Male engagement as a strategy to improve utilization and community-based delivery of maternal, newborn and child health services: evidence from an intervention in Odisha, India.
Male engagement as a strategy to improve utilization and community-based delivery of maternal, newborn and child health services: evidence from an intervention in Odisha, India.
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DOI：
10.1186/1472-6963-15-s1-s5
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发表时间：
2015
影响因子：
2.8
通讯作者：
Mohanty S
中科院分区：
文献类型：
--
作者：
Fotso JC;Higgins-Steele A;Mohanty S
针对印度农村地区孕产妇、新生儿和儿童健康水平持续低下的问题，启动了国家农村卫生使命，以支持在贫困和服务不足的社区提供可获得、负担得起和高质量的保健服务。经认可的社会保健积极分子（ASHA），即当地妇女，接受培训，成为保健宣传员，以产生需求，并促进其社区获得孕产妇和新生儿保健服务。虽然也期望它们向孕妇的丈夫提供有关孕产妇、新生儿和儿童保健和计划生育的信息，但它们对丈夫的影响有限。本研究的目的是描述的影响，男性参与项目的利用和社区为基础的提供MNCH护理在农村地区的国家。我们使用了一个项目的评估定性数据，该项目招募和培训了男性社区卫生工作者（CHW），称为男性健康活动家（MHA），以补充ASHA的工作，并将目标扩展到男性。本文使用的数据从深度访谈（IDIs）与ASHA（n=11），Anganwadi工人（AWWs）（n=4）和辅助护士助产士（ANMs）（n=2）;与妇女谁曾在家里，社区卫生中心或区医院在几个月前的采访日期（n=11）;和这些妇女的丈夫（n=7）。与会者的答复大致围绕着MHA促进ASHA的工作以及MHA开展的男性参与活动。更具体地说，这些说明反映了在提供和使用孕产妇和新生儿保健服务的三个核心领域中基于性别的分工和空间：护送妇女到保健中心进行设施分娩;动员妇女和儿童参加村庄保健和营养日和免疫日;提高男子对孕产妇和新生儿保健和计划生育的认识。这项研究揭示了男性参与作为一项战略，以改善提供，获得和孕产妇，新生儿和儿童健康的背景下，在印度农村普遍存在的性别规范和性别角色。最后，它揭示了男性和女性社区卫生工作者在以社区为基础的孕产妇和新生儿保健服务提供和需求增加方面的互补性。
In response to persistently poor levels of maternal, newborn and child health (MNCH) in rural India, the National Rural Health Mission (NRHM) was launched to support the provision of accessible, affordable and quality health care in deprived and underserved communities. The Accredited Social Health Activists (ASHAs), local women, are trained as health promoters to generate demand for, and facilitate access to MNCH care in their communities. While they are also expected to provide husbands of expectant women with information on MNCH care and family planning, their reach to the husbands is limited. The aim of this study is to describe the influence of a male engagement project on the utilization and community-based delivery of MNCH care in a rural district of the country. We used qualitative data from the evaluation of a project which recruited and trained male Community Health Workers (CHWs) known as Male Health Activists (MHAs) to complement the work of ASHAs and target outreach to men. This paper uses data from in-depth interviews (IDIs) with ASHAs (n=11), Anganwadi Workers (AWWs) (n=4) and Auxiliary Nurse Midwives (ANMs) (n=2); with women who had delivered at home, community health center or district hospital in the few months preceding the date of the interview (n=11); and with husbands of these women (n=7). Participants’ responses are broadly organized around the facilitation of ASHAs’ work by MHAs, and male engagement activities undertaken by MHAs. More specifically, the narratives reflected gender-based divisions of work and space in three core areas of delivery and use of MNCH services: escorting women to health centers for facility-based deliveries; mobilizing women and children to attend Village Health and Nutrition Days and Immunization Days; and raising awareness among men on MNCH and family planning. This study sheds light on male engagement as a strategy to improve the delivery, access and uptake of maternal, newborn and child health in the context of prevailing gender norms and gendered roles in rural India. Ultimately, it unveils the complementarity of male and female CHWs in the community-based delivery of, and increased demand for, MNCH services.