Health systems influences on male involvement in maternal and child health in Ghana
Abstract
Background: Men's involvement in maternal and child health (MCH) is a major influential
factor in the use of recommended MCH services. Men’s lack of engagement with MCH services
is as a result of a confluence of sociodemographic, cultural and health system factors. However,
as Ghana makes strides to enhance greater men's involvement in MCH, it is crucial to understand
also how the health system impacts on this agenda as there has been robust research on the other
factors. Using an adaptation of the Van Omen et al. (2010) health systems framework, this study
sought to assess the influences of the health system on male involvement in MCH. Further, the
study proposed recommendations based on emerging findings.
Methods: A desk-based review of peer-reviewed articles and published dissertations available
from Scopus, PubMed, Google scholar, NCBI, CINAHL, Science Direct, BioMed Central as
well as grey literature from other relevant sources was conducted; literature selected was
published between 1994 and 2020 on male involvement in MCH in Ghana. A total of seventeen
peer-reviewed articles, one grey literature and five dissertations were used for final review.
Results: The study revealed that the poor quality of service delivery (such as delays in service
delivery, inaccessibility to particular services), inefficient distribution of service providers and
underfunding of the health sector negatively influence men's decision to engage in MCH.
Interactions with service providers and reception at the facility also impacted on decision making
for men to engage in MCH. However, fast track services for couples and the CHPS initiative
were general positive influencers. Further, contextual factors such as the availability of TBA's
and a support system truncated men's attempt to partake in MCH.
Conclusion: Towards greater men's involvement in MCH in Ghana, efforts should be
channelled into improving funding for the NHIS/FMHCP, and the quality of service delivery by
addressing staff attitudes and the equal distribution of staff across the country. Generating
context-specific evidence is likely to result in positive outcomes for men's involvement in MCH
as a short term initiative.
KEYWORDS: Men’s involvement, Health system, Maternal and child health, Ghana.