臺灣博碩士論文加值系統

Background: Globally, maternal and neonatal mortality rates involve some of the greatest public health disparities: 99% of related deaths occur in low- and middle-income countries. However, access to public health interventions such as antenatal care (ANC) could prevent most of these deaths. Male involvement and other factors affect ANC utilisation. This study investigated the effect of male involvement on ANC service utilisation in Malawi.
Materials and methods: A cross-sectional study was conducted using a nationally representative sample of women who had given a live birth in the 5 years preceding the 2010 and 2016 Malawi Demographic Health Surveys (MDHSs). Records of individuals and couples were analysed. A multivariate logistic regression model was used to estimate the effect of male involvement on ANC service utilisation.
Results: In the 2010 MDHS, 1063 respondents (48.2%) reported ≥4 ANC visits, and in the 2016 MDHS, only 773 (50.2%) respondents reported ≥4 ANC visits. For the 2010 MDHS, married (aOR=0.70, 0.54-0.90), respondents with 2-3 children (aOR=0.61, 95%CI=0.47 - 0.79) coming from southern region (aOR=0.74, 95%CI=0.55–0.99) children wanted later (aOR 0.73 95%CI=0.56 - 0.95) HIV test aOR=1.31 95%CI=1.01 -1.70) was associated with ≥4 ANC visits. In 2016, a decision-making power of 2-3 (aOR=0.45 95%CI=0.23-0.85), Primary (aOR=1.63, 95%CI=1.09-2.43), secondary education (aOR=1.71, 95%CI=1.12-2.62) Media (aOR=1.69, 95%CI=1.25-2.30) HIV test (aOR=1.96, 95% CI=1.18-3.27) were associated with ≥4 ANC visits. In the 2010 MDHS, 796 respondents (36.1%) initiated their ANC earlier and in the 2016 MDHS, 827 (53.7%) respondents had early ANC visits. For the 2010 MDHS, a decision-making power of 2-3 & 4 (aOR=1.95,95% CI=1.08-3.49) (aOR= 1.80 95% CI=1.02-3.18) maternal age (aOR=0.59, 95% CI=0.38-0.89) paternal age (aOR= 0.73, 95%CI=0.58-0.93) having 4 or more children 0.60 95%CI=0.42 - 0.86) was associated with early ANC visits. In 2016, paternal age (aOR=0.31 95% CI=0.19 – 0.51). Women with secondary and above education level 1.80 (1.20 – 2.72) For respondents with married marital status (aOR=1.63 95% CI=1.12 – 2.39) HIV test (aOR=1.82, 95% CI=1.11 – 2.30) was associated with early ANC visits.
Conclusion: The relationship between ANC service utilisation and male involvement remains controversial, despite some positive outcomes from strategies developed to increase male involvement in ANC services. In some developing countries such as Malawi, husbands’ attendance at ANC check-ups is stigmatised due to social-cultural factors.

Background: Globally, maternal and neonatal mortality rates involve some of the greatest public health disparities: 99% of related deaths occur in low- and middle-income countries. However, access to public health interventions such as antenatal care (ANC) could prevent most of these deaths. Male involvement and other factors affect ANC utilisation. This study investigated the effect of male involvement on ANC service utilisation in Malawi.
Materials and methods: A cross-sectional study was conducted using a nationally representative sample of women who had given a live birth in the 5 years preceding the 2010 and 2016 Malawi Demographic Health Surveys (MDHSs). Records of individuals and couples were analysed. A multivariate logistic regression model was used to estimate the effect of male involvement on ANC service utilisation.
Results: In the 2010 MDHS, 1063 respondents (48.2%) reported ≥4 ANC visits, and in the 2016 MDHS, only 773 (50.2%) respondents reported ≥4 ANC visits. For the 2010 MDHS, married (aOR=0.70, 0.54-0.90), respondents with 2-3 children (aOR=0.61, 95%CI=0.47 - 0.79) coming from southern region (aOR=0.74, 95%CI=0.55–0.99) children wanted later (aOR 0.73 95%CI=0.56 - 0.95) HIV test aOR=1.31 95%CI=1.01 -1.70) was associated with ≥4 ANC visits. In 2016, a decision-making power of 2-3 (aOR=0.45 95%CI=0.23-0.85), Primary (aOR=1.63, 95%CI=1.09-2.43), secondary education (aOR=1.71, 95%CI=1.12-2.62) Media (aOR=1.69, 95%CI=1.25-2.30) HIV test (aOR=1.96, 95% CI=1.18-3.27) were associated with ≥4 ANC visits. In the 2010 MDHS, 796 respondents (36.1%) initiated their ANC earlier and in the 2016 MDHS, 827 (53.7%) respondents had early ANC visits. For the 2010 MDHS, a decision-making power of 2-3 & 4 (aOR=1.95,95% CI=1.08-3.49) (aOR= 1.80 95% CI=1.02-3.18) maternal age (aOR=0.59, 95% CI=0.38-0.89) paternal age (aOR= 0.73, 95%CI=0.58-0.93) having 4 or more children 0.60 95%CI=0.42 - 0.86) was associated with early ANC visits. In 2016, paternal age (aOR=0.31 95% CI=0.19 – 0.51). Women with secondary and above education level 1.80 (1.20 – 2.72) For respondents with married marital status (aOR=1.63 95% CI=1.12 – 2.39) HIV test (aOR=1.82, 95% CI=1.11 – 2.30) was associated with early ANC visits.
Conclusion: The relationship between ANC service utilisation and male involvement remains controversial, despite some positive outcomes from strategies developed to increase male involvement in ANC services. In some developing countries such as Malawi, husbands’ attendance at ANC check-ups is stigmatised due to social-cultural factors.

ACKNOWLEDGEMENTS. II
DECLARATION III
DEDICATION IV
Abstract V
Table of Contents. VII
List of the Table: X
List of Figures: XI
List of Abbreviations. XII
Chapter 1. Introduction . 1
1.1 Background. 1
1.2. Problem Statement. 3
1.3. Study Objectives. 6
1.3.1 Broad Objective. 6
1.3.2 Specific Objectives. 6
1.4 Study Hypothesis. 6
Chapter 2. Literature Review. 7
2.1. Male involvement definition. 7
2.1.1. Male Involvement ANC. 7
2.2. Conceptual Framework. 8
2.2.1. Predisposing Factor. 9
2.2.2. Enabling Factor. 9
2.2.3. Need Factor. 9
2.2.4. Summary of Anderson and Newton Model. 10
2.3. Variables. 11
2.3.1. Outcome Variables. 11
2.3.2. Independent Variables. 13
2.4 Significance of the Study. 23
Chapter 3. Materials and Methods. 25
3.1. Geography. 25
3.2. Data Source. 25
3.2.1. Study Design Population and Sampling Procedures. 27
3.2.2 Questionnaire and Sample Selection. 27
3.3. Variable Description 28
3.3.1. Dependent Variable Description 28
3.3.2. Independent Variable Definitions and Categorization. 29
3.4. Statistical Analysis. 31
Chapter 4. Results. 32
4.1. Number of ANC Visits. 32
4.1.1. Sample Description. 32
4.1.2. Univariate Analysis for Number of ANC Visits Factors. 35
4.1.3. Multivariate Analysis for Number of ANC Visits Factors. 35
4.2. Timing of First ANC Visit. 36
4.2.1. Sample Description. 36
4.2.2. Univariate Analysis for Early Timing of First ANC Visit Factors. 38
4.2.3 Multivariate Analysis for Early Timing of First ANC Visit Factors. 38
Chapter 5. Discussions. 41
5.1. Key results / findings. 41
5.2. Male Involvement Measurements Results. 42
5.3. Other Covariates on Number of ANC visits. 45
5.4. Other Covariates on Timing of first ANC visit. 49
5.5 Some observed Barriers for Male Involvement. 51
Chapter 6. Strength, Limitations and Future Prospective. 53
Chapter 7 Results Tables. 56
Chapter 8. References. 74

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