Prevalence and correlates of male partner involvement in antenatal care services in eastern Kenya: a cross-sectional study

Abstract

Introduction: male partner involvement in antenatal care (ANC) contributes to improved maternal health outcomes, but has been wanting in sub-Saharan Africa. We investigated the prevalence and factors associated with male involvement in ANC.

Methods: this was a cross-sectional survey conducted in November and December 2019 in Kitui East sub-county, Kenya. We recruited men above 18 years whose spouses had given birth 12-months prior to the study. Data were collected at the household level using an interviewer-administered questionnaire. Male involvement was defined as provision of physical, psycho-social, decision-making, and financial support, which was measured through twelve questions. Factor scores of the twelve questions were generated by fitting a Rasch model. Participants who scored at least 75% were involved. Bivariate and multivariate logistic regression models were fitted to identify the independent predictors of male involvement.

Results: a total of 300 participants were interviewed. The mean age was 36.7 years (SD=±7.6), 52.3% had primary level education, 64.3% had between 1-3 children, 44.6% were 5 years older than their spouses, while 37.3% earned between $50-$100 per month. The prevalence of male involvement in ANC was 61% (95%C.I: 55.7%, 66.3%) and was positively associated with previous ANC attendance by the spouse (AOR= 4.96, 95%CI: 2.37, 10.38, p<0.001), having 1-2 and 3-4 children (AOR= 4.57, 95%CI: 1.70, 12.31, p=0.003 and AOR= 4.84, 95%CI: 1.59, 14.79, p=0.006) respectively. On the contrary, participants who lacked knowledge on the minimum ANC visits (AOR= 0.37, 95% CI: 0.17, 0.83, p=0.016), unplanned pregnancy (AOR=0.22, 95%CI: 0.10, 0.48, p<0.001), and individual financial decision-making (AOR= 0.42, 95%CI: 0.21, 0.89, p=0.023) were less likely to be involved.

Conclusion: more than half of the participants reported involvement in ANC, which was significantly associated with previous ANC experience and having less than four children. Empowering men with knowledge on ANC and joint decision-making with their spouses is imperative in order to improve male involvement.