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Objective To determine whether an intervention to involve the male partners of pregnant women in maternity care influenced care-seeking, healthy breastfeeding and contraceptive practices after childbirth in urban Burkina Faso. Methods In a non-blinded, multicentre, parallel-group, superiority trial, 1144 women were assigned by simple randomization to two study arms: 583 entered the intervention arm and 561 entered the control arm. All women were cohabiting with a male partner and had a low-risk pregnancy. Recruitment took place at 20 to 36 weeks'gestation at five primary health centres in Bobo-Dioulasso.The intervention comprised three educational sessions: (i) an interactive group session during pregnancy with male partners only, to discuss their role; (ii) a counselling session during pregnancy for individual couples; and (Iii) a postnatal couple counselling session. The control group received routine care only. We followed up participants at 3 and 8 months postpartum. Findings The follow-up rate was over 96% at both times. In the intervention arm, 74% (432/583) of couples or men attended at least two study sessions. Attendance at two or more outpatient postnatal care consultations was more frequent in the intervention than the control group (risk difference, RD: 11.7%; 95% confidence interval, CI: 6.0 to 17.5), as was exclusive breastfeeding 3 months postpartum (RD: 11.4%; 95% CI: 5.8 to 17.2) and effective modern contraception use 8 months postpartum (RD: 6.4%; 95% CI: 0.5 to 12.3). Conclusion Involving men as supportive partners in maternity care was associated with better adherence to recommended healthy practices after childbirth. Objectif Determiner si une intervention visant a faire participer le compagnon des femmes enceintes aux soins de maternite a permis d'influencer le recours aux soins, l'allaitement et les pratiques contraceptives apres l'accouchement dans une ville du Burkina Faso. Methodes Dans le cadre d'un essai de superiorite en groupes paralleles, multicentrique, non aveugle, 1144 femmes ont ete reparties par randomisation simple en deux groupes d'etude: 583 dans le groupe experimental et 561 dans le groupe temoin.Toutes les femmes vivaient avec un compagnon et avalent une grossesse a faible risque. Leur recrutement a eu lieu entre 20 et 36 semaines de grossesse dans cinq centres de soins primaires de Bobo-Dioulasso. L'intervention comprenait trois seances pedagogiques: (i) une seance de groupe interactive pendant la grossesse, avec les compagnons uniquement, afin de discuter de leur role; (ii) une seance de conseil pendant la grossesse pour les couples; et (iii) une seance de conseil postnatale pour les couples. Le groupe temoin a beneficie uniquement de la prise en charge habituelle. Nous avons suivi les participants a 3 et 8 mois apres l'accouchement. Resultats Le taux de suivi etait superieur a 96% aux deux visites de suivi. Dans le groupe experimental, 74% (432/583) des couples ou des hommes avaient assiste a au moins deux des seances prevues. La presence a deux consultations postnatales externes ou plus etait plus frequente dans le groupe experimental que dans le groupe temoin (difference de risques, DR: 11,7%; intervalle de confiance de 95%, IC: 6,0 a 17,5), comme l'allaitement exclusif 3 mois apres l'accouchement (DR: 11,4%; IC 95%: 5,8 a 17,2) et l'utilisation de moyens de contraception modernes efficaces 8 mois apres l'accouchement (DR: 6,4%; IC 95%: 0,5 a 12,3). Conclusion La participation et l'accompagnement des hommes aux soins de maternite etaient associes a un meilleur suivi des pratiques recommandees apres l'accouchement. Objetivo Determinar si una Intervencion para involucrar a las parejas masculinas de las mujeres embarazadas en la atencion de la maternidad influyo en la busqueda de atencion, la lactancia materna saludable y las practicas anticonceptivas despues del parto en una zona urbana de Burkina Faso. Metodos En un ensayo preponderado, no cegado, multicentrico, de grupos paralelos, se asigno a 1144 mujeres aleatorias a dos grupos del estudio: 583 entraron en el grupo de intervencion y 561 entraron en el grupo de control. Todas las mujeres convivian con una pareja masculina y tenian un embarazo de bajo riesgo. La seleccion tuvo lugar entre las semanas 20 y 36 de gestacion en cinco centros de salud primarios en Bobo-Dioulasso. La intervencion conto con tres sesiones educativas: (i) una sesion grupai interactiva durante el embarazo solo con las parejas masculinas, para hablar sobre su papel; (ii) una sesion de asesoramiento durante el embarazo para parejas individuales; y (iii) una sesion de consejeria posnatal en pareja. El grupo de control recibio solo atencion rutinaria. Seguimos a los participantes a los 3 y 8 meses despues del parto. Resultados La tasa de seguimiento fue superior al 96% en dos visitas. En el grupo de Intervencion, el 74% (432/583) de. parejas u hombres asistieron al menos a dos sesiones de estudio. La asistencia a dos o mas consultas de atencion posnatal para pacientes ambulatorios fue mas frecuente en el grupo de intervencion que el grupo de control (diferencia de riesgo, RD: De 1,7% a 95% en el intervalo de confianza, IC: De 6,0 a 17,5), en la lactancia materna exclusiva 3 meses despues del parto (RD: De 11,4% a 95% IC: De 5,8 a 17,2) en anticonceptivos modernos efectivos 8 meses despues del parto (RD: De 6,4% a 95% IC: De 0,5 a 12,3). Conclusion Involucrar a los hombres como apoyo en la atencion de maternidad se asocio con una mejor adherencia a las practicas recomendadas de salud despues del parto., [phrase omitted] Introduction Ending preventable maternal and perinatal mortality necessarily involves engaging with families and communities. (1) Male partners, in particular, exert a considerable influence on women's use of reproductive [...]

The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as "placental disorders") in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low- and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE's objectives, and discusses the combination of qualitative methods with quantitative cohort studies more generally. We present planned qualitative work in six subject areas (health systems, health geography, mental health, community engagement, the implementation of the TraCer tool, and respectful maternity care). Based on these plans, with reference to other cohort studies on maternal and child health, and in the context of the methodological literature on mixed methods approaches, we find that qualitative work may have several different functions in relation to cohort studies, including informing the quantitative data collection or interpretation. Researchers may also conduct qualitative work in pursuit of a complementary research agenda. The degree to which integration between qualitative and quantitative methods will be sought and achieved within PRECISE remains to be seen. Overall, we conclude that the synergies resulting from the combination of cohort studies with qualitative research are an asset to the field of maternal and child health. [ABSTRACT FROM AUTHOR]

Background: Intra-uterine contraception (IUC) involves the use of an intra-uterine device (IUD), a highly effective, long-acting, reversible contraceptive method. Historically, the popularity of IUC has waxed and waned across different world regions, due to policy choices and shifts in public opinion. However, despite its advantages and cost-effectiveness for programmes, IUC's contribution to contraceptive prevalence is currently negligible in many countries. This paper presents the results of a systematic review of the global literature on provider and lay perspectives on IUC. It aims to shed light on the reasons for low use of IUC and reflect on potential opportunities for the method's promotion. Methods: A systematic search of the literature was conducted in four peer-reviewed journals and four electronic databases (MEDLINE, EMBASE, POPLINE, and Global Health). Screening resulted in the inclusion of 68 relevant publications. Results: Most included studies were conducted in areas where IUD use is moderate or low. Findings are similar across these areas. Many providers have low or uneven levels of knowledge on IUC and limited training. Many wrongly believe that IUC entails serious side effects such as pelvic inflammatory disease (PID), and are reluctant to provide it to entire eligible categories, such as HIV-positive women. There is particular resistance to providing IUC to teenagers and nulliparae. Provider opinions may be more favourable towards the hormonal IUD. Some health-care providers choose IUC for themselves. Many members of the public have low knowledge and unfounded misconceptions about IUC, such as the fear of infertility. Some are concerned about the insertion and removal processes, and about its effect on menses. However, users of IUC are generally satisfied and report a number of benefits. Peers and providers exert a strong influence on women's attitudes. Conclusion: Both providers and lay people have inaccurate knowledge and misconceptions about IUC, which contribute to explaining its low use. However, many reported concerns and fears could be alleviated through correct information. Concerted efforts to train providers, combined with demand creation initiatives, could therefore boost the method's popularity. Further research is needed on provider and lay perspectives on IUDs in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infrastructure of a generic, unified data collection platform. It is built on previous work in data harmonisation, outcome and data field standardisation, open-access software (District Health Information System 2 and the Baobab Laboratory Information Management System), and clinical research networks. The database contains globally-recommended indicators included in Health Management Information System recording and reporting forms. It comprises key outcomes (maternal and perinatal death), life-saving interventions (Human Immunodeficiency Virus testing, blood pressure measurement, iron therapy, uterotonic use after delivery, postpartum maternal assessment within 48 h of birth, and newborn resuscitation, immediate skin-to-skin contact, and immediate drying), and an additional 17 core administrative variables for the mother and babies. In addition, the database has a suite of additional modules for 'deep phenotyping' based on established tools. These include social determinants of health (including socioeconomic status, nutrition and the environment), maternal co-morbidities, mental health, violence against women and health systems. The database has the potential to enable future high-quality epidemiological research integrated with clinical care and discovery bioscience.