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

Abstract Objective 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.

[1]  S. Luchters,et al.  Involving men to improve maternal and newborn health: A systematic review of the effectiveness of interventions , 2018, PloS one.

[2]  A. Jahn,et al.  Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis , 2017, BMC Pregnancy and Childbirth.

[3]  M. Adjuik,et al.  Inclusion of men in maternal and safe motherhood services in inner-city communities in Ghana: evidence from a descriptive cross-sectional survey , 2017, BMC Pregnancy and Childbirth.

[4]  M. Temmerman,et al.  “The co-authors of pregnancy”: leveraging men’s sense of responsibility and other factors for male involvement in antenatal services in Kinshasa, DRC , 2017, BMC Pregnancy and Childbirth.

[5]  Joshua Panyin Craymah,et al.  Male Involvement in Maternal Health Care at Anomabo, Central Region, Ghana , 2017, International journal of reproductive medicine.

[6]  A. Goujon,et al.  A cross‐sectional mixed study of the opportunity to improve maternal postpartum care in reproductive, maternal, newborn, and child health services in the Kaya health district of Burkina Faso , 2016, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[7]  A. Maiga,et al.  The Role of Men in Improving Maternal and Newborn Health in Burkina Faso , 2016 .

[8]  J. Roosmalen,et al.  Opportunities for male involvement during pregnancy in Magu district, rural Tanzania , 2016, BMC Pregnancy and Childbirth.

[9]  J. Mandala,et al.  A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention , 2016, Journal of the International AIDS Society.

[10]  O. Müller,et al.  Understanding home delivery in a context of user fee reduction: a cross-sectional mixed methods study in rural Burkina Faso , 2015, BMC Pregnancy and Childbirth.

[11]  S. Rulisa,et al.  'They would never receive you without a husband': Paradoxical barriers to antenatal care scale-up in Rwanda. , 2015, Midwifery.

[12]  D. Chou,et al.  Ending preventable maternal and newborn mortality and stillbirths , 2015, BMJ : British Medical Journal.

[13]  M. Temmerman,et al.  Couple based family planning education: changes in male involvement and contraceptive use among married couples in Jimma Zone, Ethiopia , 2015, BMC Public Health.

[14]  S. Luchters,et al.  Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base , 2015, Culture, health & sexuality.

[15]  A. Muula,et al.  Invitation Cards during Pregnancy Enhance Male Partner Involvement in Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) in Blantyre, Malawi: A Randomized Controlled Open Label Trial , 2015, PloS one.

[16]  J. Leonardi-Bee,et al.  Male involvement and maternal health outcomes: systematic review and meta-analysis , 2015, Journal of Epidemiology & Community Health.

[17]  R. Smyth,et al.  Interventions for male involvement in pregnancy and labour: A systematic review , 2015 .

[18]  L. Jennings,et al.  Impact of Male Partner Antenatal Accompaniment on Perinatal Health Outcomes in Developing Countries: A Systematic Literature Review , 2015, Maternal and Child Health Journal.

[19]  Clémentine Rossier,et al.  Traditional birthspacing practices and uptake of family planning during the postpartum period in Ouagadougou: qualitative results. , 2014, International perspectives on sexual and reproductive health.

[20]  S. Middlestadt,et al.  An Evidence Review of Gender-Integrated Interventions in Reproductive and Maternal-Child Health , 2014, Journal of health communication.

[21]  Marina A. S. Daniele.  Postpartum family planning in Burkina Faso , 2014 .

[22]  A. Nakimuli,et al.  Male involvement during pregnancy and childbirth: men’s perceptions, practices and experiences during the care for women who developed childbirth complications in Mulago Hospital, Uganda , 2014, BMC Pregnancy and Childbirth.

[23]  N. Meda,et al.  How decision for seeking maternal care is made - a qualitative study in two rural medical districts of Burkina Faso , 2013, Reproductive Health.

[24]  A. Tshefu,et al.  Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review , 2012, Reproductive Health.

[25]  G. Guest,et al.  Changes in Couples' Communication as a Result of a Male-Involvement Family Planning Intervention , 2012, Journal of health communication.

[26]  D. Wamalwa,et al.  Determinants of Male Partner Involvement in Promoting Deliveries by Skilled Attendants in Busia, Kenya , 2012, Global journal of health science.

[27]  A. Malata,et al.  Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study , 2011, Reproductive health.

[28]  A. Tshefu,et al.  Male partner voluntary counselling and testing associated with the antenatal services in Kinshasa, Democratic Republic of Congo: a randomized controlled trial , 2011, International journal of STD & AIDS.

[29]  R. Baggaley,et al.  Women's sexual health and contraceptive needs after a severe obstetric complication ("near-miss"): a cohort study in Burkina Faso , 2010, Reproductive health.

[30]  O. Olayemi,et al.  Assessment of the effect of psychosocial support during childbirth in Ibadan, south‐west Nigeria: A randomised controlled trial , 2009, The Australian & New Zealand journal of obstetrics & gynaecology.

[31]  S. Radhakrishnan,et al.  Family Planning: A Global Handbook for Providers , 2009 .

[32]  M. C. Inhorn,et al.  Men's influences on women's reproductive health: medical anthropological perspectives. , 2004, Social science & medicine.

[33]  H. von Hertzen,et al.  Multicenter study of the Lactational Amenorrhea Method (LAM): I. Efficacy, duration, and implications for clinical application. , 1997, Contraception.

[34]  H. Locke,et al.  SHORT MARITAL ADJUSTMENT AND PREDICTION TESTS: THEIR RELIABILITY AND VALIDITY , 1959 .

[35]  A. Portela.  WHO Recommendations on Health Promotion Interventions for Maternal and Newborn Health , 2015 .

[36]  T. Croft,et al.  Revising unmet need for family planning. , 2012 .

[37]  Gary Barker,et al.  Engaging men and boys in changing gender-based inequity in health: Evidence from programme interventions. , 2007 .

[38]  I. Kleinschmidt,et al.  Involving men in maternity care South Africa. , 2004 .

[39]  B. Taverne,et al.  Allaitement et VIH en Afrique de l'Ouest : de l'anthropologie à la santé publique , 2001 .

[40]  G. Spanier.  Measuring Dyadic Adjustment: new scales for assessing the quality of marriage and similar dyads , 1976 .