Husbands' Involvement in Maternal Care Research - Rural Maharashtra, India

Since 1999, ICRW has been collaborating with partners in India on multi-site intervention studies on adolescent reproductive health in India. The study by FRHS (1999-2005) examines the roles of community mobilisation and improved quality of government services in increasing young married women's use of reproductive health services. The team is using a 2x2 experimental research design across 4 Primary Health Center areas and a variety of qualitative and quantitative methods to explore the constraints, attitudes of women, their families and their communities, and best approaches to increase use of reproductive health services by adolescents and youth. In this process, FRHS is working with married women under 22 years of age, their husbands and mothers-in-law, community-based organisations, and village- and district-level government health workers.

Specifically, FRHS researchers began by examining patterns of husbands' participation in health seeking for their adolescent wives' antenatal, delivery, and postnatal care. Pre-intervention qualitative interviews were conducted among 207 young women, their husbands, marital families, and health providers. A census of 1,866 married women under 22 years old was conducted in 22 villages in 2001, with a follow-up survey of 972 husbands of these women.

Youth, Women, Gender, Reproductive Health Care.

Organisers say that, since the International Conference on Population and Development, the reproductive health field has begun paying more attention to men's roles in women's reproductive health. However, they claim, much of the research has overlooked adolescents.

Here is a summary of the research findings:

• Young couples experience pregnancy and childbearing in a context of early marriage (the mean age at marriage is 23 years for men and 16 years for women), social pressure for early childbearing (86% of the wives of sample husbands reported at least one pregnancy by the age of 22), and restricted mobility and decision-making for young women
• Men know about maternal care: more than two-thirds are aware of the need for antenatal, delivery, and postnatal care and feel responsible to accompany their wives and pay for routine care and treatment of problems. Interviews revealed that, although they may not know medical details, husbands express a desire to help their wives follow treatment advice, and are concerned about nutrition and other care within the home environment.
• However, high awareness and sense of responsibility do not translate into participation: only about half the husbands accompanied wives for routine care. Husbands are, however, more likely to be present for care of problems.
• Beliefs that maternity is a "woman's issue", as well as attitudes and conditions in the health centres, contribute to this lack of involvement. For example, beliefs on the part of health clinic staff mean that even husbands who accompany their wives to clinics are often made to wait outside.

Researchers found that men who were better educated, married later, and whose wives were educated and were older when they married knew more about and were more likely to participate in antenatal, delivery, or postnatal phases of care. Many of the men surveyed were first-time fathers-to-be and were less likely to know about care and problems than their peers whose wives had been pregnant in the past. Husbands who accompany their wives for routine care in one phase of maternity are more likely to accompany them for treatment of problems or for care in other phases.