Online Program

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

Sunday, November 1, 2015

George Kimathi, Dr., Community Health Programme, Africa Medical and Research Foundation (AMREF) Kenya, Nairobi, Kenya
Johnpaul Oyore, Dr., School of Public Health, Kenyatta University, Nairobi, Kenya
Isaac Mwanzo, Dr., School of Public Health, Kenyatta University, Nairobi, 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.

Learning Areas:

Administration, management, leadership
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe individual, programmatic and health system determinants of Constructive Men's Engagement (CME) in Reproductive Health. Identify potential ways to enhance Constructive Men's Engagement (CME) in Reproductive Health within low income populations.

Keyword(s): Reproductive Health, Men’s Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator for this study as part of my PhD thesis. Further, I have designed, implemented and evaluated community health programs in Africa for over 15 years with a focus on enhancing Constructive Men's Engagement (CME) for optimal health outcomes. I currently oversee 8 integrated maternal and child health projects spanning over 15 counties, besides supervising Masters and Doctorate students at the School of Public Health, Kenyatta University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.