Interventions for improving male involvement in maternal and child healthcare in Uganda: A realist synthesis

Abstract

This study aimed at understanding how, when, and under what circumstances interventions succeed (or fail) to improve male involvement in maternal and child healthcare in Uganda. A realist synthesis approach was used to unpack the complexity of these health interventions to explain their theories and applications in specific circumstances. Our review of 19 studies revealed that men were specifically approached as clients, partners or agents for behavioural change. Broadly, mechanisms of education, training, restriction, environmental restructuring, modeling, enablement, persuasion, incentivization and coercion were used to involve men in maternal and child healthcare. Education, training, modeling, enablement and environmental restructuring mechanisms were more effective in ‘cultivating’ a sustained will of men to get involved as couples. However, unintended outcomes were inevitable in circumstances where mechanisms did not match specific contexts. Using coercion, restriction or incentivization is more likely to result in short-term and negative outcomes because of context heterogeneities.

This study aimed at understanding how, when, and under what circumstances interventions succeed (or fail) to improve male involvement in maternal and child healthcare in Uganda. A realist synthesis approach was used to unpack the complexity of these health interventions to explain their theories and applications in specific circumstances. Our review of 19 studies revealed that men were specifically approached as clients, partners or agents for behavioural change. Broadly, mechanisms of education, training, restriction, environmental restructuring, modeling, enablement, persuasion, incentivization and coercion were used to involve men in maternal and child healthcare. Education, training, modeling, enablement and environmental restructuring mechanisms were more effective in ‘cultivating’ a sustained will of men to get involved as couples. However, unintended outcomes were inevitable in circumstances where mechanisms did not match specific contexts. Using coercion, restriction or incentivization is more likely to result in short-term and negative outcomes because of context heterogeneities.