Association between male involvement during antenatal care and use of maternal health services in Mwanza City, Northwestern Tanzania: a cross-sectional study

BACKGROUND: Male involvement in antenatal care (ANC) is among interventions to improve maternal health. Globally male involvement in ANC is low and varies in low-income and middle-income countries including Tanzania where most maternal deaths occur. In Sub-Sahara, men are chief decision makers and highly influence maternal health. In Tanzania information is limited regarding influence of male involvement during ANC on utilisation of maternal health services. OBJECTIVES: To determine the effect of male involvement during ANC on use of maternal health services in Mwanza, Tanzania. DESIGN: A cross-sectional study conducted from June to July 2019. SETTING: This study was conducted at seven randomly selected health facilities providing reproductive, maternal and child health (RCH) services in Mwanza City. PARTICIPANTS: Included 430 postpartum women who delivered 1 year prior to the study and attending for RCH services (growth monitoring, vaccination, postpartum care). OUTCOME MEASURES: 4 or more ANC visits, skilled birth attendant (SBA) use during childbirth and postnatal care (PNC) utilisation 48 hours after delivery. METHODS: Interviews and observation of the women’s ANC card were used to collect data. Data was entered, cleaned and analysed by SPSS. RESULTS: The mean age of participants was 25.7 years. Of 430 women, 54.4% reported their partners attended ANC at least once, 69.7% reported they attended for four or more ANC visits during last pregnancy, 95% used SBAs during childbirth and 9.2% attended PNC within 48 hours after delivery. Male involvement during ANC was significantly associated with four or more ANC visits (Crude Odds Ratio (COR): 1.90; 95% CI: 1.08–3.35) but not with SBA use or PNC utilisation. CONCLUSION: Male involvement in ANC is still low in Mwanza, as 46% of the partners had not attended with partners at ANC. Alternative strategies are needed to improve participation. Studies among men are required to explore the barriers of participation in overall RCH services.