Using the RE-AIM Framework to Evaluate Implementation of Male Involvement Strategies to Optimize the PMTCT Program in Malawi

A Mixed-Methods Study

Bibliographic Data

ID21748705
AuthorsMphatso Kumwenda (0000-0002-4758-0271, Kamuzu Central Hospital, corresponding author), Emmanuel Singogo (0000-0002-2015-335X, Lilongwe University of Agriculture and Natural Resources), Alinane Linda Nyondo-Mipando (0000-0002-3572-3810, Kamuzu Central Hospital)
Year2023
Volume17
Issue4
Pages15579883231192320-15579883231192320
Publication date2023-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAmerican Journal of Men s Health (JOURNAL)
Journal identifiersISSN: 1557-9883 • E-ISSN: 1557-9891
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/15579883231192320
PMID37606316
OpenAlexW4386045755
LanguageEN
Citations received1
References cited33

Involvement of male partners has been shown to be key for the prevention of mother-to-child HIV transmission (PMTCT). Despite the recorded success, uptake and implementation of strategies to involve men in PMTCT continues to be low in Malawi. In this study, we used the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) implementation science framework to explore the implementation of male involvement (MI) strategies in Lilongwe, Malawi. We used a cross-sectional mixed-methods complementary-concurrent design from September to October 2020 in two health facilities. Qualitatively, we used a phenomenological approach and conducted seven focus group discussions (FGDs), three with women and four with men. We further conducted four key informant interviews (KIIs) among health care workers. Quantitatively, we conducted a cross-sectional study comprising 138 men presenting at an antenatal clinic (ANC). We used univariate analysis in Stata for the quantitative data, whereas a manual thematic analysis was applied to the qualitative data. Implementation and adoption of the strategies was high among health providers and there were indications of maintenance of the strategies. Provider’s attitude, coordinated service provision, integrated training and service provision, information provision, and baby’s HIV outcomes were driving factors in implementing the MI strategies. These factors have contributed to the sustained implementation of the strategies over time. In contrast, financial and time constraints, inadequate human resources, and male-friendly spaces impede the implementation of MI strategies. Improving MI will require a systems approach considering health system and individual-level factors for both providers and consumers

Business · Environmental health · Focus group · Health facility · Health services · Implementation research · Population · Psychological intervention · Qualitative property · Qualitative research · Service delivery framework · Service provider · Thematic analysis · Adolescent Sexual and Reproductive Health · Computer Science · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology · Marketing