Article Text

Original research
Leaving no one behind: using action research to promote male involvement in maternal and child health in Iringa region, Tanzania
  1. Stephen Maluka1,
  2. Paul Japhet1,
  3. Sian Fitzgerald2,
  4. Khadija Begum3,
  5. May Alexander4,
  6. Peter Kamuzora1
  1. 1Institute of Development Studies, University of Dar es Salaam, Dar es Salaam, United Republic of Tanzania
  2. 2Healthbridge Foundation, Ottawa, Ontario, Canada
  3. 3Health Bridge Foundation, Ottawa, UK
  4. 4Iringa Region, Health Department, Iringa, United Republic of Tanzania
  1. Correspondence to Dr Stephen Maluka; Stephenmaluka{at}


Introduction Male involvement has been reported to improve maternal and child health (MCH) outcomes. However, most studies in low-income and middle-income countries have reported low participation of men in MCH-related programmes. While there is a growing interest in the involvement of men in MCH, little is known on how male involvement can be effectively promoted in settings where entrenched unequal gender roles, norms and relations constrain women from effectively inviting men to participate in MCH.

Methods and analysis This paper reports participatory action research (PAR) aimed to promote male participation in pregnancy and childbirth in Iringa Region, Tanzania. As part of the Innovating for Maternal and Child Health in Africa project, PAR was conducted in 20 villages in two rural districts in Tanzania. Men and women were engaged separately to identify barriers to male involvement in antenatal care and during delivery; and then they were facilitated to design strategies to promote male participation in their communities. Along with the PAR intervention, researchers undertook a series of research activities. A thematic analysis was used to analyse the data. The common strategies designed were: engaging health facility committees; using male champions and male gatekeepers; and using female champions to sensitise and provide health education to women. These strategies were validated during stakeholders’ meetings, which were convened in each community.

Discussion The use of participatory approach not only empowers communities to diagnose barriers to male involvement and develop culturally acceptable strategies but also increases sustainability of the interventions beyond the life span of the project. More lessons will be identified during the implementation of these strategies.

  • antenatal
  • public health
  • maternal medicine

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  • Contributors SM, PK, KB and MA conceptualised the study, including developing data collection tools. SM, PK and PJ collected, coded and analysed data. PJ and SM drafted the manuscript. PK, SF, KB and MA contributed to the manuscript writing. All authors approved the final manuscript.

  • Funding The study was funded by a joint initiative of three Canadian government agencies, namely; the Canadian Institutes of Health Research (CIHR), Global Affairs Canada and Canada’s International Development Research Centre (IDRC) under IMCHA programme grant no: IDRC 108023-001.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study got approval from the Ethical Committee of the Medical Research Council of Tanzania (NIMR) No: NIMR/HQ/R.8a/Vol.IX/2119. The study was also approved by the Regional Administrative Officers in the region of study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The datasets are not publicly available since participants did not give consent for the public sharing of their information. However, summaries of the information and data collection tools are available from the corresponding author on request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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