Table 1 Indicators of male involvement in the composite index

Accompanying female partner to ANC at least once during the most recent pregnancy

Most common definition of involvement used in the literature

Anecdotally, husband would rarely join wife in the consultation in Myanmar; instead may wait in the waiting room or outside*

1: Participant sometimes, mostly or always accompanied their wife to ANC

1

Broad meaning of ‘accompany’; non-specific measure of involvement

0: Never accompanied

Father’s presence at the most recent childbirth

Common indicator in the literature

Broad meaning of ‘presence’; non-specific measure of involvement

1: Present

1

0: Not present

Presence in the room during labour is culturally inappropriate in Myanmar,* but presence nearby allows husband to support his wife and newborn in other ways

Discussion of partner’s most recent pregnancy and birth with a health care provider

May indicate a greater depth of involvement and a greater readiness to assist

May indicate a male-dominant approach to pregnancy care

1: Discussion between participant and provider

1

Not seen elsewhere in the literature

0: No discussion (or participant doesn’t recall, n = 1)

Shared decision-making regarding antenatal and delivery care provider with their partner during the last pregnancy

Reflective of inter-spousal communication, which is an important component of involvement and impacts on MNH outcomes

Subject to recall and social desirability biases

1: Both participant and wife made the decision

1

Doesn’t describe the extent or depth of communication within couples

0: Participant, wife, older family members or others made the decision

Shared contraceptive decision-making with partner

Inter-spousal communication in the context of contraceptive use is well examined in the literature and associated with positive family planning outcomes

1