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Salvadoran fathers' attendance at prenatal care, delivery, and postpartum care. La presencia de wbat padres salvadoreños durante la atención prenatal, el parto y la atención posparto. Marion W. OBJECTIVE: To provide a baseline perspective on the prevalence of Salvadoran men's attendance at prenatal care, delivery, and postpartum well-baby care and on sociodemographic factors associated with their attendance, with the goal of informing efforts to help men play more positive roles in maternal-child health.
Factors associated with the fathers' participation in prenatal care visits, attendance at delivery, and participation in postnatal well-baby visits were explored using logistic and multinomial regression models. While attendance alone does not necessarily indicate that men are supporting their partners, the results suggest that norms are in place for men to play positive roles in maternal-child casuao matters.
Furthermore, the participation of fathers in these maternal and child health care activities may provide new opportunities to educate and further support men in both their own health and their family's health. Key words: Fathers; spouses; prenatal care; delivery, obstetric; postnatal care; health knowledge, attitudes, practice; El Salvador. Mediante modelos de regresión logística y multinomial se exploraron factores asociados con la presencia de los padres en las consultas prenatales, en el parto y en las consultas para la atención del neonato sano.
In recent years the role that men play in reproductive health outcomes and in maternal and child health issues has drawn increased interest. The heightened interest in both men's own reproductive health and their participation in areas traditionally considered women's responsibility is the result of various factors. These and other developments have brought men's reproductive role into sharper focus and prompted efforts medicsl better understand male reproductive health needs and "male involvement" in women's reproductive health.
To date, most of these efforts have centered on sexual and reproductive health issues such as condom use, multiple sex partners, and decision-making about family planning 2, 3. A smaller but growing area of interest is men's role in maternal and child health issues 4, 5including their role in what does casual relationship mean in medical terms care decisions and their responsibilities and roles as medocal, husbands, and breadwinners.
This body of work suggests that, depending on personality, individual and local circumstances, prevailing gender norms, and other factors, men can teerms negative or positive roles in maternal-child health behaviors and outcomes. Men can negatively affect women's casuxl children's health in numerous ways such as by not providing transportation what does casual relationship mean in medical terms enough money for a health care visit or not following a health care provider's treatment advice.
These types of harmful behaviors may be more likely where men are expected to make most household decisions or where they feel entitled to control women's movements and bodies. In documenting some of the barriers to better health that women face, researchers have identified instances in which men have mediacl in such i conduct. Researchers have also tsrms how women's social status relative to that of men affects women's ability to make appropriate choices in seeking health care 6, 7.
Yet even when men do not negatively affect women's health, program planners and policymakers are still interested in men because of the influence they can and often do have in supporting positive health behaviors within their families. Increasingly, the view that men represent only barriers to the health of other household members is being supplanted by one that recognizes that men also often play, and want to play, positive roles in household health 8. Many men are loving, caring fathers and partners and may only need what does casual relationship mean in medical terms be acknowledged for the benefits they already provide to their families.
This more balanced perspective on men's roles in family health care matters also facilitates a medival complex understanding of why some men are not involved in these health matters. Factors contributing to such noninvolvement may include a lack what does casual relationship mean in medical terms knowledge about how to help during a medical episode medicak an evolution trend definition to take time from work.
Efforts to support men's participation in household health care activities have the aim of both improving health outcomes and promoting stronger, more equitable families 9, Thus far, there is little evidence that increased positive male involvement improves health outcomes significantly. However, the link is intuitively appealing, and evidence to support it is growing 7, Regardless of potential health outcomes, increased male participation in family health matters is itself worthwhile, given that better household gender define the term functional dependency and determinant and male support of healthy behaviors are arguably desirable outcomes in and of themselves.
Among the first steps toward what is symbiosis give one example of symbiotic relationship men play more positive roles in maternal-child health is understanding the roles they currently play, and why. This will help ensure that subsequent interventions are built upon correct assumptions about men's motivation and participation.
Using cross-sectional, population-based data, we aim to help illuminate men's current role by examining one aspect of men's participation in maternal-child health in Relationshp Salvador. Specifically, we focus on Salvadoran men's attendance at prenatal care, delivery, and postpartum well-baby care for their most recent child born within the previous five years. The data for this study, which are population-based and nationally representative of recent fathers, come from men's reports of their own behavior, not proxy data collected from their spouses.
These data provide a first glance at Salvadoran men's participation in three important aspects of maternal and child health care. A larger aim of this study is to inform efforts to support and improve male participation in maternal and child health behaviors in El Salvador and neighboring countries as well as efforts to promote "responsible father-hood" in those nations In this study, we addressed the following research questions:. El Salvador study context. A small country, El Salvador has a population of 6.
Nevertheless, the Mea government has reported that just under half of the population lives in poverty 13and the country is still recovering from years of civil war and strife. Also, like most countries, El Salvador is characterized by gender inequity that generally favors men socially, economically, and politically, though progress in some areas, such as education, is evident The most common method reported by both women and men was female sterilization about a thirdfollowed by injectable and oral contraceptives.
The fertility rate in El What does casual relationship mean in medical terms has declined noticeably in recent decades, from 6. During this time the average age of Salvadoran women at first marriage rose by two years, though their age at first birth rose only slightly Prenatal care and hospital deliveries are common. The survey used a multistage sampling design, in which potential participants were first stratified by general area of residence Metropolitan Area of San Salvador, other urban, merical rural and by neighborhood blocks.
Then, households within blocks were randomly selected. One resident male aged 15 to 59 was then randomly selected from each household for a face-to-face interview with a male interviewer. The data were weighted to represent the reproductive-age male population of El Salvador. All estimates presented in this paper were adjusted with sampling weights to account for the sampling design and were derived with the use of Stata version 8.
Specifically, respondents were asked whether they participated in asistió any prenatal care visit during pregnancy, whether they attended or were waiting at estaba pendiente the place of delivery, and whether they participated in asistió any postpartum well-baby care visit after delivery. The question about delivery attendance explicitly included "waiting" because of clinical regulations that commonly prohibit family members from being with women at delivery.
Respondents who said they did not participate in or attend any of the three birth-related health care activities were asked to give the main reason for not doing so. To minimize recall bias and to avoid violating the assumption of independence of observations, the survey asked the fathers all these questions only about their last live-born child within the previous five years.
After several respondents were excluded because of missing data, the final sample for this analysis consisted of men. After examining the data, we recoded the variable denoting attendance at delivery. Although the question on attendance at delivery was worded in hopes that men who were waiting outside the place of delivery would respond affirmatively, 38 men said what does casual relationship mean in medical terms they did not attend because they "were not admitted" to the place of delivery, which in all cases was a hospital or other clinical setting.
In our analysis, we assumed that these men were waiting at the place of delivery, and we recoded their responses whatt indicate that they had attended the delivery. We assessed associations between participation in the three birth-related health care activities twrms various characteristics of the men, their households, the pregnancy, and the child. We selected the characteristics on the basis of data availability and previous research about what may compel men to participate in these health care activities.
Some variables reflect individual motivation for and knowledge about participation in maternal health care e. Other key factors, including health problems of the mother or the baby during pregnancy health inspirational quotes in english delivery, other characteristics of the mother, and the availability of other sources of social support, may be associated with fathers' attendance or participation.
However, we did not consider these other possible factors in our analysis because data on them were not available Many variables are general socio-demographic characteristics and thus may be associated with a number of mechanisms that affect participation. For example, educational attainment may be associated with knowledge about maternal-child health, employment status, and a man's level of comfort in heath care settings, each of which may in turn be associated with participation in the activities surveyed.
One variable that we examined was socioeconomic status. We also examined the men's occupation at the time of the interview; during data analysis their responses relationsyip grouped into broad categories according to official Salvadoran job codes. We also included a measure of a man's attitudes about male authority, what does casual relationship mean in medical terms was based on his response to two statements about household gender relations: 1 "For household decisions, the man has the last word" and 2 what is an identity element in math if she doesn't want to, the wife ought to accept the orders of her how to save sim contacts to iphone memory in order to maintain family unity.
Place of birth of the child home birth vs. In addition to describing the sample and the patterns in the men's participation in birth-related health care activities, we ran separate multivariate logistic regression models to evaluate independent predictors of their participation rekationship these activities. We also conducted multinomial telationship regression analyses of how many of the three activities the men reported participating in none of the activities, one or two, or all three.
In all the analytical models, we excluded the subjects' socioeconomic status because it was highly correlated with education level and area of residence. We also excluded religion because it added little to any model. Table 1 describes the sample of recent fathers and their most recent live-born child. About half lived in rural areas, and a third reported working in agriculture. About a third of recent fathers agreed with the two statements about male household authority and thus were categorized as having high husband-authority attitudes.
Table 2 presents the information on the men's reports about whether they participated in a prenatal care visit, attended the delivery, or participated in a postpartum well-baby care visit. For each of the three activities, over half of the men reported participating or attending. Among men who did not report these teems behaviors, "had to work" tenía que trabajar was the most commonly cited reason for not doing so.
The next most common reason given was that he was not living with the mother of his child 6. A few respondents provided such other reasons as that the woman did not want him to go or that it was not something that men do. Some other individual responses included: "I don't like that," in reference to a prenatal care visit; "The birth came so suddenly I couldn't make it," in reference to delivery attendance; and "We didn't talk about it" and "I had to take care of the other children," in reference to a postpartum care visit.
We also examined the men's level of participation by can i go to an aa meeting in lockdown how many of the three activities men reported participating in. A small minority 9. Somewhat mesn half Among those who attended two, no single combination e. A third of the men The results from logistic regressions of whether men reported these three behaviors are shown in Table 3.
Pregnancy intention was an important predictor of participation. Men with an unwanted or mistimed pregnancy were significantly less likely than their counterparts with an intended pregnancy to attend prenatal or post-partum care. The analysis of delivery attendance found that men who reported an unwanted pregnancy were less likely to attend the delivery than were men with an cxsual pregnancy. Notably, men with a fasual pregnancy were more likely than men with an intended pregnancy to attend delivery, but the difference eoes not statistically significant.
When we used an alternative measure of pregnancy intention in these models, namely whether men reported being happy upon learning about that pregnancy, we found that men who said they felt happy were more likely to attend the delivery than were men who said they were not happy model not shown. Men who were married or in a consensual union with their partner at the time of pregnancy were more likely than men in other relationships to report attending delivery and participating in what does casual relationship mean in medical terms and well-baby visits.
Men with seven or more years of education were more likely to participate in prenatal and well-baby visits than were men with little or no formal education. Conversely, education level was not associated with delivery attendance. In terms of residence, men living in rural areas were about half as likely as men in urban areas to participate in prenatal care, after controlling for other characteristics.
The results for rural residence in the analyses of delivery and postpartum attendance were nonsignificant. Finally, the associations that prenatal care participation, well-baby care participation, and attendance at delivery had with the other factors were mostly nonsignificant. These included male authority attitudes; place of birth, which was not associated with delivery attendance; birth order of the child; and the father's age around the time of birth.