Male Partner Involvement in the Utilization of Hospital Delivery Services by Pregnant Women Living with HIV in Sub Saharan Africa: A Systematic Review and Meta-analysis
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Objective The level of male partner involvement in hospital delivery by pregnant women living with HIV in sub Saharan Africa (SSA) is low. We conducted a systematic review and meta-analysis to identify the approaches that are used in improving male partner involvement and their impact on the utilization of hospital delivery services by pregnant women living with HIV in SSA. Methods Ovid Medline, Embase, PsycINFO, Cochrane library, ClinicalTrials.gov, Web of Science and Current Controlled Trials were searched. Only studies carried out in SSA that reported an approach used in involving male partners and the impact on the uptake of hospital delivery services irrespective of the language and date of publication were included. Odds ratios were extracted or calculated from studies and combined in a meta-analysis using the statistical package Stata version 11.0. A forest plot was used to show the impact of various male involvement approaches. A funnel plot was used to report publication bias. Results From an initial 2316 non-duplicate articles, 08 articles were included in the systematic review and meta-analysis. The overall pooled OR was 1.56 (95% CI 1.45–1.68). After stratification, the odds ratios were: 1.51 (95% CI 1.38–1.65), 1.58 (95% CI 1.38–1.80), 3.47 (95% CI 2.16–5.58) for complex community interventions without community health workers (CHWs), complex community interventions with community health workers, and verbal encouragement respectively. The overall I-square was 91.0% but after stratification into the three different approaches, the I-squared within the complex community intervention without CHWs group was 0.0%. Conclusions for Practice Complex community interventions and verbal encouragement increase the utilization of hospital delivery services by pregnant women living with HIV in SSA. The overall heterogeneity was high but very low for studies that used complex community interventions without CHWs. More well conducted studies (including randomized controlled trials) are needed in future to add to the quality of evidence.
KeywordsMale partner involvement PMTCT Hospital delivery
Sub Saharan Africa
Prevention of mother to child transmission
Human immunodeficiency virus
Community health workers
Preferred reporting items for systematic reviews and meta-analyses
The authors would like to thank the University of Glasgow Library for assess to OVID Medline, OVID Embase, and other search databases.
NFT and MM conceived the paper. NFT, MM and LNA developed the search strategy. NFT and MM independently searched the literature and screened the articles. NFT, and MM carried the meta-analysis and meta-regression. NFT made the first draft of the manuscript. NFT, MM and LNA reviewed several versions of the manuscript. All the authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
No ethical approval was needed since the included studies were published studies that had already obtained ethical approvals.
All authors consented to the publication.
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