CHAPTER ONE

CARE.INTRODUCTIONMen’s role in antenatal care is pivotal to changing the course of the

epidemic maternal death rate. When men participate in antenatal care, their knowledge
of women sufferings before and after birth increases, their behavior becomes
supportive, and their receptiveness to postnatal care testing in medical centers
increases. In recent time, multiple efforts have been implemented by governmental and
non-governmental organizations that encourage men to ‘‘follow’’ their wives to obstetric
and gynic, However, only few of men have participated in this care.

The limited progress in meeting the Goal of reducing maternal mortality in developing
countries, particularly in africa, necessitates new approaches to maternal health
interventions. Education and health services provided during the antenatal period can
reduce pregnancy and delivery complications and improve birth outcomes in resource-
poor settings; however, these benefits are contingent upon user compliance. At the
same time, women's ability to seek health care or implement lessons learned from
health education interventions is often determined by the household head, usually the
husband.
The important role that male partners play in women's reproductive health is becoming
increasingly recognized, and, especially as a result of the rate of maternal death
epidemic, more attention is being focused on how to incorporate men into reproductive
health education interventions. Male involvement in reproductive health decisions and
practice has been shown to be considerable, particularly related to antenatal and even
post natal care.
Educational interventions for pregnancy health have traditionally been inadequate in
addressing a woman's degree of influence within the household on health-related
decisions, particularly as compared with her husband. Observational studies have
shown that educating men about the importance of health care for the family increases
the promotion of some health-seeking behaviors, such as antenatal care (ANC) and
child immunizations, and enhances communication and support of female partners.In
general, men who are exposed to a multimedia entertainment–education intervention
regarding birth preparedness responded favorably by exhibiting new knowledge gains
and birth preparations.
While such evidence indicates that men can influence health care utilization during
pregnancy and thereby the outcome of an obstetric emergency, few interventions have
targeted men directly in ANC, birth preparedness or obstetric decision making, and
randomized trials of the impact of involving men in such interventions are scarce. Using
a randomized controlled design, we evaluated the impact of including husbands in
antenatal health education sessions on birth preparedness and maternal health care
utilization.
BACKGROUND OF THE PROBLEM
The reproductive health field is paying more attention to men’s roles in women’s
reproductive health. However, much researches has overlooked adolescents. As part
of an adolescent reproductive health intervention study, researchers, with input from
international center for research on women( ICRW), examined patterns of husbands’
participation in health seeking for their adolescent wives’ antenatal, delivery, and
postnatal care.
Socio cultural context: The mean age at marriage is 23 years for men compared to 16
years for women.Thus, while men marry after adolescence, on average, women tend to
marry early. These young couples face enormous pressure to bear children soon after
marriage from the joint family and from peers. Consequently, childbearing is early with
86% of the wives of sample husbands reporting at least one pregnancy by the age of
22 years. Young women have limited mobility and depend on husbands or other family
members to take them to a health centre. This entails time spent by husbands, who
may not accompany their wives unless they perceive it necessary. However, given the
high value placed on proving fertility early in the marriage, pregnancy care is sought
relatively promptly, especially for the first child.
Husbands’ awareness of maternal care: While a majority of husbands are aware of the
need for care, and that problems can arise during pregnancy, fewer know details. While
77% say that women should seek antenatal care, only one third know about all the
antenatal care services that can be provided. A high 85% say care is needed during
delivery, but for most reported the need for institutional deliveries (72%) rather than
care during home deliveries. Interviews with husbands reveal, however, that though
they may not know medical details, they help wives follow treatment advice, and are
concerned about nutrition and other care within the home environment .

STATEMENT OF THE PROBLEM

Most husbands feel responsible for routine care and treatment of problems. Men
indicate they want to participate in maternal care. Yet, high awareness and sense of
responsibility do not translate into participation: only about half the husbands
accompanied wives for routine care. Husbands were more likely to accompany their
wives and pay for treatment for problems. In both routine care and treatment of
problems, husbands participated more often by paying for care than accompanying
their wives.Husbands may be dissuaded by the belief that maternity is ‘women’s affair’
and by young women going to their natal home for delivery. In addition, beliefs of
health staff and poor conditions in health centers mean that even husbands who
accompany their wives to clinics are often made to wait outside .
Men who were better educated, married later, and whose wives were educated and
were older when they married knew more about and were more likely to participate in
all three phases of care. Experience matters: being young, many men were first-time
fathers-to-be and were less likely to know about care and problems than their peers
whose wives had been pregnant in the past. Moreover, it is the same sub-set of men
who participate: those who know about the need for care are more likely to accompany
their wives for care, be it antenatal, delivery, or postnatal routine care or treatment for
problems. Similarly, husbands who accompany their wives for routine care in one phase
of maternity are more likely to accompany them for treatment of problems or for care in
other phases.

OBJECTIVE OF THE STUDY

·1 To educate Young couples to experience pregnancy and childbearing in a context of
early marriage, social pressure for early childbearing, and restricted mobility and
decision making for young women
·2 To let Men know about maternal care: more than two-thirds will be aware of the
need for antenatal, delivery, and postnatal care and feel responsible to accompany and
pay for routine care and treatment of problems
·3 more husbands will accompany their wives for care; because at the moment
husbands are more likely to be present for care of problems than for routine care
·4to inculcate the Beliefs that maternity is not only a “woman’s issue” as well as
attitudes and conditions in the health centers contribute

SIGNIFICANCE OF THE STUDY

.Educational efforts on maternal care with men should go beyond basic information to
also include specifics of maternal services, precautions, and problems
· Work with the health system should improve conditions – such as lack of privacy that
make it difficult for husbands to participate, and identify other ways health staff could
encourage husbands to be present
· Where young women have limited say over their care, “men’s involvement” needs to
be defined more broadly to include husbands’ support to young wives in negotiating
their environment.

SCOPE AND DELIMITATION

The study will examines the relative (and additive) roles of community mobilization
and improved quality of government services in increasing young married women’s use
of reproductive health services, and a variety of qualitative and quantitative methods to
explore the constraints, attitudes of women, their families and their communit ies, and
best approaches to increase use of reproductive health services by adolescents and
youth. In this process, their husbands and mothers-in-law, community-based
organizations, and village- and district-level government health workers will participate
in antenatal care.

RESEARCH QUESTION
How much do husbands participate in their adolescent and young wives’ pregnancy and
maternity care?
DEFINATION OF TERMS
1 antenatal care:-
2 pregnancies:-
3 childbearing:-
4 obsteric :- Obstetrics (from the Latin obstare, "to stand by") is the surgical specialty
dealing with the care of women and their children during pregnancy, childbirth and
postnatal
5. Midwifery :- is the non-surgical equivalent of obsterics
5 gynecology:-