in sub-Saharan Africa: progress or stagnation? Bull World Health Organ 2011; 89:137-43.
Bankole A, Sedgh G, Okonofua FE, Imarhiagbe C, Hussain R, Wulf D. Barriers to safe motherhood in Nigeria. New York: Guttmacher Institute, 2009.
Kashitala J, Nyambe N, Mwalo S, Musamba J, Chishinga N, Kasonde P, et al. Is male involvement in ANC and PMTCT associated with increased facility-based obstetric delivery in pregnant women? Afr J Reprod Health 2015; 19:117-24