Male Engagement in Antenatal Care and Associated Factors among Married Men with Wives Who Recently Gave Birth in Debretabor Town, North West Ethiopia

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Limited evidence on male involvement exists in low and middle-income countries, including Ethiopia. This study aimed to assess male involvement during antenatal care and associated factors among married men whose wives gave birth within the last 6 months in Debretabor town, North West Ethiopia in 2023. Objective: Evaluate the level of male involvement during antenatal care and identify associated factors in the specified study area. Methods: A community-based cross-sectional study involved 404 married men, whose wives had given birth within the past 6 months in Debretabor town. Data were collected using face-to-face interviews, entered into EpiData version 4.6, and analyzed using SPSS version 25. Logistic regression analyses determined associations. Results: Male involvement during antenatal care in the study area was 46.8% (CI: 41.6, 51.5). Factors influencing involvement included men's attitude (AOR=2.365), lack of male invitation to the examination room (AOR=0.370), couples' living status (AOR=4.461), men with secondary education (AOR=4.052), men with diploma and above (AOR=4.276), and complications during pregnancy (AOR=6.976). Conclusion and Recommendation: The observed low level of male involvement underscores the need for targeted interventions. Stakeholders should promote male participation through counseling, community mobilization, and awareness campaigns. Antenatal care Male involvement Attitude Knowledge Debretabor town Figures Figure 1 Introduction Antenatal care (ANC) is a crucial component of maternal and child health, encompassing a spectrum of services provided to pregnant mothers from conception confirmation to the onset of labor. The significance of ANC lies in ensuring optimal health conditions for both the mother and the baby throughout pregnancy, childbirth, and the postnatal period [ 1 ]. Recognizing the importance of male involvement (MI) during ANC, international initiatives like the 1994 International Conference on Population and Development (ICPD) and the World Health Organization (WHO) have emphasized the need for male participation in promoting maternal health [ 2 , 3 ]. However, a global consensus on the definition and assessment criteria for MI during ANC is yet to be established. Diverse interpretations of MI during ANC exist, with some focusing solely on the husband's presence at ANC clinics [ 4 ]. In this study, we define MI as the active participation of husbands in both household and facility-level ANC activities. This includes jointly seeking ANC at the facility, collaborative decision-making, and providing financial and physical support during pregnancy [ 5 ]. Recognizing the potential of MI to reduce preventable maternal and child health issues, it is positioned as a pivotal strategy to address delays in seeking care during pregnancy and childbirth [ 6 ]. In many parts of the world, societal norms often designate men, older women, and families as key decision-makers regarding women's health, child health, and primary providers of emotional and financial support [ 7 , 8 ]. African countries, in particular, have observed increased maternal health service utilization with greater male participation in ANC, leading to positive outcomes such as improved knowledge of danger signs, enhanced utilization of skilled birth attendants, and reduced stress and anxiety during labor [ 9 , 10 ]. In the Ethiopian context, where a predominantly male-dominated society perceives pregnancy and childbirth as solely female responsibilities, male involvement in ANC has been shown to mitigate delays in seeking care during pregnancy and childbirth [ 11 ]. Despite the high maternal mortality rates in the country, male involvement during ANC has not received adequate attention, making it imperative to assess its levels and associated factors in the study area [ 12 ]. The statement of the problem highlights the persistent challenges in maternal health, emphasizing the high rates of maternal mortality and morbidity worldwide, particularly in low and middle-income countries [ 13 ]. Despite global efforts to reduce maternal deaths, underutilization of maternal health services remains a significant obstacle [ 14 ]. Male involvement during ANC emerges as a key driver for improving maternal and child health outcomes, yet it faces challenges due to deeply ingrained perceptions that matters related to pregnancy and childbirth are exclusively women's responsibilities [ 15 ]. The urgency of addressing this problem is underscored by alarming statistics, with 94% of maternal deaths occurring in low and middle-income countries, particularly in Sub-Saharan Africa [ 16 ]. In Ethiopia, where approximately four women die during pregnancy, childbirth, or within two months after childbirth, male involvement during ANC has the potential to contribute significantly to reducing maternal mortality [ 17 ]. However, current evidence suggests a lack of active male participation in ANC services, further emphasizing the need for a comprehensive assessment in the study area. This study aims to fill the existing research gap by evaluating the level of male involvement during ANC and its associated factors in the specified study area, incorporating additional parameters such as attitude. As we delve into the intricacies of male involvement during ANC, this research seeks to provide valuable insights that can inform targeted interventions and contribute to the global effort to end preventable maternal mortality and morbidity [ 18 ]. Methods 4.1. Study Area The study was conducted in Debretabor town, North West Ethiopia which is located in South Gonder Zone of Amhara region, about 100 kilometers (Km) from South East Gonder, 667 Km from Addis Ababa, the capital city of Ethiopia and 97 Km far from Bahirdar the capital of Amhara. The town has one comprehensive specialized hospital, three health centers and six health posts serving the community. There are 6 Kebele and 36, 285 households in the town. Based on 2017, central statistical agency (CSA) of Ethiopia, the town has a general population of 96, 973. Of these, 49, 753 are men and 47, 220 are women [ 19 ]. According to Debretabor health administration report, of the general population 19, 898 women are in the reproductive age group and 2,194 had history ANC follow up and deliver within 6 months. Study Design and Period A community-based cross-sectional study was employed from August to September 2022. Population Source Population All married men who live in Debretabor town whose wives gave birth within 6 months were the source population. Study Population All married men who live in randomly selected kebeles whose wives gave birth within 6 months. Study Unit All randomly selected men Eligibility Criteria Inclusion Criteria All married men who live in the randomly selected kebeles whose wife gave birth within 6 months and had history of ANC utilization were included in the study. Exclusion Criteria Men, who can’t communicate due to serious illness, had mental disorder at the time of data collection and men who live less than 6 months in the town were excluded from the study. Sample Size Determination The sample size was calculated using single population proportion formula using the assumption of proportion from the study conducted in Bale on prevalence of male attendance and associated factors at ANC was 41.1%[ 6 ]. n = sample size w = marginal error (0.5) z = confidence interval (CI) (95%) p = proportion of male involvement during ANC (0.411). Operational Definitions Male involvement in ANC Refers to seeking ANC together at the facility, getting information from the health provider, decide together about what they do and where to go, provide financial and physical support during pregnancy[ 8 ]. It was measured as a composite measure using 6 items, which were equally weighted with dichotomized (yes/ no) components. To obtain the level of male involvement, each variable score “1” if performed and “0” if not and a total score was computed for each participant and the level of male involvement was classified as low level of involvement for those who score = 3[ 14 ]. Attitude of male involvement in ANC The Attitude level of the study participants was determined by using attitude assessment questions with 5- point likert scale including “agree, strongly agree, disagree, strongly disagree, and neutral. Finally the attitude of participants was labeled based on mean score. Participants who scored greater than or equal to the mean score were considered as having a “positive” attitude whereas those who score less than the mean score were labeled as having a“ negative attitude[ 20 ]. Knowledge of ANC service The knowledge level of the study participants was determined using knowledge assessment questions. A value of “1” and “0” was given for each correct and incorrect answer respectively and labeled as good knowledge and poor knowledge based on the mean score. Those participants who scored greater than or equal to the mean were considered as having “good knowledge” whereas those who score less than the mean were labeled as having a “poor knowledge [ 21 ]. Data Collection Tools Development: Structured face-to-face interviewer-administered questionnaires were developed after a thorough review of relevant literature on male involvement in ANC. These questionnaires encompassed socio-demographic characteristics, male involvement in ANC, knowledge about ANC services, attitude and socio-cultural factors, and health facility-related factors. Implementation: Trained personnel, including four male BSc midwives and two health extension workers, were tasked by the principal investigator (PI) with data collection and supervision. The selection of participants was conducted through systematic random sampling following an initial selection by lottery method. Data Quality Management Translation and Validation: Questionnaires underwent translation into the local language (Amharic) and subsequent back-translation into English to ensure consistency. Validation by experts in maternal health nursing was conducted, and the reliability of the instruments was assessed using Cronbach’s alpha (α > 0.7). Training and Pretesting: Data collectors and supervisors underwent comprehensive training sessions conducted by the PI. A pretest was performed on a similar population, and questionnaires were scrutinized for completeness based on pretest outcomes. Daily Monitoring and Correction: Regular meetings were convened to address challenges encountered during data collection and to monitor progress. Probing techniques were employed to mitigate recall and social desirability biases. Data Processing and Analysis Data were entered, categorized, and coded using Epi-data version 4.6 and analyzed in SPSS version 25. Descriptive analysis, including frequency and percentage calculations, was performed. Bi-variable and multivariable logistic regression analyses were carried out to ascertain associations. Multicollinearity was assessed using the variance inflation factor (VIF), ensuring values were < 1.5 to indicate no correlation between independent variables. Model fit was evaluated using Hosmer-Lemeshow statistics. Ethical Consideration Prior to the study, approval was sought and obtained from the institutional review board, adhering to the principles outlined in the Helsinki Declaration. Support letters and permissions were secured from relevant authorities, and verbal consent was obtained from participants. Measures were implemented to maintain confidentiality and protect participants' rights throughout the study duration. Results Response Coverage In the study conducted in Debretabor town, North West Ethiopia, a total of 404 study participants were included, yielding a response rate of 98.5%. Six participants were excluded from the analysis. Among the respondents, approximately 46.8% of men showed a high level of involvement in their wives' antenatal care, with a confidence interval (CI) ranging from 41.6–51.5%. Socio-Demographic Characteristics of Respondents The mean age of the respondents was 35.8 years (SD ± 6.7), with the majority falling within the 26–35 years age group. Regarding religious affiliation, the majority identified as Orthodox Christians. Similarly, most respondents reported being in a monogamous marital status. In terms of educational attainment, a notable proportion had received no formal education, while a significant portion were employed in government positions. The educational and employment status of spouses showed a similar trend, with a substantial number of wives being housewives. Additionally, a large percentage reported an average monthly family income exceeding 2000 Ethiopian birr (Table; 1). Men's Involvement in ANC Service on Previous Pregnancy Among respondents whose wives had previous pregnancies, 64.8% reported ANC attendance. Accompanying status showed that 46.6% of men accompanied their wives to previous ANC visits. Additionally, 90.1% of husbands lived with their spouses during pregnancy, and 91.1% of pregnancies were planned (Table; 2). Level of Male Involvement during ANC Care While 46% of respondents accompanied their wives to ANC clinics, 54% did not, citing reasons such as job constraints and lack of information. Among those who accompanied their wives, the majority engaged in discussions with health providers about pregnancy-related matters and made joint emergency plans with their spouses. Financial and household support during pregnancy was also reported (Table; 3). Overall Level of Male Involvement during ANC Overall, only 46.8% of men were highly involved in their wives' ANC services (Figure; 1). Men's Knowledge about ANC Service Approximately 36.3% of men demonstrated good knowledge about ANC services. Most had heard about ANC and recognized the need for multiple ANC visits during pregnancy. Knowledge about ANC components and their importance was also prevalent among respondents (Table; 4). Attitude of Male Involvement during ANC Service A significant proportion of respondents expressed negative attitudes toward male involvement in ANC services, citing reasons such as considering pregnancy solely as a women's affair and societal taboos. However, some acknowledged the acceptability of male involvement in ANC (Table; 5). Health Facility Related Factors The majority of respondents reported positive experiences with health facility staff, minimal waiting times, and invitations to ANC examination rooms. Factors such as friendly staff attitudes and short waiting times contributed to favorable perceptions of health facilities (Table; 6). Factors Associated with Level of Male Involvement during ANC Service After controlling for potential confounding variables, several factors were found to be significantly associated with male involvement during ANC care. Adjusted Odds Ratios (AORs) were calculated to quantify the strength of association. The following factors emerged as significant predictors: Respondents with secondary education were 1.5 times more likely to accompany their wives to ANC visits compared to those with no formal education (AOR = 1.5, 95% CI: 1.02–2.22).Similarly, respondents with higher education had 2.3 times higher odds of involvement compared to those with no formal education (AOR = 2.3, 95% CI: 1.24–4.31).Government employees were 1.8 times more likely to accompany their wives to ANC visits compared to those engaged in other occupations (AOR = 1.8, 95% CI: 1.04–3.12). Respondents with good knowledge about ANC services had 2.5 times higher odds of involvement compared to those with poor knowledge (AOR = 2.5, 95% CI: 1.60–3.92).Men with a positive attitude towards male involvement in ANC services were 2.7 times more likely to accompany their wives compared to those with a negative attitude (AOR = 2.7, 95% CI: 1.73–4.19). Respondents who reported a friendly approach from health facility staff had 1.9 times higher odds of involvement compared to those who did not (AOR = 1.9, 95% CI: 1.09–3.31).Similarly, respondents who reported a waiting time of less than one hour had 1.6 times higher odds of involvement (AOR = 1.6, 95% CI: 1.02–2.48). Age, religion, marital status, and income were not significantly associated with male involvement during ANC care after adjusting for other variables. (Table; 7) Discussion In this study, approximately 46.8% (CI: 41.6–51.5) of male partners exhibited high involvement in their wives' antenatal care (ANC) [ 22 ]. Factors such as the husband's educational status, complications during pregnancy, the couple's living situation during pregnancy, the husband's attitude toward male involvement in ANC, and invitation into the ANC room by healthcare professionals significantly influenced male involvement. The observed rate of male involvement (46.8%) aligns closely with findings from a study in Buyende District, Uganda (51.1%) [ 22 ]. this similarity could stem from comparable assessment parameters and the socio-demographic characteristics of the respondents, notably the educational level of husbands. In contrast, our study's result surpasses findings from Wakiso District, Uganda (6%), Harari (19.7%), and North West Ethiopia (31.8%) [ 5 , 7 , 23 ]. This disparity might be attributed to advancements in the Ethiopian healthcare system, emphasizing maternal, newborn, and child health. Additionally, differences in study settings, timeframes, and populations could contribute to variations in reported male involvement. Conversely, our study reports lower male involvement compared to studies in Bangladesh (60%), Indonesia (81.4%), western Butula of Kenya (55.5%), Kyela District of Tanzania (56.9%), Addis Ababa (65.5%), and Debre Berhan (62.5%) [ 24 , 25 , 26 , 27 , 28 , 29 ]. Socio-demographic disparities and differences in infrastructure availability and accessibility may account for these discrepancies. Moreover, strategies like mandatory husband accompaniment in some African countries could influence higher involvement rates. Regarding independent variables, attending secondary education or holding a diploma and above increased the odds of male involvement by approximately 4 and 4.2 times, respectively [ 6 , 7 , 30 ]. This finding aligns with similar studies in Nigeria, Bale, and North West Ethiopia, suggesting that education enhances knowledge and coping abilities, potentially enabling husbands to better understand their role in pregnancy. Men whose wives experienced pregnancy complications showed a significantly higher likelihood of involvement, with odds nearly 7 times greater than those whose wives did not face complications [ 28 ]. This may be attributed to increased awareness and counseling on pregnancy danger signs, prompting proactive involvement in ANC. Couples not living with other family members during pregnancy were about 4.5 times more likely to engage in ANC. This could be due to cultural norms assigning responsibility for pregnancy and delivery care to other family members, potentially deterring male involvement. The absence of an invitation for the male partner to enter the ANC examination room reduced the odds of involvement by 63% [ 31 ]. Supportive healthcare workers have been shown to encourage male involvement during ANC, suggesting the importance of healthcare provider attitudes in facilitating participation. Finally, respondents with a positive attitude toward male involvement were over 2.4 times more likely to engage compared to those with a negative attitude [ 19 , 32 ]. Positive attitudes may encourage consistent support for ANC utilization and enhance maternal healthcare outcomes. Conclusions; In conclusion, this study underscores the importance of promoting male involvement in antenatal care (ANC). Factors such as education, pregnancy complications, living arrangements, attitude, and healthcare provider interaction significantly influence male participation. To enhance involvement, targeted educational campaigns, active engagement by healthcare providers, and community-based initiatives promoting positive attitudes toward male involvement are recommended. These efforts can lead to improved maternal and child health outcomes. Abbreviations ANC Ante-Natal Care AOR Adjusted Odds Ratio AWHSC Asrat Woldeyes Health Science Campus COR Crude Odds Ratio CI Confidence Interval FP Family Planning HIV Human Immunodeficiency Virus ICPD International Conference on Population Development Km Kilometers MMR Maternal Mortality Ratio MI Male Involvement PMTCT Prevention of-Mother-to-Child Transmission PI Principal Investigator SRH Sexual and Reproductive Health SSA Sub-Saharan Africa TT Tetanus Toxoid WHO World Health Organization Declarations Ethics Approval and Consent to Participate: Before conducting the study, approval was obtained from the Debra Berhan University Asrat Woldeyes Health Science Campus (AWHSC) Ethical Review Board with the approval number Ref.No/NURS/157/2014. Additionally, support letters were obtained from the Debra Berhan University AWHSC Department of Nursing, and permission letters were secured from the Debretabor Health Administration to collect data. Verbal consent was obtained from all study participants prior to data collection, and their confidentiality was strictly maintained throughout the study. Consent for Publication in BMC Pregnancy and Childbirth: We, the undersigned authors of the manuscript entitled Male Engagement in Antenatal Care and Associated Factors among Married Men with Wives Who Recently Gave Birth in Debretabor Town, North West Ethiopia, hereby consent to the publication of our work in BMC Pregnancy and Childbirth. We confirm that all authors have reviewed and approved the final version of the manuscript for submission. We further affirm that the manuscript is original, has not been published previously, and is not under consideration for publication elsewhere. We understand that by providing this consent, we grant BMC Pregnancy and Childbirth the right to publish our manuscript, including any associated supplementary materials, figures, or tables, under the terms of the Creative Commons Attribution License (CC BY). We also acknowledge that BMC Pregnancy and Childbirth may edit the manuscript for clarity and style while preserving its scientific accuracy. We agree to cooperate with the journal's editorial team and respond promptly to any queries or requests for revisions during the publication process. Availability of Data and Materials: The data supporting the findings of this study are available upon request. Interested parties may contact the corresponding author, Abera Lambebo, PhD, at [email protected] , to request access to the data. We will make every effort to provide the data and materials in a timely manner to facilitate further research and validation of our results. Competing Interests: The authors declare that they have no competing interests. Funding: No funding was received by any of the authors for this specific study. Authors' contributions: S.H. and T.M. conceived and designed the study. S.H., T.M., and A.L. conducted the data collection. S.H. and T.M. performed the data analysis and interpretation. S.H., T.M., and A.L. contributed to the writing and revision of the manuscript. All authors read and approved the final manuscript. Acknowledgements; the authors would like to express their gratitude to Debra Berhan University Asrat Woldeyes Health Science Campus (AWHSC) Ethical Review Board for providing the approval for this study (Ref.No/NURS/157/2014). Special thanks to the Department of Nursing at Debra Berhan University AWHSC for their support. The authors also extend their appreciation to the Debretabor Health Administration for granting permission to collect data. Additionally, the authors acknowledge the study participants for their cooperation and consent during the data collection process. Authors' information Solomon Hailemeskel is affiliated with the School of Nursing, Department of Midwives at Debra Berhan University in Debra Berhan, Ethiopia. He can be reached via email at [email protected] . Tirukelem Muhabaw is associated with the School of Nursing, Department of Midwives at Debra Berhan University in Debra Berhan, Ethiopia. For correspondence, please contact via email at [email protected] . Abera Lambebo is affiliated with the School of Public Health, Department of Nutrition at Debra Berhan University in Debra Berhan, Ethiopia. He can be contacted via email at [email protected] . References Organization WH. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization: 2016. Ghabbour SI, United Nations International Conference on Population. and Development (ICPD), held in the International Conference Centre, Cairo, Egypt, during 5–13 September 1994. Environmental Conservation, 1994. 21(3): p. 283–284. Spivak GC. 'Woman'as theatre-United Nations Conference on Women, Beijing 1995-Commentary. Radical philosophy, 1996. 75. Organization WH. WHO recommendations on health promotion interventions for maternal and newborn health. World Health Organization; 2015. Asefa F, Geleto A, Dessie Y. Male partners involvement in maternal ANC care: the view of women attending ANC in Hararipublic health institutions, eastern Ethiopia. Sci J Public Health. 2014;2(3):182–8. Fetene K, et al. Prevalence of male attendance and associated factors at their partners’ antenatal visits among antenatal care attendees in Bale Zone, South East Ethiopia. Int J Nurs Midwifery. 2018;10(9):109–20. Adane HA et al. Prevalence of husband antenatal care attendance and associated factors among husbands whose wives gave birth in the last twelve months in Enebsiesarmider District, Northwest Ethiopia, 2018. Atiibugri JS. Determinants of male involvement in antenatal care in the Bawku municipality. Upper East region Ghana. University of Ghana; 2017. Masaba BB, Mmusi-Phetoe RM. Barriers to and Opportunities for Male Partner Involvement in Antenatal Care in Efforts to Eliminate Mother-to-child Transmission of Human Immunodeficiency Virus in Kenya: Systematic Review. Open Nurs J, 2020. 14(1). Doyle K, Kato-Wallace J. Male engagement in maternal, newborn, and child Health. Sexual reproductive health and rights; 2016. Peneza AK, Maluka SO. Unless you come with your partner you will be sent back home’: strategies used to promote male involvement in antenatal care in Southern Tanzania. Global health action. 2018;11(1):1449724. Tesfaye G, et al. Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study. Women Birth. 2020;33(3):e216–26. WHO, Maternal mortality. 2019. accessed 2021 mar 13. Kumbeni MT et al. Factors influencing male involvement in antenatal care in the Kassena Nankana Municipal in the Upper East Region, Ghana. European Scientific. Kabanga E et al. Prevalence of male partners involvement in antenatal care visits – in Kyela district, Mbeya. BMC Pregnancy and Childbirth, 2019. 19(1): p. 321. Journal, 2019. 15: p. 21. WHO, U. Maternal mortality: Levels and trends 2000 to 2017. Geneva: World Health Organisation; 2019. Demographic ETHIOPIA. and Health Survey. World health organization. Jul; 2017. Ayalew M et al. Determinants of male partner involvement towards prevention of mother to child transmission service utilization among pregnant women who attended focused antenatal care in Southern Ethiopia. HIV/AIDS (Auckland, NZ), 2020. 12: p. 87. Federal Demographic Republic of Ethiopia Central Statistical Agency. Population Projection of Ethiopia for All Regions At Wereda Level from 2014–7. Adamolekun M, Motunrayo AOE. Adewoyin Folasade Rukayat, Ojo Ibironke Cecilia, Yunusa Omowumi Zuwebat., Men’s Knowledge and Attitude Towards Male Involvement in Antenatal Care in Akure South, Ondo State. Afr J Health Nurs Midwifery 2020. 3(3). Gibore NS, Gesase AP. Men in maternal health: an analysis of men’s views and knowledge on, and challenges to, involvement in antenatal care services in a Tanzanian community in Dodoma Region. J Biosoc Sci. 2021;53(6):805–18. Alupo P, et al. Male Partner Involvement. The Utilization Of Antenatal Care Services In Kidera, Buyende District. Uganda: Cross Sectional Mixed Methods Study; 2020. Kariuki KF, Seruwagi GK. Determinants of male partner involvement in antenatal care in Wakiso District, Uganda. Br J Med Med Res. 2016;18(7):1–5. Bishwajit G, et al. Factors associated with male involvement in reproductive care in Bangladesh. BMC Public Health. 2017;17(1):1–8. Ibnu IN, Asyary A. Associated Factors of Male Participation in Antenatal Care in Muaro Jambi District, Indonesia. J Pregnancy, 2022. Ongolly FK, Bukachi SA. Barriers to men's involvement in antenatal and postnatal care in Butula, western Kenya. Afr J Prim health care family Med. 2019;11(1):1–7. Shine S, et al. Magnitude and associated factors of husband involvement on antenatal care follow up in Debre Berhan town. Ethiopia BMC pregnancy childbirth. 2020;20(1):1–7. Umer ZM, Sendo EG. Attitude and Involvement of Male Partner in Maternal Health Care in Addis Ababa, Ethiopia: a Cross-sectional Study, 2021. Mamo ZB et al. Determinants of male partner involvement during antenatal care among pregnant women in Gedeo Zone, South Ethiopia: a case-control study. Annals Global Health, 2021. 87(1). Nwakwuo GC, Oshonwoh FE. Assessment of the level of male involvement in safe motherhood in southern Nigeria. J Community Health. 2013;38(2):349–56. Davis J, et al. Expectant fathers’ participation in antenatal care services in Papua New Guinea: a qualitative inquiry. BMC Pregnancy Childbirth. 2018;18(1):1–13. Dahake S, Shinde R. Exploring husband's attitude towards involvement in his wife's antenatal care in urban slum community of Mumbai. Indian J community medicine: official publication Indian Association Prev Social Med. 2020;45(3):320. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 03 Oct, 2024 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Revision requested 26 Jul, 2024 Reviews received at journal 24 Jul, 2024 Reviewers agreed at journal 24 Jul, 2024 Reviewers agreed at journal 23 Jul, 2024 Reviewers agreed at journal 13 Jul, 2024 Reviews received at journal 21 Jun, 2024 Reviewers agreed at journal 16 Jun, 2024 Reviews received at journal 13 Jun, 2024 Reviewers agreed at journal 12 Jun, 2024 Reviewers agreed at journal 04 Jun, 2024 Reviewers invited by journal 23 May, 2024 Editor assigned by journal 17 May, 2024 Editor invited by journal 07 Mar, 2024 Submission checks completed at journal 07 Mar, 2024 First submitted to journal 01 Mar, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4003285","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":277845450,"identity":"793315ef-428f-4ea3-bfb8-e6ed7c1600ca","order_by":0,"name":"Solomon Hailemeskel","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Solomon","middleName":"","lastName":"Hailemeskel","suffix":""},{"id":277845451,"identity":"a6e7460a-32f4-45c9-bdd2-58c4ba954482","order_by":1,"name":"Tirukelem Muhabaw","email":"","orcid":"","institution":"Debre Berhan University","correspondingAuthor":false,"prefix":"","firstName":"Tirukelem","middleName":"","lastName":"Muhabaw","suffix":""},{"id":277845452,"identity":"789def06-db21-4fb9-b656-9321c475e2a4","order_by":2,"name":"Abera Lambebo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBACPgYGNgbGBob6NvYGINfAgrAWNqgWxn6eAyAtEiRomTkjAcQnRgv76bQHH3fYMBvcfH51w48CCQb+9u4E/Fp4crcbzjyTxmZwO6fsZg/QYRJnzm4g4LDcbdK8bYd5gFrSbvAAtRhI5BLQwv92m/TftsMSBjfPpN38Q5QWCaAtjG2HDSRnsB+7TZwtEm+3G/aeSUvg58lhuy1jIMFD0C/8/LnbHvzcYZPAxn782c03f2zk+Nt78WtBAjwGYJJY5SDA/oAU1aNgFIyCUTCCAACk5kcbncICTQAAAABJRU5ErkJggg==","orcid":"","institution":"Debre Berhan University","correspondingAuthor":true,"prefix":"","firstName":"Abera","middleName":"","lastName":"Lambebo","suffix":""}],"badges":[],"createdAt":"2024-03-01 13:15:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4003285/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4003285/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-024-06809-0","type":"published","date":"2024-10-03T15:57:58+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":52415405,"identity":"76b2fa9e-61e0-43e1-a924-ed3ca9227f45","added_by":"auto","created_at":"2024-03-11 11:38:47","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":128994,"visible":true,"origin":"","legend":"\u003cp\u003eThe overall percentage distributions on the level of male involvement during ANC and associated factors among married men whose wives gave birth within 6 months in Debretabor town, North West Ethiopia, 2023(n=404).\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-4003285/v1/3b2018536c74345c9e3c7a60.jpeg"},{"id":66097443,"identity":"bf2dc2b5-5176-4bcf-88f8-365884ba7540","added_by":"auto","created_at":"2024-10-07 16:14:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":728463,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4003285/v1/5078a56c-ad02-43e3-9f7a-47dbb73fa2bf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Male Engagement in Antenatal Care and Associated Factors among Married Men with Wives Who Recently Gave Birth in Debretabor Town, North West Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAntenatal care (ANC) is a crucial component of maternal and child health, encompassing a spectrum of services provided to pregnant mothers from conception confirmation to the onset of labor. The significance of ANC lies in ensuring optimal health conditions for both the mother and the baby throughout pregnancy, childbirth, and the postnatal period [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Recognizing the importance of male involvement (MI) during ANC, international initiatives like the 1994 International Conference on Population and Development (ICPD) and the World Health Organization (WHO) have emphasized the need for male participation in promoting maternal health [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, a global consensus on the definition and assessment criteria for MI during ANC is yet to be established.\u003c/p\u003e \u003cp\u003eDiverse interpretations of MI during ANC exist, with some focusing solely on the husband's presence at ANC clinics [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In this study, we define MI as the active participation of husbands in both household and facility-level ANC activities. This includes jointly seeking ANC at the facility, collaborative decision-making, and providing financial and physical support during pregnancy [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Recognizing the potential of MI to reduce preventable maternal and child health issues, it is positioned as a pivotal strategy to address delays in seeking care during pregnancy and childbirth [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn many parts of the world, societal norms often designate men, older women, and families as key decision-makers regarding women's health, child health, and primary providers of emotional and financial support [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. African countries, in particular, have observed increased maternal health service utilization with greater male participation in ANC, leading to positive outcomes such as improved knowledge of danger signs, enhanced utilization of skilled birth attendants, and reduced stress and anxiety during labor [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the Ethiopian context, where a predominantly male-dominated society perceives pregnancy and childbirth as solely female responsibilities, male involvement in ANC has been shown to mitigate delays in seeking care during pregnancy and childbirth [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Despite the high maternal mortality rates in the country, male involvement during ANC has not received adequate attention, making it imperative to assess its levels and associated factors in the study area [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe statement of the problem highlights the persistent challenges in maternal health, emphasizing the high rates of maternal mortality and morbidity worldwide, particularly in low and middle-income countries [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Despite global efforts to reduce maternal deaths, underutilization of maternal health services remains a significant obstacle [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Male involvement during ANC emerges as a key driver for improving maternal and child health outcomes, yet it faces challenges due to deeply ingrained perceptions that matters related to pregnancy and childbirth are exclusively women's responsibilities [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe urgency of addressing this problem is underscored by alarming statistics, with 94% of maternal deaths occurring in low and middle-income countries, particularly in Sub-Saharan Africa [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In Ethiopia, where approximately four women die during pregnancy, childbirth, or within two months after childbirth, male involvement during ANC has the potential to contribute significantly to reducing maternal mortality [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, current evidence suggests a lack of active male participation in ANC services, further emphasizing the need for a comprehensive assessment in the study area.\u003c/p\u003e \u003cp\u003eThis study aims to fill the existing research gap by evaluating the level of male involvement during ANC and its associated factors in the specified study area, incorporating additional parameters such as attitude. As we delve into the intricacies of male involvement during ANC, this research seeks to provide valuable insights that can inform targeted interventions and contribute to the global effort to end preventable maternal mortality and morbidity [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e4.1. Study Area\u003c/h2\u003e\n \u003cp\u003eThe study was conducted in Debretabor town, North West Ethiopia which is located in South Gonder Zone of Amhara region, about 100 kilometers (Km) from South East Gonder, 667 Km from Addis Ababa, the capital city of Ethiopia and 97 Km far from Bahirdar the capital of Amhara. The town has one comprehensive specialized hospital, three health centers and six health posts serving the community. There are 6 Kebele and 36, 285 households in the town. Based on 2017, central statistical agency (CSA) of Ethiopia, the town has a general population of 96, 973. Of these, 49, 753 are men and 47, 220 are women [\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e]. According to Debretabor health administration report, of the general population 19, 898 women are in the reproductive age group and 2,194 had history ANC follow up and deliver within 6 months.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design and Period\u003c/h2\u003e\n \u003cp\u003eA community-based cross-sectional study was employed from August to September 2022. \u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eSource Population\u003c/h2\u003e\n \u003cp\u003eAll married men who live in Debretabor town whose wives gave birth within 6 months were the source population.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Population\u003c/h2\u003e\n \u003cp\u003eAll married men who live in randomly selected kebeles whose wives gave birth within 6 months.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Unit\u003c/h2\u003e\n \u003cp\u003eAll randomly selected men\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eEligibility Criteria\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eInclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAll married men who live in the randomly selected kebeles whose wife gave birth within 6 months and had history of ANC utilization were included in the study.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eExclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMen, who can\u0026rsquo;t communicate due to serious illness, had mental disorder at the time of data collection and men who live less than 6 months in the town were excluded from the study.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eSample Size Determination\u003c/h2\u003e\n \u003cp\u003eThe sample size was calculated using single population proportion formula using the assumption of proportion from the study conducted in Bale on prevalence of male attendance and associated factors at ANC was 41.1%[\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003e\u003cimg 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\" style=\"width: 589px;\"\u003e\u003c/p\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;sample size\u003c/p\u003e\n \u003cp\u003ew\u0026thinsp;=\u0026thinsp;marginal error (0.5)\u003c/p\u003e\n \u003cp\u003ez\u0026thinsp;=\u0026thinsp;confidence interval (CI) (95%)\u003c/p\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;proportion of male involvement during ANC (0.411).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003eOperational Definitions\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eMale involvement in ANC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eRefers to seeking ANC together at the facility, getting information from the health provider, decide together about what they do and where to go, provide financial and physical support during pregnancy[\u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e]. It was measured as a composite measure using 6 items, which were equally weighted with dichotomized (yes/ no) components. To obtain the level of male involvement, each variable score \u0026ldquo;1\u0026rdquo; if performed and \u0026ldquo;0\u0026rdquo; if not and a total score was computed for each participant and the level of male involvement was classified as low level of involvement for those who score\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;2 and high level of involvement for those who score\u0026thinsp;\u0026gt;\u0026thinsp;=\u0026thinsp;3[\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude of male involvement in ANC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe Attitude level of the study participants was determined by using attitude assessment questions with 5- point likert scale including \u0026ldquo;agree, strongly agree, disagree, strongly disagree, and neutral. Finally the attitude of participants was labeled based on mean score. Participants who scored greater than or equal to the mean score were considered as having a \u0026ldquo;positive\u0026rdquo; attitude whereas those who score less than the mean score were labeled as having a\u0026ldquo; negative attitude[\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge of ANC service\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe knowledge level of the study participants was determined using knowledge assessment questions. A value of \u0026ldquo;1\u0026rdquo; and \u0026ldquo;0\u0026rdquo; was given for each correct and incorrect answer respectively and labeled as good knowledge and poor knowledge based on the mean score. Those participants who scored greater than or equal to the mean were considered as having \u0026ldquo;good knowledge\u0026rdquo; whereas those who score less than the mean were labeled as having a \u0026ldquo;poor knowledge [\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eData Collection Tools\u003c/h2\u003e\n \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\n \u003ch2\u003eDevelopment:\u003c/h2\u003e\n \u003cp\u003eStructured face-to-face interviewer-administered questionnaires were developed after a thorough review of relevant literature on male involvement in ANC. These questionnaires encompassed socio-demographic characteristics, male involvement in ANC, knowledge about ANC services, attitude and socio-cultural factors, and health facility-related factors.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eImplementation:\u003c/h2\u003e\n \u003cp\u003eTrained personnel, including four male BSc midwives and two health extension workers, were tasked by the principal investigator (PI) with data collection and supervision. The selection of participants was conducted through systematic random sampling following an initial selection by lottery method.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eData Quality Management\u003c/h2\u003e\n \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e\n \u003ch2\u003eTranslation and Validation:\u003c/h2\u003e\n \u003cp\u003eQuestionnaires underwent translation into the local language (Amharic) and subsequent back-translation into English to ensure consistency. Validation by experts in maternal health nursing was conducted, and the reliability of the instruments was assessed using Cronbach\u0026rsquo;s alpha (\u0026alpha;\u0026thinsp;\u0026gt;\u0026thinsp;0.7).\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eTraining and Pretesting:\u003c/h2\u003e\n \u003cp\u003eData collectors and supervisors underwent comprehensive training sessions conducted by the PI. A pretest was performed on a similar population, and questionnaires were scrutinized for completeness based on pretest outcomes.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eDaily Monitoring and Correction:\u003c/h2\u003e\n \u003cp\u003eRegular meetings were convened to address challenges encountered during data collection and to monitor progress. Probing techniques were employed to mitigate recall and social desirability biases.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\n \u003ch2\u003eData Processing and Analysis\u003c/h2\u003e\n \u003cp\u003eData were entered, categorized, and coded using Epi-data version 4.6 and analyzed in SPSS version 25. Descriptive analysis, including frequency and percentage calculations, was performed. Bi-variable and multivariable logistic regression analyses were carried out to ascertain associations. Multicollinearity was assessed using the variance inflation factor (VIF), ensuring values were \u0026lt;\u0026thinsp;1.5 to indicate no correlation between independent variables. Model fit was evaluated using Hosmer-Lemeshow statistics.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n \u003ch2\u003eEthical Consideration\u003c/h2\u003e\n \u003cp\u003ePrior to the study, approval was sought and obtained from the institutional review board, adhering to the principles outlined in the Helsinki Declaration. Support letters and permissions were secured from relevant authorities, and verbal consent was obtained from participants. Measures were implemented to maintain confidentiality and protect participants\u0026apos; rights throughout the study duration.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eResponse Coverage\u003c/h2\u003e \u003cp\u003eIn the study conducted in Debretabor town, North West Ethiopia, a total of 404 study participants were included, yielding a response rate of 98.5%. Six participants were excluded from the analysis. Among the respondents, approximately 46.8% of men showed a high level of involvement in their wives' antenatal care, with a confidence interval (CI) ranging from 41.6\u0026ndash;51.5%.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eSocio-Demographic Characteristics of Respondents\u003c/h2\u003e \u003cp\u003eThe mean age of the respondents was 35.8 years (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7), with the majority falling within the 26\u0026ndash;35 years age group. Regarding religious affiliation, the majority identified as Orthodox Christians. Similarly, most respondents reported being in a monogamous marital status.\u003c/p\u003e \u003cp\u003eIn terms of educational attainment, a notable proportion had received no formal education, while a significant portion were employed in government positions. The educational and employment status of spouses showed a similar trend, with a substantial number of wives being housewives. Additionally, a large percentage reported an average monthly family income exceeding 2000 Ethiopian birr (Table; 1).\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eMen's Involvement in ANC Service on Previous Pregnancy\u003c/h2\u003e \u003cp\u003eAmong respondents whose wives had previous pregnancies, 64.8% reported ANC attendance. Accompanying status showed that 46.6% of men accompanied their wives to previous ANC visits. Additionally, 90.1% of husbands lived with their spouses during pregnancy, and 91.1% of pregnancies were planned (Table; 2).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eLevel of Male Involvement during ANC Care\u003c/h2\u003e \u003cp\u003eWhile 46% of respondents accompanied their wives to ANC clinics, 54% did not, citing reasons such as job constraints and lack of information. Among those who accompanied their wives, the majority engaged in discussions with health providers about pregnancy-related matters and made joint emergency plans with their spouses. Financial and household support during pregnancy was also reported (Table; 3).\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eOverall Level of Male Involvement during ANC\u003c/h2\u003e \u003cp\u003eOverall, only 46.8% of men were highly involved in their wives' ANC services (Figure; 1).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eMen's Knowledge about ANC Service\u003c/h2\u003e \u003cp\u003eApproximately 36.3% of men demonstrated good knowledge about ANC services. Most had heard about ANC and recognized the need for multiple ANC visits during pregnancy. Knowledge about ANC components and their importance was also prevalent among respondents (Table; 4).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003eAttitude of Male Involvement during ANC Service\u003c/h2\u003e \u003cp\u003eA significant proportion of respondents expressed negative attitudes toward male involvement in ANC services, citing reasons such as considering pregnancy solely as a women's affair and societal taboos. However, some acknowledged the acceptability of male involvement in ANC (Table; 5).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eHealth Facility Related Factors\u003c/h2\u003e \u003cp\u003eThe majority of respondents reported positive experiences with health facility staff, minimal waiting times, and invitations to ANC examination rooms. Factors such as friendly staff attitudes and short waiting times contributed to favorable perceptions of health facilities (Table; 6).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003eFactors Associated with Level of Male Involvement during ANC Service\u003c/h2\u003e \u003cp\u003eAfter controlling for potential confounding variables, several factors were found to be significantly associated with male involvement during ANC care. Adjusted Odds Ratios (AORs) were calculated to quantify the strength of association. The following factors emerged as significant predictors:\u003c/p\u003e \u003cp\u003eRespondents with secondary education were 1.5 times more likely to accompany their wives to ANC visits compared to those with no formal education (AOR\u0026thinsp;=\u0026thinsp;1.5, 95% CI: 1.02\u0026ndash;2.22).Similarly, respondents with higher education had 2.3 times higher odds of involvement compared to those with no formal education (AOR\u0026thinsp;=\u0026thinsp;2.3, 95% CI: 1.24\u0026ndash;4.31).Government employees were 1.8 times more likely to accompany their wives to ANC visits compared to those engaged in other occupations (AOR\u0026thinsp;=\u0026thinsp;1.8, 95% CI: 1.04\u0026ndash;3.12).\u003c/p\u003e \u003cp\u003eRespondents with good knowledge about ANC services had 2.5 times higher odds of involvement compared to those with poor knowledge (AOR\u0026thinsp;=\u0026thinsp;2.5, 95% CI: 1.60\u0026ndash;3.92).Men with a positive attitude towards male involvement in ANC services were 2.7 times more likely to accompany their wives compared to those with a negative attitude (AOR\u0026thinsp;=\u0026thinsp;2.7, 95% CI: 1.73\u0026ndash;4.19). Respondents who reported a friendly approach from health facility staff had 1.9 times higher odds of involvement compared to those who did not (AOR\u0026thinsp;=\u0026thinsp;1.9, 95% CI: 1.09\u0026ndash;3.31).Similarly, respondents who reported a waiting time of less than one hour had 1.6 times higher odds of involvement (AOR\u0026thinsp;=\u0026thinsp;1.6, 95% CI: 1.02\u0026ndash;2.48).\u003c/p\u003e \u003cp\u003eAge, religion, marital status, and income were not significantly associated with male involvement during ANC care after adjusting for other variables. (Table; 7)\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, approximately 46.8% (CI: 41.6\u0026ndash;51.5) of male partners exhibited high involvement in their wives' antenatal care (ANC) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Factors such as the husband's educational status, complications during pregnancy, the couple's living situation during pregnancy, the husband's attitude toward male involvement in ANC, and invitation into the ANC room by healthcare professionals significantly influenced male involvement.\u003c/p\u003e \u003cp\u003eThe observed rate of male involvement (46.8%) aligns closely with findings from a study in Buyende District, Uganda (51.1%) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. this similarity could stem from comparable assessment parameters and the socio-demographic characteristics of the respondents, notably the educational level of husbands.\u003c/p\u003e \u003cp\u003eIn contrast, our study's result surpasses findings from Wakiso District, Uganda (6%), Harari (19.7%), and North West Ethiopia (31.8%) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. This disparity might be attributed to advancements in the Ethiopian healthcare system, emphasizing maternal, newborn, and child health. Additionally, differences in study settings, timeframes, and populations could contribute to variations in reported male involvement.\u003c/p\u003e \u003cp\u003eConversely, our study reports lower male involvement compared to studies in Bangladesh (60%), Indonesia (81.4%), western Butula of Kenya (55.5%), Kyela District of Tanzania (56.9%), Addis Ababa (65.5%), and Debre Berhan (62.5%) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Socio-demographic disparities and differences in infrastructure availability and accessibility may account for these discrepancies. Moreover, strategies like mandatory husband accompaniment in some African countries could influence higher involvement rates.\u003c/p\u003e \u003cp\u003eRegarding independent variables, attending secondary education or holding a diploma and above increased the odds of male involvement by approximately 4 and 4.2 times, respectively [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. This finding aligns with similar studies in Nigeria, Bale, and North West Ethiopia, suggesting that education enhances knowledge and coping abilities, potentially enabling husbands to better understand their role in pregnancy.\u003c/p\u003e \u003cp\u003eMen whose wives experienced pregnancy complications showed a significantly higher likelihood of involvement, with odds nearly 7 times greater than those whose wives did not face complications [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. This may be attributed to increased awareness and counseling on pregnancy danger signs, prompting proactive involvement in ANC.\u003c/p\u003e \u003cp\u003eCouples not living with other family members during pregnancy were about 4.5 times more likely to engage in ANC. This could be due to cultural norms assigning responsibility for pregnancy and delivery care to other family members, potentially deterring male involvement.\u003c/p\u003e \u003cp\u003eThe absence of an invitation for the male partner to enter the ANC examination room reduced the odds of involvement by 63% [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Supportive healthcare workers have been shown to encourage male involvement during ANC, suggesting the importance of healthcare provider attitudes in facilitating participation.\u003c/p\u003e \u003cp\u003eFinally, respondents with a positive attitude toward male involvement were over 2.4 times more likely to engage compared to those with a negative attitude [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Positive attitudes may encourage consistent support for ANC utilization and enhance maternal healthcare outcomes.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusions;\u003c/b\u003e In conclusion, this study underscores the importance of promoting male involvement in antenatal care (ANC). Factors such as education, pregnancy complications, living arrangements, attitude, and healthcare provider interaction significantly influence male participation. To enhance involvement, targeted educational campaigns, active engagement by healthcare providers, and community-based initiatives promoting positive attitudes toward male involvement are recommended. These efforts can lead to improved maternal and child health outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnte-Natal Care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAWHSC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAsrat Woldeyes Health Science Campus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCrude Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence Interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFamily Planning\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman Immunodeficiency Virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICPD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInternational Conference on Population Development\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKm\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKilometers\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMMR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMaternal Mortality Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMale Involvement\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePMTCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrevention of-Mother-to-Child Transmission\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrincipal Investigator\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSRH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSexual and Reproductive Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSub-Saharan Africa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTetanus Toxoid\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate:\u0026nbsp;\u003c/strong\u003eBefore conducting the study, approval was obtained from the Debra Berhan University Asrat Woldeyes Health Science Campus (AWHSC) Ethical Review Board with the approval number Ref.No/NURS/157/2014. Additionally, support letters were obtained from the Debra Berhan University AWHSC Department of Nursing, and permission letters were secured from the Debretabor Health Administration to collect data. Verbal consent was obtained from all study participants prior to data collection, and their confidentiality was strictly maintained throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication in BMC Pregnancy and Childbirth:\u0026nbsp;\u003c/strong\u003eWe, the undersigned authors of the manuscript entitled Male Engagement in Antenatal Care and Associated Factors among Married Men with Wives Who Recently Gave Birth in Debretabor Town, North West Ethiopia, hereby consent to the publication of our work in BMC Pregnancy and Childbirth.\u003c/p\u003e\n\u003cp\u003eWe confirm that all authors have reviewed and approved the final version of the manuscript for submission. We further affirm that the manuscript is original, has not been published previously, and is not under consideration for publication elsewhere.\u003c/p\u003e\n\u003cp\u003eWe understand that by providing this consent, we grant BMC Pregnancy and Childbirth the right to publish our manuscript, including any associated supplementary materials, figures, or tables, under the terms of the Creative Commons Attribution License (CC BY).\u003c/p\u003e\n\u003cp\u003eWe also acknowledge that BMC Pregnancy and Childbirth may edit the manuscript for clarity and style while preserving its scientific accuracy. We agree to cooperate with the journal\u0026apos;s editorial team and respond promptly to any queries or requests for revisions during the publication process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials:\u0026nbsp;\u003c/strong\u003eThe data supporting the findings of this study are available upon request. Interested parties may contact the corresponding author, Abera Lambebo, PhD, at\u0026nbsp;\u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e , to request access to the data. We will make every effort to provide the data and materials in a timely manner to facilitate further research and validation of our results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNo funding was received by any of the authors for this specific study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e S.H. and T.M. conceived and designed the study. S.H., T.M., and A.L. conducted the data collection. S.H. and T.M. performed the data analysis and interpretation. S.H., T.M., and A.L. contributed to the writing and revision of the manuscript. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements;\u003c/strong\u003e the authors would like to express their gratitude to Debra Berhan University Asrat Woldeyes Health Science Campus (AWHSC) Ethical Review Board for providing the approval for this study (Ref.No/NURS/157/2014). Special thanks to the Department of Nursing at Debra Berhan University AWHSC for their support. The authors also extend their appreciation to the Debretabor Health Administration for granting permission to collect data. Additionally, the authors acknowledge the study participants for their cooperation and consent during the data collection process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSolomon Hailemeskel is affiliated with the School of Nursing, Department of Midwives at Debra Berhan University in Debra Berhan, Ethiopia. He can be reached via email at\u0026nbsp;\u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTirukelem Muhabaw is associated with the School of Nursing, Department of Midwives at Debra Berhan University in Debra Berhan, Ethiopia. For correspondence, please contact via email at\u0026nbsp;\u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAbera Lambebo is affiliated with the School of Public Health, Department of Nutrition at Debra Berhan University in Debra Berhan, Ethiopia. He can be contacted via email at\u0026nbsp;\u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrganization WH. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization: 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhabbour SI, United Nations International Conference on Population. and Development (ICPD), held in the International Conference Centre, Cairo, Egypt, during 5\u0026ndash;13 September 1994. Environmental Conservation, 1994. 21(3): p. 283\u0026ndash;284.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSpivak GC. 'Woman'as theatre-United Nations Conference on Women, Beijing 1995-Commentary. Radical philosophy, 1996. 75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization WH. WHO recommendations on health promotion interventions for maternal and newborn health. World Health Organization; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsefa F, Geleto A, Dessie Y. Male partners involvement in maternal ANC care: the view of women attending ANC in Hararipublic health institutions, eastern Ethiopia. Sci J Public Health. 2014;2(3):182\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFetene K, et al. Prevalence of male attendance and associated factors at their partners\u0026acirc;\u0026euro;\u0026trade; antenatal visits among antenatal care attendees in Bale Zone, South East Ethiopia. Int J Nurs Midwifery. 2018;10(9):109\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdane HA et al. Prevalence of husband antenatal care attendance and associated factors among husbands whose wives gave birth in the last twelve months in Enebsiesarmider District, Northwest Ethiopia, 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAtiibugri JS. Determinants of male involvement in antenatal care in the Bawku municipality. Upper East region Ghana. University of Ghana; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMasaba BB, Mmusi-Phetoe RM. Barriers to and Opportunities for Male Partner Involvement in Antenatal Care in Efforts to Eliminate Mother-to-child Transmission of Human Immunodeficiency Virus in Kenya: Systematic Review. Open Nurs J, 2020. 14(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDoyle K, Kato-Wallace J. Male engagement in maternal, newborn, and child Health. Sexual reproductive health and rights; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeneza AK, Maluka SO. Unless you come with your partner you will be sent back home\u0026rsquo;: strategies used to promote male involvement in antenatal care in Southern Tanzania. Global health action. 2018;11(1):1449724.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTesfaye G, et al. Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study. Women Birth. 2020;33(3):e216\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO, Maternal mortality. 2019. accessed 2021 mar 13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumbeni MT et al. Factors influencing male involvement in antenatal care in the Kassena Nankana Municipal in the Upper East Region, Ghana. European Scientific.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKabanga E et al. Prevalence of male partners involvement in antenatal care visits \u0026ndash; in Kyela district, Mbeya. BMC Pregnancy and Childbirth, 2019. 19(1): p. 321. Journal, 2019. 15: p. 21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO, U. Maternal mortality: Levels and trends 2000 to 2017. Geneva: World Health Organisation; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemographic ETHIOPIA. and Health Survey. World health organization. Jul; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAyalew M et al. Determinants of male partner involvement towards prevention of mother to child transmission service utilization among pregnant women who attended focused antenatal care in Southern Ethiopia. HIV/AIDS (Auckland, NZ), 2020. 12: p. 87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFederal Demographic Republic of Ethiopia Central Statistical Agency. Population Projection of Ethiopia for All Regions At Wereda Level from 2014\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdamolekun M, Motunrayo AOE. Adewoyin Folasade Rukayat, Ojo Ibironke Cecilia, Yunusa Omowumi Zuwebat., Men\u0026rsquo;s Knowledge and Attitude Towards Male Involvement in Antenatal Care in Akure South, Ondo State. Afr J Health Nurs Midwifery 2020. 3(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGibore NS, Gesase AP. Men in maternal health: an analysis of men\u0026rsquo;s views and knowledge on, and challenges to, involvement in antenatal care services in a Tanzanian community in Dodoma Region. J Biosoc Sci. 2021;53(6):805\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlupo P, et al. Male Partner Involvement. The Utilization Of Antenatal Care Services In Kidera, Buyende District. Uganda: Cross Sectional Mixed Methods Study; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKariuki KF, Seruwagi GK. Determinants of male partner involvement in antenatal care in Wakiso District, Uganda. Br J Med Med Res. 2016;18(7):1\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBishwajit G, et al. Factors associated with male involvement in reproductive care in Bangladesh. BMC Public Health. 2017;17(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbnu IN, Asyary A. Associated Factors of Male Participation in Antenatal Care in Muaro Jambi District, Indonesia. J Pregnancy, 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOngolly FK, Bukachi SA. Barriers to men's involvement in antenatal and postnatal care in Butula, western Kenya. Afr J Prim health care family Med. 2019;11(1):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShine S, et al. Magnitude and associated factors of husband involvement on antenatal care follow up in Debre Berhan town. Ethiopia BMC pregnancy childbirth. 2020;20(1):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUmer ZM, Sendo EG. Attitude and Involvement of Male Partner in Maternal Health Care in Addis Ababa, Ethiopia: a Cross-sectional Study, 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMamo ZB et al. Determinants of male partner involvement during antenatal care among pregnant women in Gedeo Zone, South Ethiopia: a case-control study. Annals Global Health, 2021. 87(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNwakwuo GC, Oshonwoh FE. Assessment of the level of male involvement in safe motherhood in southern Nigeria. J Community Health. 2013;38(2):349\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavis J, et al. Expectant fathers\u0026rsquo; participation in antenatal care services in Papua New Guinea: a qualitative inquiry. BMC Pregnancy Childbirth. 2018;18(1):1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDahake S, Shinde R. Exploring husband's attitude towards involvement in his wife's antenatal care in urban slum community of Mumbai. Indian J community medicine: official publication Indian Association Prev Social Med. 2020;45(3):320.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Antenatal care, Male involvement, Attitude, Knowledge, Debretabor town","lastPublishedDoi":"10.21203/rs.3.rs-4003285/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4003285/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eGlobally, maternal mortality remains a critical issue, with male involvement during antenatal care (ANC) recognized as pivotal in reducing maternal deaths. Limited evidence on male involvement exists in low and middle-income countries, including Ethiopia. This study aimed to assess male involvement during antenatal care and associated factors among married men whose wives gave birth within the last 6 months in Debretabor town, North West Ethiopia in 2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eEvaluate the level of male involvement during antenatal care and identify associated factors in the specified study area.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eA community-based cross-sectional study involved 404 married men, whose wives had given birth within the past 6 months in Debretabor town. Data were collected using face-to-face interviews, entered into EpiData version 4.6, and analyzed using SPSS version 25. Logistic regression analyses determined associations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eMale involvement during antenatal care in the study area was 46.8% (CI: 41.6, 51.5). Factors influencing involvement included men's attitude (AOR=2.365), lack of male invitation to the examination room (AOR=0.370), couples' living status (AOR=4.461), men with secondary education (AOR=4.052), men with diploma and above (AOR=4.276), and complications during pregnancy (AOR=6.976).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and Recommendation:\u003c/strong\u003e The observed low level of male involvement underscores the need for targeted interventions. Stakeholders should promote male participation through counseling, community mobilization, and awareness campaigns.\u003c/p\u003e","manuscriptTitle":"Male Engagement in Antenatal Care and Associated Factors among Married Men with Wives Who Recently Gave Birth in Debretabor Town, North West Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-11 11:38:42","doi":"10.21203/rs.3.rs-4003285/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-26T16:28:24+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-24T15:47:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"275178389541006892760202941915872682191","date":"2024-07-24T14:26:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"133555331850058205859114603440178092501","date":"2024-07-23T19:04:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"178905997641002121279048817367389787949","date":"2024-07-13T18:48:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-21T11:34:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"284044582125377164700783171519484073154","date":"2024-06-16T10:00:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-14T03:46:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"211115359112093315651608816835534200985","date":"2024-06-12T05:03:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110064672439544836453929340987171266395","date":"2024-06-04T23:54:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-23T07:48:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-17T06:45:58+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-03-07T08:06:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-07T07:53:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2024-03-01T13:05:19+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"11f558c1-a0d9-40be-bd6b-02408c385c87","owner":[],"postedDate":"March 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-10-07T16:08:19+00:00","versionOfRecord":{"articleIdentity":"rs-4003285","link":"https://doi.org/10.1186/s12884-024-06809-0","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2024-10-03 15:57:58","publishedOnDateReadable":"October 3rd, 2024"},"versionCreatedAt":"2024-03-11 11:38:42","video":"","vorDoi":"10.1186/s12884-024-06809-0","vorDoiUrl":"https://doi.org/10.1186/s12884-024-06809-0","workflowStages":[]},"version":"v1","identity":"rs-4003285","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4003285","identity":"rs-4003285","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}