Development of a Facility-Based Intervention Model on Male Partner Involvement in Maternal and Neonatal Health in A Public Health Facility, Kiambu County, Kenya

Abstract

The 1994 International Conference on Population and Development (ICPD) emphasized the need for men to actively participate in sexual and reproductive health. However, male partner involvement in maternal, newborn and child health (MNCH) in Kenya remains limited. This study aimed to develop, implement, and evaluate the effectiveness of a facility-based intervention model to promote male partner involvement (MPI) in maternal and neonatal health at Thika County and Referral Hospital. An exploratory sequential mixed-methods design was employed. The qualitative phase involved three focus group discussions (FGDs) with nurses and two FGDs with male partners to explore barriers and enablers to male involvement. Thematic analysis was conducted using MAXQDA 2022 software, which revealed key themes including limited awareness, traditional gender norms, and logistical constraints as major barriers. These insights informed the design of a structured health facility-based intervention, tested using a quasi-experimental pre-test/post-test design. Ethical approval was sought from Jomo Kenyatta University of Agriculture and Technology (Ref. No. JKU/ISERC/02316/1113) and informed consent from participants. A total of 60 women (30 intervention, 30 control) between 17–28 weeks’ gestation were recruited via systematic random sampling. Male partners in the intervention group received formal invitations to attend antenatal care (ANC) and were followed through six months postpartum. Quantitative data were collected using pre tested semi-structured questionnaires and analysed using SPSS v27.0. Statistical tests included chi-square, Fisher’s exact test, and Mann–Whitney U test, with a significance threshold of p < 0.05. The primary outcome male accompaniment to ANC was significantly higher in the intervention group (U = 11.000, p < 0.001), with a large effect size (r = 0.98). Significant improvements were also observed in male support during pregnancy and childbirth (p < 0.001), knowledge of danger signs in pregnancy (p < 0.001), awareness of exclusive breastfeeding recommendations (p = 0.005), and uptake of couple HIV counselling and testing (p < 0.001). These findings demonstrate that a context-specific, structured, facility-based intervention model can effectively enhance male partner involvement in MNCH and contribute to improved maternal and infant health outcomes. This study recommends that the National and County governments should consider adapting the intervention model to promote MPI in MNCH services.