Exploring Men’s Perceptions, Experiences and Beliefs on Their Role in Maternal Healthcare in Rural Southern Malawi: A Qualitative study

Background In Malawi, women experience poor maternal health outcomes. Although this is strongly linked to gender inequalities, men should not be excluded from the solution. Male partners can play a supportive role at home, or actively attend healthcare services. Their engagement has been shown to improve health outcomes for women, partly through increased consistent antenatal care service utilisation. Initiatives have been implemented in Malawi, although they have had little success. The aim of this study was to investigate the beliefs, perceptions and experiences of the lay male community members of Chilaweni, rural Blantyre district in Southern Malawi, on the role of men during pregnancy. Methods A qualitative study design was selected using flexible semi-structured interviews to explore participant views in depth. Interviews were conducted at two sites in Chilaweni. Participant responses were translated from Chichewa to English. Data was transcribed clean verbatim and analysed using Braun and Clarkes’ six step approach to reflexive thematic analysis. Results Twenty interviews were conducted. Four main themes addressing the aim of the study were identified: roles, barriers, facilitators and topic reception. Roles in maternal healthcare included attending clinics or providing transport. Although often men felt their role was to work instead. It was discussed that for some men work was a barrier, along with the social embarrassment driven by cultural beliefs surrounding men who are involved in women’s healthcare. Encouragingly, participants did recognise the benefits of active participation in maternal health which are presented under the theme ‘facilitators’, reporting factors such as the opportunity to be tested for sexually transmitted infections to motivate them, as well as several personal reasons including an act of love. The theme ‘topic reception’ considers participants’ awareness and approach to the topic, which was positive, serving as promise for change in the future. Conclusion Overall, this study highlights key roles men feel they play during pregnancy, as well as barriers and facilitators to their engagement. Participants were receptive to the concept of male partner involvement, wanting to actively take part. In addition, the study recommends several strategies based on the findings to increase men’s engagement in pregnancy in Malawi.