The association between male involvement in institutional delivery and women's use of institutional delivery in Debre Tabor town, North West Ethiopia: Community based survey

Background Maternal deaths remain high in Ethiopia mainly due to poor maternal health service utilization. Despite men are the chief decision-makers and economically dominant in Ethiopia, the impact of their involvement on maternal health services utilization is not clear. This study aimed to assess the association between male involvement and women's use of institutional delivery, and factors influencing male partners' involvement in institutional delivery. Methods A community based cross-sectional study was conducted between March and May, 2019. A total of 477 married men who have children less than one year of age were interviewed. Face-to-face interviews using a pre-tested and structured questionnaire were used for data collection. Bivariate and multiple logistic regressions were carried out. SPSS version 23 was used for data analysis. Results Overall 181 (37.9%) husbands/partners were involved in institutional delivery for the most recent child birth. Male partners involvement in institutional delivery was strongly associated with an increased odds of attending institutional delivery by spouse [AOR: 66.2, 95% CI: 24.8, 177.0]. Education [AOR: 0.33, 95% CI: 0.18-0.59], knowledge on maternal health [AOR: 1.67, 95% CI: 1.11-2.50], favourable attitude towards institutional delivery [AOR: 1.83, 95% CI: 1.23-2.71], and no fear while supporting spouse [AOR: 2.65, 95% CI: 1.28-5.50] were positively associated with male partners involvement in institutional delivery. Conclusion Male partner's involvement in institutional delivery was inadequate. This study reported a significant beneficial impact of male involvement on maternal health through improved utilisation of institutional delivery. Therefore, maternal health interventions should target husbands as consumers of maternal health services, and healthcare/government policies that isolate or discourage men from having active engagement in maternal health should be improved.

Automated summary

This study found that male partners' involvement in institutional delivery has a positive impact on women's utilization of institutional delivery, but their involvement is still inadequate. Factors such as education level, knowledge on maternal health, favorable attitude towards institutional delivery, and lack of fear while supporting their spouse are important influences on male partners' involvement in institutional delivery. Therefore, maternal health interventions should target husbands as consumers of maternal health services, and policies that isolate or discourage men from active engagement in maternal health should be improved.