Male involvement in facilitating the uptake of maternal health services by women in Uganda.

Abstract

Background: Health promotion programmes in maternal health are increasingly reaching out to men as partners, husbands and community leaders in a bid to improve women`s uptake of health facilities and or skilled care at birth. Aim: To explore the contribution of male spousal involvement in facilitating uptake for maternal health services. Four main objectives: 1) conduct a scoping review on the rationale for male involvement in maternal health in Low and Middle Income Countries; 2) conduct a literature review on the use of board games with non-health professionals; 3) conduct a pilot study on the use of board games with men in maternal health; and 4) establish the feasibility of using board games as an educational strategy with men in maternal health in Uganda. Methods: The main study used a mixed-methods approach with face-to-face questionnaires (quantitative) and focus group discussions (qualitative) to collect data in Uganda. Completed questionnaires were entered into EPI DATA software and exported into STATA version 13 for analysis. Qualitative data were thematically analysed. The pilot study comprised focus group discussions Results: Quantitative findings showed a 26% increase in men`s ability to identify danger signs during pregnancy/childbirth (p < 0.001), a 26% increase in their knowledge of complication during delivery (p<0.005), and a 22% increase in joint decision making regarding maternal health (p < 0.01) following the Whose Shoes? board game. The likelihood of choosing facility births for women was increased but this was not statistically significant (p = 0.218). The key themes in the qualitative part of the study were; 1) perceptions regarding Whose Shoes?; 2) proposed new behaviour after engaging with the game; 3) perceptions and barriers to male involvement in maternity services. Conclusion: Involving men in maternal health facilitates access to maternal health services through joint decision making, financial support, nutrition in pregnancy and help with care-giving roles at home. This enables women to seek appropriate maternity care and have adequate rest during pregnancy and after childbirth. Maternal health programmes need to target men to increase uptake of maternity services for women. Educational games are a useful strategy to engage men in maternal health. The Whose Shoes? board game was acceptable to a group of Ugandan men living in London and effective in its ability to engage men on topics regarding pregnancy/childbirth complications, health facility birth and nutrition. This was the first-time maternal health messages were packaged through the medium of a board game targeting male spouses in Uganda.