Percent of men present at the health facility during the birth of last child

 

Definition:

The percent of men who were at the health facility during the birth of their last child, either in the room with their partners during birth or in a waiting area.

This indicator is calculated as:

(# of men present at health facility during the birth of last child/ Total # of men surveyed who have children) x 100

‘Present’ can be defined as the father is in the room with his partner during the birth or is waiting at the facility.  Some facilities may discourage or disallow men from being in the room during delivery, there may be open delivery wards, and/or religious or cultural practices may dissuade men from being in the room - even if that is the father's intention.

Data Requirements:

Surveys and in-depth interviews. Where the detail is available, disaggregation of the indicator by father’s age, number of children, education, income, urban/rural status and other relevant factors may contribute to interpretation of findings.

Data Sources:

Surveys among the male clientele at health facilities or among the men in the general public (population based);  alternative sources are surveys among the spouses and partners of participants in male-focused programs.

Purpose:

The extent of men’s support for their spouses’ and partners’ reproductive health care can significantly affect outcomes, especially regarding family planning, safe motherhood, and newborn health.  Men’s presence at the health facility during birth can indicate an increased level of support for their spouse or partner.  Burgess (2008) found that a father’s presence (or a close friend or relative) at the birth can help make labor and delivery a more positive experience for the mother.  If there is a need for a procedure, such as a caesarean delivery or follow-up surgery, the men’s presence can help with decision-making and consent.  If the father is able to interact with the mother and newborn immediately after birth, this can time together can improve bonding of the father and infant, as well as, provide support for his partner. 

Research has shown that new fathers often are open to information that can help ensure the health and survival of their babies (Promundo, UNFPA, MenEngage, 2010).  Male engagement during their partners’ pregnancy, birth of the infant, and newborn period improves outcomes for the family as a whole and increases the likelihood the father will continue providing care throughout the children’s lives (Burgess, 2007).

A father’s ability to be present at delivery is subject to numerous external constraints, such as, hospital regulations, time and work demands, and even health providers’ and other family members’ attitudes toward men’s involvement.  Younger men appear to be more affected by these constraints than older men and disaggregating the indicator by age is advised.  Programs targeting first time and younger fathers for engaging them in maternal, newborn, and child healthcare (MNCH) can affirm young men’s identity as fathers, encourage participation in MNCH, provide support of developing parenting skills, and address men’s anxieties and concerns about childbirth and parenting (Promundo, UNFPA, MenEngage, 2010).

Issue(s):

Responses to this question are subject to bias, especially if men are aware that their attitudes or behaviors deviate from socially accepted responses. They may try to respond as they expect will please the interviewer and it is best if the interviewers ask these questions in a neutral matter-of-fact way. An alternative approach is to interview women about their spouses’ or partners’ presence at the facility during the birth of their last child, however, these accounts may be biased if the women know that their partners participate in male-focused programs and that this would have been ‘expected’ behavior.

This indicator does not count fathers' presence at home deliveries.  While the father may be close by, they may be less likely to be in the room during delivery at home, particularly if traditional norms discourage their presence.

It is important to recognize that male involvement is not necessarily a positive and does not ensure favorable outcomes if male behavior is dominant and controlling. 

References:

Burgess, A. (2007). The costs and benefits of active fatherhood: evidence and insights to inform the development of policy and practice. Fathers Direct.

Burgess, A. (2008). Maternal and infant health in the perinatal period: the father’s role. Abergavenny, UK: The Fatherhood Institute.

Promundo, UNFPA, MenEngage, 2010, Engaging Men and Boys in Gender Equality and Health: A Global Toolkit for Action. http://www.unfpa.org/public/site/global/pid/6815