AIDS and Behavior

, Volume 13, Supplement 1, pp 92–102 | Cite as

Male Involvement in PMTCT Services in Mbeya Region, Tanzania

  • Stefanie Theuring
  • Paulina Mbezi
  • Hebel Luvanda
  • Brigitte Jordan-Harder
  • Andrea Kunz
  • Gundel Harms
Original Paper

Abstract

Throughout all stages of programmes for the prevention of mother-to-child-transmission of HIV (PMTCT), high dropout rates are common. Increased male involvement and couples’ joint HIV counselling/testing during antenatal care (ANC) seem crucial for improving PMTCT outcomes. Our study assessed male attitudes regarding partner involvement into ANC/PMTCT services in Mbeya Region, Tanzania, conducting 124 individual interviews and six focus group discussions. Almost all respondents generally supported PMTCT interventions. Mentioned barriers to ANC/PMTCT attendance included lacking information/knowledge, no time, neglected importance, the services representing a female responsibility, or fear of HIV-test results. Only few perceived couple HIV counselling/testing as disadvantageous. Among fathers who had refused previous ANC/PMTCT attendance, most had done so even though they were not perceiving a disadvantage about couple counselling/testing. The contradiction between men’s beneficial attitudes towards their involvement and low participation rates suggests that external barriers play a large role in this decision-making process and that partner’s needs should be more specifically addressed in ANC/PMTCT services.

Keywords

Tanzania ANC PMTCT Male involvement Partner involvement 

References

  1. Adeleye, O., & Chiwuzie, J. (2007). “He does his own and walks away”. Perceptions about male attitudes and practices regarding safe motherhood in Ekiadolor, southern Nigeria. African Journal of Reproductive Health, 11(1), 76–89.PubMedCrossRefGoogle Scholar
  2. Amin, A., Erhardt, S., & Simbakalia, C. (2007). Field testing of WHO guidelines on integrating gender into HIV/AIDS programmes in Tanzania. WHO/GTZ/MoH: Summary report.Google Scholar
  3. Antelman, G., Smith Fawzi, M., Kaaya, S., Mbwambo, J., Msamanga, G., Hunter, D., & Fawzi, W. (2001). Predictors of HIV-1 serostatus disclosure: A prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania. AIDS (London, England), 15(14), 1865–1874. doi:10.1097/00002030-200109280-00017.
  4. Biratu, B., & Lindstrom, D. (2006). The influence of husband’s approval on women’s use of prenatal care: Results from Yirgalem and Jimma towns, south west Ethiopia. Ethiopian Journal of Health Development, 20(2), 84–92.Google Scholar
  5. Bolu, O., Allread, V., Creek, T., Stringer, E., Forna, F., Bulterys, M., & Shaffer, N. (2007). Approaches for scaling up human immunodeficiency virus testing and counseling in prevention of mother-to-child HIV transmission settings in resource-limited countries. American Journal of Obstetrics and Gynecology, 197(3, Supplement), S83–S89. doi:10.1016/j.ajog.2007.03.006.
  6. Burke, M., Rajabu, M., & Burke, J. (2004). Maximising male participation in PMTCT programs in Tanzania. International AIDS Conference, July 11–16 2004; 15; abstract no. ThPeE8144.Google Scholar
  7. Dardian, M. (2003). Prevention of mother-to-child transmission: Assessing feasibility, acceptability, and cost of services in Kenya and Zambia. Horizons Report of the Population Council; www.popcouncil.org/horizons/newsletter/horizons(7).html.
  8. DiPaoli, M., Manongi, R., & Klepp, K.-I. (2002). Counsellors’ perspectives on antenatal HIV testing and infant feeding dilemmas facing women with HIV in Northern Tanzania. Reproductive Health Matters, 10(20), 144–156. doi:10.1016/S0968-8080(02)00088-5.CrossRefGoogle Scholar
  9. Dudgeon, M., & Inhorn, M. (2004). Men’s influences on women’s reproductive health: Medical anthropological perspectives. Social Science and Medicine, 59, 1379–1395. doi:10.1016/j.socscimed.2003.11.035.PubMedCrossRefGoogle Scholar
  10. Farquhar, C., Kiarie, J., Richardson, B., Kabura, M., John, F., Nduati, R., et al. (2004). Antenatal couple counselling increases uptake of interventions to prevent HIV-1 transmission. Journal of Acquired Immune Deficiency Syndromes, 37, 1620–1626. doi:10.1097/00126334-200412150-00016.PubMedCrossRefGoogle Scholar
  11. Harms, G., Kunz, A., & Theuring, S. (2007). Prevention of mother-to-child transmission of HIV in Kenya, Tanzania and Uganda. German HIV Practice Collection. Eschborn: Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH. http://hiv.prg.googlepages.com/home.
  12. Homsy, J., Kalamya, J., Obonyo, J., Ojwang, J., Mugumya, R., Opio, C., et al. (2006). Routine intrapartum HIV counseling and testing for prevention of mother-to-child transmission of HIV in a rural Ugandan hospital. Journal of Acquired Immune Deficiency Syndrome, 42(2), 149–154. doi:10.1097/01.qai.0000225032.52766.c2.CrossRefGoogle Scholar
  13. Kunene, B., Beksinska, M., Zondi, S., Mthembu, N., & Mullick, S. (2004). Involving men in maternity care, South Africa. University of the Witswatersrand, Department of Obstetrics and Gynecology, Durban, South Africa. http://www.popcouncil.org/pdfs/FRONTIERS/FR_FinalReports/SA_MIM.pdf.
  14. Maman, S., Mbwambo, J., Hogan, N., Weiss, E., Kilonzo, G., & Sweat, M. (2003). High rates and positive outcomes of HIV-serostatus disclosure to sexual partners. AIDS and Behavior, 7(4), 373–382. doi:10.1023/B:AIBE.0000004729.89102.d4.PubMedCrossRefGoogle Scholar
  15. Manzi, M., Zachariah, R., Teck, R., Buhendwa, L., Kazima, J., Bakali, E., et al. (2005). High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: Scaling up requires a different way of acting. Tropical Medicine & International Health, 10(12), 1242–1250.Google Scholar
  16. Medley, A., Garcia-Moreno, C., McGill, S., & Maman, S. (2004). Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: Implications for prevention of mother-to-child transmission programmes. Bulletin of the World Health Organization, 82(4), 299–307.PubMedGoogle Scholar
  17. Montgomery, C., Hosegood, V., Busza, J., & Timaeus, I. (2006). Men’s involvement in the South African family: Engendering change in the AIDS era. Social Science and Medicine, 62, 2411–2419. doi:10.1016/j.socscimed.2005.10.026.PubMedCrossRefGoogle Scholar
  18. Muia, E., Olenja, J., Kimani, V., & Leonard, A. (2000). Integrating men into the reproductive health equation: Acceptability and feasibility in Kenya. The Robert H. Ebert Program on Critical Issues in Reproductive Health, Population Council. http://www.popcouncil.org/pdfs/ebert/FinalKenyaStudy.pdf.
  19. Mullany, B. (2006). Barriers to and attitudes towards promoting husbands’ involvement in maternal health in Kathmandu, Nepal. Social Science and Medicine, 62, 298–2809. doi:10.1016/j.socscimed.2005.11.013.Google Scholar
  20. National Bureau of Statistics Tanzania. (2002). Population and housing census general report. Dar es Salaam, Tanzania. http://www.tanzania.go.tz/census/.
  21. Nzioka, C. (2000). Factors influencing male interest in family planning in Kenya. African Journal of Reproductive Health, 2(2), 122–141.Google Scholar
  22. Nzioka, C. (2001). Research on men and its implications on policy and programme development in reproductive health. In: Programming for male involvement in Reproductive Health. Report of the meeting of WHO Regional Advisors in Reproductive Health. Sept. 5–7, 2001, Washington D.C., USA.Google Scholar
  23. Painter, T. (2001). Voluntary counselling and testing for couples: A high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Social Science and Medicine, 53, 1397–1411. doi:10.1016/S0277-9536(00)00427-5.PubMedCrossRefGoogle Scholar
  24. Peacock, D. (2003). Men as partners: Promoting men’s involvement in care and support activities for people living with HIV/AIDS. Expert Group Meeting on “The role of men and boys in achieving gender equality”, Brazil. http://www.un.org/womenwatch/daw/egm/men-boys2003/EP5-Peacock.pdf.
  25. Rely, K., Bertozzi, S., Avila-Figueroa, C., & Guijarro, M. T. (2003). Cost-effectiveness of strategies to reduce mother-to-child HIV transmission in Mexico, a low prevalence setting. Health Policy and Planning, 18(3), 290–298. doi:10.1093/heapol/czg035.PubMedCrossRefGoogle Scholar
  26. Richter, L., Manegold, J., Pather, R., & Mason, A. (2004). The fatherhood project. Children first, 54, 16–20.Google Scholar
  27. Saha, K., Singh, N., Chatterjee Saha, U., & Roy, J. (2007). Male involvement in reproductive health among scheduled tribe: Experiences from Khairwars of central India. Rural and Remote Health, 7, 605.PubMedGoogle Scholar
  28. Sarker, M., Sanou, A., Snow, R., Ganame, J., & Gondos, A. (2007). Determinants of HIV counselling and testing participation in a prevention of mother-to-child transmission programme in rural Burkina Faso. Tropical Medicine & International Health, 12(12), 1475–1483.Google Scholar
  29. Semrau, K., Kuhn, L., Vwalika, C., Kasonde, P., Sinkala, M., Kankasa, C., Shutes, E., Aldrovandi, G., & Thea, D. (2005). Women in couples’ antenatal HIV counselling and testing are not more likely to report adverse social events. AIDS (London, England), 19(6), 603–609. doi:10.1097/01.aids.0000163937.07026.a0.
  30. Sharma, M. (2002). Sharing reproductive health responsibilities: men’s perspectives. The Journal of Family Welfare, 48(Special Issue), 66–76.Google Scholar
  31. Stringer, E., Sinkala, M., Stringer, J., Mzyece, E., Makuka, I., Goldenberg, R., Kwape, P., Chilufya, M., & Vermund, S. (2003). Prevention of mother-to-child transmission of HIV in Africa: Successes and challenges in scaling-up a nevirapine-based program in Lusaka, Zambia. AIDS (London, England), 17, 1377–1382. doi:10.1097/00002030-200306130-00012.
  32. UNAIDS/WHO. (2007). AIDS epidemic update. Geneva: UNAIDS. http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf.
  33. United Nations. (2007). The Millennium Development Goals Report 2007, New York. http://www.un.org/millenniumgoals/pdf/mdg2007.pdf.
  34. USAID/Synergy. (2004). Women’s experiences with HIV serodisclosure in Africa: Implications for VCT and PMTCT. Meeting report. Washington (DC): USAID. http://www.synergyaids.com/documents/VCTDisclosureReport.pdf.
  35. Van Eijk, A., Bles, H., Odhiambo, F., Ayisi, J., Blokland, I., Rosen, D., et al. (2006). Use of antenatal services and delivery care among women in rural western Kenya: A community based survey. Reproductive Health, 3, 2.PubMedCrossRefGoogle Scholar
  36. Walston, N. (2005). Challenges and opportunities for male involvement in reproductive health in Cambodia. Policy Project. Washington (DC): USAID. http://www.synergyaids.com/documents/MaleRHInvolvement_Cambodia.pdf.
  37. WHO. (2004). Gender dimensions of HIV status disclosure to sexual partners: Rates, barriers and outcomes. A review paper. Geneva: WHO. http://www.who.int/gender/documents/en/genderdimensions.pdf.
  38. WHO. (2008). Integrating gender into HIV/AIDS programmes in the health sector: tool for improving responsiveness to women’s needs. Geneva: WHO.Google Scholar
  39. WHO/UNAIDS. (2006). Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections. United Republic of Tanzania. Geneva: WHO. http://www.who.int/GlobalAtlas/predefinedReports/EFS2006/EFS_PDFs/EFS2006_TZ.pdf.

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Stefanie Theuring
    • 1
  • Paulina Mbezi
    • 2
  • Hebel Luvanda
    • 2
  • Brigitte Jordan-Harder
    • 1
  • Andrea Kunz
    • 1
  • Gundel Harms
    • 1
  1. 1.Institute of Tropical Medicine and International HealthCharité University MedicineBerlinGermany
  2. 2.PMTCT Programme Mbeya Region, Ministry of Health and Social WelfareMbeyaTanzania

Personalised recommendations