7 research outputs found
an implementation study in Mbeya Region, Tanzania
Background The benefits of male partner involvement in antenatal care (ANC)
and prevention of mother-to-child transmission of HIV (PMTCT) for maternal and
infant health outcomes have been well recognised. However, in many sub-Saharan
African settings, male involvement in these services remains low. Previous
research has suggested written invitation letters as a way to promote male
partner involvement. Methods In this implementation study conducted at three
study sites in southwest Tanzania, acceptability of written invitation letters
for male partners was assessed. Pre-study CVCT rates of 2–19 % had been
recorded at the study sites. Pregnant women approaching ANC without a male
partner were given an official letter, inviting the partner to attend a joint
ANC and couple voluntary counselling and testing (CVCT) session. Partner
attendance was recorded at subsequent antenatal visits, and the invitation was
repeated if the partner did not attend. Analysis of socio-demographic indices
associated with male partner attendance at ANC was also performed. Results Out
of 318 women who received an invitation letter for their partner, 53.5 %
returned with their partners for a joint ANC session; of these, 81 % proceeded
to CVCT. Self-reported HIV-positive status at baseline was negatively
associated with partner return (p = 0.033). Male attendance varied
significantly between the rural and urban study sites (p < 0.001) with rates
as high as 76 % at the rural site compared to 31 % at the urban health centre.
The majority of women assessed the joint ANC session as a favourable
experience, however 7 (75 %) of women in HIV-positive discordant or concordant
relationships reported problems during mutual disclosure. Beneficial outcomes
reported one month after the session included improved client- provider
relationship, improved intra-couple communication and enhanced sexual and
reproductive health decision-making. Conclusion Official invitation letters
are a feasible intervention in a resource limited sub-Saharan African context,
they are highly accepted by couple members, and are an effective way to
encourage men to attend ANC and CVCT. Pre-intervention CVCT rates were
improved in all sites. However, urban settings might require extra emphasis to
reach high rates of partner attendance compared to smaller rural health
centres
Comparable Outcomes Using Written versus Verbal Invitations in an Urban Facility-Based Controlled Intervention Trial in Mbeya, Tanzania
In many Sub-Saharan African settings male partner involvement in antenatal
care (ANC) remains low, although great benefits for maternal and infant health
outcomes have been long recognised, in particular regarding the prevention of
HIV transmission. Yet there is paucity on evidence regarding the effectiveness
of strategies to increase male partner involvement. This controlled
intervention trial in Ruanda Health Centre in Mbeya, Tanzania, assessed the
effectiveness of invitation letters for male involvement in ANC. Pregnant
women approaching ANC without partners received official letters inviting the
partner to attend ANC. A control group was instructed to verbally invite
partners. Partner attendance was recorded at two subsequent ANC visits. Rates
for male partner return, couple voluntary counselling and testing (CVCT), and
influencing factors were analysed. From 199 ANC clients in total, 97 were
assigned to the invitation letter group; 30 of these (30.9%) returned with
their male partners for ANC. In the control group of 102 women, 28 (27.5%)
returned with their partner. In both groups CVCT rates among jointly returning
couples were 100%. Partner return/CVCT rate was not statistically different in
intervention and control group (OR 1.2, p = 0.59). Former partner attendance
at ANC during a previous pregnancy was the only factor found to be
significantly linked with partner return (p = 0.03). Our study demonstrates
that rather simple measures to increase male partner attendance in ANC and
CVCT can be effective, with written and verbal invitations having comparable
outcomes. In terms of practicability in Sub-Saharan African settings, we
recommend systematic coaching of ANC clients on how to verbally invite male
partners in the first instance, followed by written invitation letters for
partners in case of their non-attendance. Further studies covering both urban
and rural settings will be more informative for effective translation into
policy
Increasing Partner Attendance in Antenatal Care and HIV Testing Services: Comparable Outcomes Using Written versus Verbal Invitations in an Urban Facility-Based Controlled Intervention Trial in Mbeya, Tanzania.
In many Sub-Saharan African settings male partner involvement in antenatal care (ANC) remains low, although great benefits for maternal and infant health outcomes have been long recognised, in particular regarding the prevention of HIV transmission. Yet there is paucity on evidence regarding the effectiveness of strategies to increase male partner involvement. This controlled intervention trial in Ruanda Health Centre in Mbeya, Tanzania, assessed the effectiveness of invitation letters for male involvement in ANC. Pregnant women approaching ANC without partners received official letters inviting the partner to attend ANC. A control group was instructed to verbally invite partners. Partner attendance was recorded at two subsequent ANC visits. Rates for male partner return, couple voluntary counselling and testing (CVCT), and influencing factors were analysed. From 199 ANC clients in total, 97 were assigned to the invitation letter group; 30 of these (30.9%) returned with their male partners for ANC. In the control group of 102 women, 28 (27.5%) returned with their partner. In both groups CVCT rates among jointly returning couples were 100%. Partner return/CVCT rate was not statistically different in intervention and control group (OR 1.2, p = 0.59). Former partner attendance at ANC during a previous pregnancy was the only factor found to be significantly linked with partner return (p = 0.03). Our study demonstrates that rather simple measures to increase male partner attendance in ANC and CVCT can be effective, with written and verbal invitations having comparable outcomes. In terms of practicability in Sub-Saharan African settings, we recommend systematic coaching of ANC clients on how to verbally invite male partners in the first instance, followed by written invitation letters for partners in case of their non-attendance. Further studies covering both urban and rural settings will be more informative for effective translation into policy
Socio-demographic baseline information and differences between intervention and control group.
<p>Socio-demographic baseline information and differences between intervention and control group.</p
Flow chart: Study participants and partner return rates at each visit.
<p>Flow chart: Study participants and partner return rates at each visit.</p
Univariate and multivariate analysis of influencing factors on partner attendance/CVCT.
<p>Univariate and multivariate analysis of influencing factors on partner attendance/CVCT.</p