Barriers and facilitators to father involvement in early child health services: A qualitative study in rural Mozambique
Barriers and facilitators to father involvement in early child health services: A qualitative study in rural Mozambique
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DOI：
10.1016/j.socscimed.2021.114363
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发表时间：
2021-09-06
影响因子：
5.4
通讯作者：
Yousafzai, Aisha K.
中科院分区：
文献类型：
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作者：
Jeong, Joshua;Ahun, Marilyn N.;Yousafzai, Aisha K.
使男子参与并增加他们作为伴侣和父母的参与，可以改善儿童的健康和发展。尽管关于父亲参与和照料的全球证据和宣传越来越多，但促进幼儿健康的父亲包容性干预措施仍然很少，特别是在低收入和中等收入国家的初级卫生系统内。在这项研究中，我们从社区角度探讨了父亲在生命最初三年的早期儿童健康服务中的作用，以确定莫桑比克北部农村Monapo区的父亲参与的障碍和促进因素。在2020年10月至11月进行的定性干预实施评估中嵌入了一项定性子研究。对36名护理人员、15名保健设施提供者、12名社区保健提供者、4名政府官员和7个非政府伙伴组织进行了深入访谈。采用归纳主题内容分析法对数据进行分析。结果显示，父亲一般不参与早期儿童保健服务。父亲参与的主要障碍包括许多家庭中没有父亲；与父亲陪同子女前往卫生机构有关的机会成本；在设施轮候时间过长；保健提供者对父亲的消极态度；以及男权性别规范。受访者还强调了父亲参与的促进因素，包括父亲在家中更广泛地参与孩子的活动；父亲支持伴侣的愿望；父母对父亲参与儿童保健重要性的认识；以及直接针对父亲的社区外展和宣传活动。我们的研究强调了加强儿童保健服务的重点、设计和提供的机会，以便使这些服务更具包容性和对父亲作出反应。未来的研究应评估以父亲为中心的儿童健康干预措施对照料和早期儿童健康和发展结果的可行性、可接受性和有效性。这些战略不仅应全面处理个人和家庭因素，而且还应处理卫生系统和社区一级更广泛的结构和社会文化决定因素。
Engaging men and increasing their involvement as partners and parents can improve child health and development. Despite the increasing global evidence and advocacy around father involvement and caregiving, there remain few father-inclusive interventions for promoting early child health, especially within primary health systems in low- and middle-income countries. In this study, we explored community perspectives regarding fathers' roles in early child health services during the first three years of life to identify the barriers and facilitators to father involvement in Monapo District in northern, rural Mozambique. A qualitative sub-study was embedded within a qualitative intervention implementation evaluation conducted in October-November 2020. In-depth interviews were conducted with 36 caregivers, 15 health facility providers, 12 community health providers, 4 government officials, and 7 non-governmental partner organizations. Data were analyzed using inductive thematic content analysis. Results revealed that fathers were generally uninvolved in early child healthcare services. Primary barriers to fathers' involvement included the absence of fathers in many households; opportunity costs associated with fathers' accompanying children to health facilities; long waiting times at facilities; negative health provider attitudes towards fathers; and patriarchal gender norms. Respondents also highlighted facilitators of father involvement, which included fathers' broader engagement with their child at home; fathers' desires to support their partners; parental awareness about the importance of father involvement in child healthcare; and community outreach and sensitization campaigns targeting fathers directly. Our study highlights opportunities for enhancing the focus, design, and delivery of child health services so that they are more inclusive and responsive to fathers. Future research should assess the feasibility, acceptability, and effectiveness of father-focused child health interventions on caregiving and early child health and development outcomes. These strategies should holistically address not only individual and household factors, but also broader structural and sociocultural determinants at the health system and community levels.