The role of women’s empowerment and male engagement in pregnancy healthcare seeking behaviors in western Kenya

ABSTRACT

We sought to understand whether women’s empowerment and male partner engagement were associated with use of antenatal care (ANC). Women presenting for ANC in Nyanza province of Kenya between June 2015 and May 2016, were approached for participation. A total of 137 pregnant women and 96 male partners completed baseline assessments. Women’s empowerment was measured using the modified Sexual Relationship Power Scale. ANC use measures included timing of the first ANC visit and number of visits. Male engagement was based on whether a husband reported accompanying his wife to one or more antenatal visits during the pregnancy. Multiple linear and logistic regression analyses were used to identify factors independently related to use and timing of ANC. Women with higher mean empowerment scores were likely to have more than one ANC visit in the index pregnancy [Adjusted Odds Ratio (AOR) = 2.8, 95% Confidence Interval (CI): 1.1–7.3], but empowerment was not associated with early ANC use. Women who were more empowered were less likely to have a husband who reported attending an ANC visit with his wife (AOR = 0.1, 95% CI: 0.03–0.8). Women’s empowerment is important and may be related to ANC use and engagement of male partners in complex ways.

KEYWORDS:

• Male engagement
• women’s empowerment
• prevention of mother-to-child transmission
• HIV
• antenatal care

Acknowledgments

We thank the dedicated staff of the KEMRI Research Care and Treatment Program (RCTP) and Family AIDS Care and Education Services (FACES) who contributed their time and logistical support to this project. Special acknowledgment goes to the baseline data collection team, including Moses Okombo Ayany, Celestine Adhiambo Ngerhe, Julius Odiwour June, Jane Atieno June, and Irene Awuor Jimbo. We acknowledge the important role of the KEMRI-UCSF Collaborative group, the Director of KEMRI, the Director of KEMRI’s Centre for Microbiology Research, and the Kenya Ministry of Health Teams in the study locations for their important support in conducting this research. The research described in this manuscript was supported by the U.S. National Institute of Mental Health (NIMH), though grant R34MH102103. The content is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. National Institutes of Health.

Disclosure statement

The authors declare no competing interests.

Additional information

Funding

The research described in this manuscript was funded by the U.S. National Institute of Mental Health (NIMH), though grant [R34MH102103].