title: Male involvement in reproductive, maternal and child health: a qualitative study of policymaker and practitioner perspectives in the Pacific.
abstract: BACKGROUND
  The importance of involving men in reproductive, maternal and child health programs is increasingly recognised globally. In the Pacific region, most maternal and child health services do not actively engage expectant fathers and fathers of young children and few studies have been conducted on the challenges, benefits and opportunities for involving fathers. This study explores the attitudes and beliefs of maternal and child health policymakers and practitioners regarding the benefits, challenges, risks and approaches to increasing men's involvement in maternal and child health education and clinical services in the Pacific.
  
  
  METHODS
  In-depth interviews were conducted with 17 senior maternal and child health policymakers and practitioners, including participants from five countries (Cook Island, Fiji, Papua New Guinea, Solomon Island, and Vanuatu) and four regional organisations in the Pacific. Qualitative data generated were analysed thematically.
  
  
  RESULTS
  Policymakers and practitioners reported that greater men's involvement would result in a range of benefits for maternal and child health, primarily through greater access to services and interventions for women and children. Perceived challenges to greater father involvement included sociocultural norms, difficulty engaging couples before first pregnancy, the physical layout of clinics, and health worker workloads and attitudes. Participants also suggested a range of strategies for increasing men's involvement, including engaging boys and men early in the life-cycle, in community and clinic settings, and making health services more father-friendly through changes to clinic spaces and health worker recruitment and training.
  
  
  CONCLUSIONS
  These findings suggest that increasing men's involvement in maternal and child health services in the Pacific will require initiatives to engage men in community and clinic settings, engage boys and men of all ages, and improve health infrastructure and service delivery to include men. Our findings also suggest that while most maternal and child health officials consulted perceived many benefits of engaging fathers, perceived challenges to doing so may prevent the development of policies that explicitly direct health providers to routinely include fathers in maternal and child health services. Pilot studies assessing feasibility and acceptability of context-appropriate strategies for engaging fathers will be useful in addressing concerns regarding challenges to engaging fathers.
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia. jdavis@burnet.edu.au.|Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia. jdavis@burnet.edu.au.
authors.forename: Jessica
authors.initials: J
authors.lastname: Davis
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Vyankandondera
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.|Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Victoria, Australia.|International Centre for Reproductive Health, Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Stanley
authors.initials: S
authors.lastname: Luchters
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.|Present Address: West Gippsland Healthcare Group, Warragul, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Simon
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Holmes
mesh_terms: D000288:Administrative Personnel / Q000523:psychology*; D000328:Adult; D000067576:Child Health; D005220:Fathers / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D000068097:Maternal Health; D010139:Pacific Islands; D010465:Perception; D011247:Pregnancy; D036301:Qualitative Research; D060728:Reproductive Health
keywords: Expectant fathers; Father involvement; Male involvement; Maternal and child health; Men as partners; Men’s involvement; Pacific