Determinants of Constructive Men's Engagement (CME) in Reprodutive Health in Makindu and Mutitu Sub-counties of Kenya

Kenya’s MMR has worsened from 414 (2003) to 488 (2009). Men play cardinal and dominant roles in reproductive health (RH) though enhancing their participation is sub-optimal. This study assessed individual, programmatic and healthcare provider determinants of Constructive Men’s Engagement (CME) in RH. An interventional quasi-experimental design was applied with 968 men and 32 nurses participating. A GEM Scale for CME-RH was applied to establish its levels among respondents. At pre-test, Makindu and Mutitu had 43.4% and 44.6% of men who had CME-RH respectively. However Makindu recorded 60.3%, while Mutitu had only 47.1% of men who were CME-RH compliant at post-test. Education level OR= 2.095 (0.902- 4.839) p=0.004, monthly income OR= 1.802 (1.329 -2.506) p<0.001, ANC attendance knowledge OR =1.738 (1.239 - 2.925) p=0.008 and knowledge of FP methods OR= 0.733 (0.579 - 0.968) p=0.043 were identified as independent predictors of CME-RH. Spousal approval for use of FP OR= 1.316 (0.06 - 2.296) p=0.002 as well as approval for access to FP services by young unmarried couples OR= 2.881 (1.783 - 5.271) p<0.001 were also significant. Programmatic predictors of CME-RH included having male-only RH sessions OR= 1.094 (0.766 - 1.703) p=0.015, limited confidentiality among ANC/MCH staff OR=1.297 (0.793 - 2.237) p=0.016 and minimal involvement of men OR=1.963 (1.289 - 2.19) p=0.003.    Capacity of healthcare providers also influenced CME-RH.  CME-RH should be prioritized with a multi-sectoral approach to RH while ensuring staff at ANC/MCH clinics observe confidentiality.  Men must be engendered to play seminal roles at household and community level.