Factors associated with knowledge of obstetric danger signs and perceptions of the need for obstetric care among married men in northern Nigeria: a cross-sectional survey

Background: Male involvement in maternal, newborn and child health contributes to better health outcomes for women and their children, especially in restrictive societies. There is evidence that when men have better understanding of women's health needs, attitudes toward utilization of maternal and child health services, of both women and men, are improved. Given the role of men as the ultimate decision makers in families in northern Nigerian society, this study assessed the determinants of men's knowledge of danger signs in pregnancy and the continuum of obstetric care, and their perceptions of the importance of antenatal care utilization and health facility delivery. Methods: This was a cross-sectional descriptive study. Structured questionnaires with close ended questions were administered to 1627 married men who had at least one wife younger than 25years in communities in Nigeria northern states of Kaduna and Katsina. We use crosstabulations and means to compare characteristics of study respondents in the two states, assessing statistical significance of the differences with (2)-square and Anova tests as appropriate, and logistic regressions to assess the determinants of knowledge and perceptions. Results: Knowledge of obstetric danger signs, especially during the postpartum period, was poor overall, but respondents were relatively more knowledgeable about danger signs during pregnancy and delivery compared with the postpartum period. Most perceived that antenatal care can reduce the risk of complications. Literate men were twice more likely to have positive health-behaviour perceptions. Wealth was positively associated with the perception that women should deliver in a health facility or hospital but did not have a statistically significant effect on the perception that antenatal care can reduce the risk of complications. Conclusions: While knowledge of obstetric danger signs was poor, literacy and household wealth significantly influenced knowledge of obstetric danger signs and perceptions that women should deliver at a health facility. Male involvement programmes need to ensure that men are empowered to understand obstetric danger signs along the continuum of obstetric care to improve perception and utilization of maternal health services for better maternal and newborn health outcomes.