Is Male Involvement in ANC and PMTCT Associated with Increased Facility-Based Obstetric Delivery in Pregnant Women?

Ensuring that pregnant women are delivering in a health facility and are attended to by skilled birth attendants is critical to reducing maternal and infant morbidity and mortality. This study sought to determine the associations between male involvement in antenatal care (ANC) services and pregnant women delivering at health facilities and being attended to by skilled birth attendants as well as attending postnatal care. This was a retrospective cohort study using secondary analysis of program data. We reviewed health records of all pregnant women who attended antenatal services irrespective of HIV status between March and December 2012 in 10 health facilities in three provinces of Zambia. An extraction questionnaire was used to collect sociodemographic and clinical information from registers used in services for maternal neonatal child health as well as delivery. Using logistic regression, we calculated the odds ratios (OR) and 95% confidence intervals (CI) of the association between (1) male involvement and delivery at a health facility by a skilled birth attendant and (2) male involvement and women's attendance at postnatal services. We found that more women who had been accompanied by their male partner during ANC delivered at a health facility than those who had not been accompanied (88/220 = 40% vs. 543/1787 = 30.4%, respectively; OR 1.53, 95% CI: 1.15-2.04). Also, we noted that a greater proportion of the women who returned for postnatal visits had been accompanied by their partner at ANC visits, compared to those women who came to ANC without their partner (106/220 = 48.2% vs. 661/1787 = 37.0%, respectively; OR 1.58, 95% CI: 1.20-2.10). Male involvement seems to be a key factor in women's health-seeking behaviours and could have a positive impact on maternal and infant morbidity and mortality.