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CHAPTER FIVE
DISCUSSIONS, CONCLUSIONS, RECOMMENDATION AND IMPLICATIONS TO NURSING PRACTICE
5.1 Introduction
This chapter presents the discussions, conclusions, recommendations of the study and implication to the nursing practice.
5.2 Discussion of results
5.2.1 Demographic Characteristics
Regarding the age of the respondents, the majority 14 (46.7%) were between 18 -25 years while the minority 4 (13.3%) were above 34 years which implies that the researcher acquired information from mature respondents whom she expects to provide accurate information.
On religion, majority of the respondents 13 (43.3%) were protestants while the least 2 (6.7%) were Muslims this implies that the factors that influence men involvement care for their spouses during labor cuts across all religion but for this study the protestant religion was dominant.
According to research findings, majority of the respondents 25 (83.3%) were married while 2 (6.7%) had Divorced. This implies that most of the respondents had ever experienced child birth and gave reliable information.
According to the findings of the study majority of respondents 14 (46.7%) had attended primary level education while minority 3 (10%) had attended tertiary and university level education implying that majority of the respondents had attended formal education and were able to read and interpret the research questions. This also enables them not to entirely follow their religious and cultural norms to take decisions of adopting new
Majority of respondents 25 (83.3%) were monogamous while minority 5 (16.7%) had polygamous families. Implying that men had time to get involved in care for their spouses during child birth but due to cultural practices, they could not get involved and because they believed that it’s not their work.
The results in the study indicate that majority 25 (83.3%) were not polygamous while minority 2 (6.7%) had two wives. This implies that most of the respondents were able to get involved in the reproductive health of their spouses.
The results in the study also reveal that majority of respondent 16 (53.3%) had 1-3 children while minority 5 (16.7%) had 7 and above children. This meant that the study population were well aware of the challenges that come with child birth.
5.2.2 Individual factors that influence male involvement in care of their spouses in labor
The results shows that majority of respondents 21 (70%) had never received maternal health education while minority 9 (30%) said they have received it. This is contrary to Carter, (2012), who in his study carried out in rural Guatemala revealed that variations in male involvement was due to exposure to maternal health education and their maternal health knowledge, which are the main predictors of their involvement in maternal care. The level of husbands” involvement in maternal health was found to be off-balanced. Their level of financial support was high (95.8 % for antenatal care and postnatal care) but very low on the direct involvement as accompaniment for child birth (35.6%).
The results in the study futher revealed that majority of respondents 21 (70%) gave other sources of of maternal health information while minority 1 (3.3%) said mass media which is commonly used in Uganda. This implies that very few respondents were exposed to marternal health information from mass media which is commonly used in Uganda which is in line with Ditekemena et.al, (2012), who reviewed that determinants of male involvement in maternal and child health services in 5 African countries (Malawi, Congo Brazaville, Mozambique, Ethiopia and Guinea Bissau), where they found out that, the major barrier to men’s involvement during pregnancy and child birth was the lack of knowledge on the health implications to the woman and the newborn baby.
The findings also show that majority of the respondents 24 (80%) revealed that they have ever accompanied their spouses for child birth wholle minority 6 (20%) said they have never. This is in line with Ditekemena et.al, (2012) who revaled in his study in 5 African countries (Malawi, Congo Brazaville, Mozambique, Ethiopia and Guinea Bissau) that majority of men expressed that their duty was only to make the woman pregnant and issues to deal with pregnancy and child birth are purely for the woman.
The results further revealed that, majority of respondents 18 (60%) said that were welcomed by friebdly halth workers when they accompnied their spouses for child birth while miority 1 (3.3%) said they were harassed and scolded by health workers. Which is in line with Gungor & Beji, (2010) who carried out a study in Turkey among 142 fathers who escorted their wives to labour suites and exposed that majority (92.8%) male spouses were alienated from the birth process,, ignored or mistreated by healthcare providers in unsupportive hospital environments, (Gungor & Beji, 2010)
The findings of the study reveal that majority of respondents 16 (53.3%) said its not acceptable for men to escort their wives for delivery while minority 14 (46.7%) said that its not acceptable. Thyis is in line with A study was conducted in Turkey by Gungor & Beji, (2010), to examine the effects of fathers” attendance to labor and experiences of childbirth among 142 fathers who escorted their wives to labour suites and exposed that attempts at being involved during child birth predisposed men to psychological or mental scarring. In their study majority (92.8%) male spouses were alienated from the birth process
Concerning the acceptability of men to escort their wives to delivery, majority of respondents 16 (53%) said “that its ladies work to take their fellow ladies for delivery while some others said it’s not appropriate and uncomfortable for them to go”.
The results indicate that majority of respondents 18 (60%) said that their friends think escorting their wives to delivery is a task for women while minority 2 (7%) said that those who do are charmed by their wives
According to the results in the study, majority of the respondents 18 (60%) said that it’s the duty of females to escort their fellow women for delivery while the least 12 (40%) said it’s not anyone can take that role
The reasons why some respondents believed that it’s a female’s duty to escort their fellow women for delivery were
- That women know better how to handle fellow women in times of pregnancy than men.
- Experience was also another reason given; that since some of these females have ever delivered, they can easily help a fellow woman in labor pains
This contradicts with Iliyasu et.al, (2010), in his study in Nigeria to establish the birth preparedness, complication readiness and fathers’ participation in maternity care among 148 fathers found in Ibadan General Hospital labour ward exposed that they had a high level of involvement in women activities related to child birth including; escorting their wives to the health facility for delivery, arranging for where their women would deliver, and responding to the invitation to the health center for delivery services. They noted a moderate positive correlation between Involvement of men in child delivery and health system factors.
5.2.3 Socio-cultural factors that influence male involvement in care of their spouses in labor
According to the results in the study, majority of the respondents 21 (70%) said that it’s not important for men to be involved in care during child birth while minority 9 (30%) said it’s important. This is in line with Mugisha et.al. (2013) who stated that limited information about the benefits of men involvement in child birth has blinded men from realizing that its very necessary for them to be around their spouses during child birth.
Respondents argued that it’s not important for them to be involved during child birth because during that time they are busy arranging the home and looking for money to cater for the mother after delivery. Meanwhile those who said yes never gave reasons why.
The results reveal that majority of respondents 17 (56.7%) said that there are cultural barriers that prevent men from accompanying their wives for delivery while minority 13 (43.3%) said that there are no such limitations in their culture. This corresponds with Kululanga et.al, (2012), who evaluated the barriers to husbands’ involvement in maternal health care in a rural setting in Malawi and found that majority (46.7%) husbands had a positive perception towards attending maternal health services with their wives but had unreceptive attitudes towards their own involvement, attributed to external factors such as men’s perspectives of pregnancy as a socially constructed ‘female domain’, their lack of awareness of the importance of their involvement and perceived low accessibility to labor wards.
The reason why respondents believed that there are social or cultural barriers that prevent them from accompanying their wives for delivery were; socially/gender roles dictate that men should ensure that they provide only financial support for their wives in times of delivery and they don’t need to escort them to the hospital during delivery therefore majority 17 (56.7%) of the respondents decided to keep on with that tradition.
5.2.4 Health facility based factors that influence male involvement in care of their spouses in labor
The findings in the study revealed that majority 27 (90%) said that they are not aware of any policies or regulations accepting them to accompany their spouses for delivery services while minority 3 (10%) said they are aware. This corresponds with Kainz, Eliasson & Von Post, (2010), who stated that health workers should set policies that compels men to accompany their wives for antenatal care and during child birth.
The findings further revealed that majority of respondents 21 (70%) said that they have never been invited by midwives to attend the delivery of their spouse while minority 9 (30%) said they had ever been invited. This is contrary to the study carried out by Misra et.al, (2010), which revealed that in Turkey nurses always invite husbands to get involved in the process of child birth.
The results in the study revealed that majority of respondents 25 (83.3%) said that they didn’t feel welcome in the labor ward while minority 5 (16%) said that they felt welcomed this is in line with Kwambai et.al, (2013), who lamented that much as some men wanted to be with their wives during child birth, they stated that labor wards are so chaotic that men are not welcomed inside.
According to the findings majority of respondents 16 (53.3%) said that they were told to wait outside while minority 2 (6.7%) said there was enough space with waiting rooms for men. This corresponds with Kunene et.al, (2009), in their study among 338 randomly selected males in South Africa revealed that on the overall, men who had positive attitudes towards escorting their wives for hospital delivery stated that men should stay outside the labour ward since their presence may cause more problems.
5.3 Conclusion
The study concludes that that majority of respondents 21 (70%) had never attended to maternal health education, another 21 (70%) gave other sources of of maternal health information while minority. majority of respondents 24 (80%) revealed that they have never accompanied their spouses for child birth and 18 (60%) said that were welcomed by friebdly halth workers when they accompnied their spouses for child birth.
The study revealed that majority of respondents 17 (56.7%) said that there are cultural barriers that prevent men from accompanying their wives for delivery and another majority 21 (70%) of the respondents said that it’s not important for men to be involved in care during child birth
The study further concludes that majority 27 (90%) said that they are not a aware of any policies or regulations regarding male involvement in child birth and another majority of respondents 21 (70%) said that they have never been invited by midwives while 25 (83.3%) said that they didn’t feel welcome in the labor ward and majority of respondents 16 (53.3%) said that they were told to wait outside
In all men don’t accompany their spouses during labor because of social-cultural factors and also healthy facility factors that are not conducive that prohibit them to do so.
5.4 Recommendation
The study made the following recommendations
5.4.1 To the government
The study recommended that government of Uganda should invest in awareness campaign programmes that will facilitate hospitals all over the country to carry out massive training and improve on antenatal care services that will involve men. Also improve infrastructures that promotes privacy even when men are in the labor ward because lack of space to maintain privacy makes health workers to chase men out of labor ward for the sake of other women who are not their wives but they have come to deliver.
5.4.2 Kapchorwa Hospital, Kapchorwa District
The study recommended that the hospital management should carry out refresher training programmes that will improve on the skills of their health workers to be able to encourage men who are willing to be there with their wives during delivery.
5.4.3 To the health workers.
The study recommended that health workers should act professionally while sensitizing men and women who attend antenatal care and inform them that it’s ok for men to get involved and don’t leave everything to their female counterparts.
5.4.4 To husbands
The study further recommends that husbands should pay attention to health workers advices and take part in the birth of their children.
5.5 Implication to the nursing practice
The study recommends nurses to counsel men on the benefits of getting involved when their wives are delivering.
