Health systems influences on male involvement in maternal and child health in Ghana
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.