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Barriers and facilitators to father involvement in early child health services: A qualitative study in rural Mozambique

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  • Jeong, Joshua
  • Ahun, Marilyn N.
  • Bliznashka, Lilia
  • Velthausz, Daan
  • Donco, Rotafina
  • Yousafzai, Aisha K.

Abstract

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.

Suggested Citation

  • Jeong, Joshua & Ahun, Marilyn N. & Bliznashka, Lilia & Velthausz, Daan & Donco, Rotafina & Yousafzai, Aisha K., 2021. "Barriers and facilitators to father involvement in early child health services: A qualitative study in rural Mozambique," Social Science & Medicine, Elsevier, vol. 287(C).
    • Handle: RePEc:eee:socmed:v:287:y:2021:i:c:s027795362100695x
    DOI: 10.1016/j.socscimed.2021.114363
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    1. Egger, Dennis & Miguel, Edward & Warren, Shana S. & Shenoy, Ashish & Collins, Elliott & Karlan, Dean & Parkerson, Doug & Mobarak, A. Mushfiq & Fink, Günther & Udry, Christopher & Walker, Michael & Hau, 2021. "Falling living standards during the COVID-19 crisis: Quantitative evidence from nine developing countries," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 7(6), pages 1-1.
    2. McLean, Kristen E., 2020. "Men's experiences of pregnancy and childbirth in Sierra Leone: Reexamining definitions of “male partner involvement”," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Ganle, John Kuumuori & Dery, Isaac & Manu, Abubakar A. & Obeng, Bernard, 2016. "‘If I go with him, I can't talk with other women’: Understanding women's resistance to, and acceptance of, men's involvement in maternal and child healthcare in northern Ghana," Social Science & Medicine, Elsevier, vol. 166(C), pages 195-204.
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    1. Jeong, Joshua & McCann, Juliet K. & Alsager, Alya & Bhojani, Alina & Andrew, Ngusa & Joseph, Julieth & Ahun, Marilyn N. & Kabati, Mary & Joachim, Damas, 2023. "Formative research to inform the future design of a multicomponent fatherhood intervention to improve early child development in Mwanza, Tanzania," Social Science & Medicine, Elsevier, vol. 331(C).
    2. Baran, Marek B. & Sawrikar, Vilas, 2024. "Service-level barriers and facilitators to father engagement in child and family services: A systematic review and thematic synthesis of qualitative studies," Children and Youth Services Review, Elsevier, vol. 156(C).

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