It takes two! Understanding male involvement within pregnancy and childcare in Kinshasa, DRC
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Description
Background: There has been increased recognition of the inclusion of men in maternal and child health programs. Engaging men as partners in pregnancy and childrearing is vital because of the positive ramifications for the child, the mother, and even the men themselves. Despite this growing evidence, there are a limited number of studies exploring male involvement during pregnancy and in childcare in the Democratic Republic of Congo (DRC). Objective: Using a mixed-methods approach, this dissertation aimed to contribute to the literature on male involvement by exploring male involvement during pregnancy and in childcare as a complex process determined by multiple factors. More specifically, the dissertation [1] explored the role of fathers during pregnancy and in childcare, the perceived barriers to and enablers of involvement, and the normative determinants of participation in childcare; [2] identified the factors associated with male involvement during pregnancy and a male partner’s willingness to be involved in routine childcare activities Methods: Employing a three-paper approach, this dissertation analyzed secondary data from the Gates-funded MOMENTUM study in Kinshasa, the capital of DRC. In paper 1, 12 focus group transcripts from 125 first-time mothers (FTMs) and male partners of FTMs collected during the formative evaluation were analyzed using thematic content analysis. Papers 2 and 3 used cross-sectional data from 1,674 male partners interviewed at the baseline, and the analysis was restricted to participants without missing data on any of the variables. Factor analysis was employed to characterize involvement and multivariate regressions were used to estimate the associations between involvement during pregnancy, gender-equitable attitudes, co-parental relationship factors, and personal agency in Paper 2. Finally, paper 3 used multivariate regressions and path analysis to explore the associations between male partners’ willingness to be involved in childcare and gender-equitable attitudes, co-parental relationship factors, personal agency, and perceived norms and beliefs about paternal involvement. Results: Findings from the qualitative paper suggests that men played and were expected to play multiple roles during pregnancy and in childcare; however, many faced sanctions for their involvement. Several participants reported involvement was often low, although they mentioned that fathers would continue to be involved despite these sanctions. Fathers also faced many barriers that deterred involvement, and the perception of pregnancy as a woman’s domain and the lack of financial resources were the most reported. The quantitative results indicated various dimensions of involvement during pregnancy and willingness to be involved in childcare. Participation in pregnancy-related activities was low, ranging from 11% (finding a blood donor) to 49% (saving money during emergencies). For childcare, 50% were extremely willing to participate in all interactive activities and only 17% were extremely willing to participate in all caregiving responsibilities. Factors influencing involvement or willingness varied depending on the type of activity. Conclusion: Results of the dissertation provide a nuanced understanding and insight into the male involvement during pregnancy and in childcare in Kinshasa, with the potential to inform intervention strategies and planning. Involvement is multidimensional and influenced by multiple factors. Interventions that integrate strategies addressing these factors can potentially impact male participation during pregnancy and in childcare.