Study settings
A cross-sectional study was conducted in the community of Burayu town administration from May 2016 to July 2016. Husbands of women who gave birth in the last 12 months prior to the study were enrolled. Burayu is located in Oromia National Regional State, 15 km from Addis Ababa. The population of Burayu town administration is estimated to be 156,463, of which 51% are women. The estimated total number of women of reproductive age and women who gave birth within the last 12 months in the town are 17,926 and 3161 respectively (Data from town administration health office). The town administration has two health centers, serving an estimated 32,596 estimated households. All the health centers and health posts give maternal health services.
Source population
All husbands/ partners of women in reproductive age who have at least one child and living in Burayu town administration, Oromia region, Ethiopia.
Study population
Husbands/ partners of women in reproductive age who delivered 12 months prior to the study period in the selected kebeles of Burayu town administration, Oromia region, Ethiopia.
Inclusion and exclusion criteria
Husbands/ partners who reside in the study area 1 year prior to the study and whose wives gave birth with in12 months preceding the survey participated in the study. Whereas those who were unable to give consent, were too ill to undergo an interview, and lived apart from their wives were excluded from the study.
Sample size determination
The formula for calculating the sample size was:
$$ n=\frac{{Z^2}_{1-\raisebox{1ex}{$\alpha $}\!\left/ \!\raisebox{-1ex}{$2$}\right.}p\left(1-p\right)}{d^2} $$
Where; n is the desired sample size, p is proportion of husbands/ partners of women who are involved in birth preparedness from the previous study in Mekele town, Tigray region, Ethiopia [10], Z21-α/2 was critical value at 95% CI (1.96), d is the margin of error between the sample and the proportion. Calculation of the sample size for both husband’s knowledge of obstetric (OB) danger signs and involvement were compared, and the result of involvement in BP/CR was taken because of the maximum figure, which was account 524 sample size, considering a design effect of 1.5 and a non-response rate of 10%.
Sampling procedure
Multistage sampling was carried out in Burayu town. The town administration is constituted by six kebeles (the smallest administrative structure in Ethiopia which has its own health post according to the Ethiopian health system). To get representative and adequate sample kebeles, five kebeles were selected using simple random sampling from the total six kebeles. By using each health post in a kebele as a reference point, the total sample size was allocated to each selected kebeles through proportionally and systematically random sampling method applied to select the study subject.
We used all directions from this reference point (North, South, East and West directions as far as suitable roads were available for systematic random sampling method application).
From the houses which were included under the sampling interval, one house was selected using random sampling method. A systematic random sampling was applied to the next household using the calculated every Kth interval in every kebele. For absent study subjects, rescheduling was done to conduct the study. However, if the selected household does not fulfill the inclusion criteria, the next household was substituted for our study, and if more than one candidate was available in the single house hold, one of them was interviewed through a lottery method.
Data collection tools and procedure
A structured questionnaire was used which contained sections; socio-demographic, obstetric, BP/CR and knowledge on key obstetric danger signs (Additional file 1).
The English version of the questionnaire was translated to Amharic and Afan Oromo was then back translated to English. The questionnaire was pre-tested before the actual study on a similar characteristic residing outside of the study area. The pre-test findings were discussed with data collectors and some amendments were done on the questionnaire. Data collection was administered by five female Health Extension Workers (HEWs) who were fluent in both Amharic and Afan Oromo. One supervisor with BSc nursing background supervised the data collectors. The data collectors underwent 2 days of training to become familiar with questionnaire undergo practical exercise on the study instrument and data collection procedures. Data were collected through face-to-face interview with the study subjects.
Men’s involvement on birth preparedness and complication readiness was dependent variable. Whereas, socio-demographic variables, Health Extension Workers (HEWs) influence, obstetric/service utilization of a wife; perceived quality of care provided; accessibility of health facility; husband/ partner individual factor; awareness on danger sign of obstetric complication were considered as independent factors.
Operational definitions
Men’s involvement on birth preparedness and complication readiness
A husband / partner of a woman was considered well prepared or involved if he was found to have made arrangements for at least three of the component practices of BP/CR (identified place of delivery, identified skilled provider, saved money, identified transport ahead of emergency and identified blood donor) for his pregnant wife.
Knowledgeable on danger signs of pregnancy
A husband was considered well knowledgeable- if he mentioned at least two danger sign of pregnancy (vaginal bleeding, swollen hand/ face, blurred vision).
Knowledgeable on danger signs of labor/childbirth
A husband was considered well knowledgeable on danger signs of labor/childbirth- if he could mention at least three of the key four danger signs for labor/childbirth (vaginal bleeding, prolonged labor (> 12 h), convulsion, retained placenta).
Data management
Data were checked for completeness every day and entered into Epi-Info version 7.0 statistical software and cleaned thoroughly before exported to SPSS version 20 for further analysis. Corrections were made and the cleaned data were exported from Epi Info version 7.0 to SPSS version 20 for analysis.
Data analysis procedures
Univariate and bivariate logistic regression analysis were used. Binary logistic analysis used to determine the association between the independent and outcome. Multiple logistic regression analysis was used to control confounding factors. P-value less than 0.05 were taken as a statistically significant association.
Ethical consideration
Prior to the beginning of the study, ethical clearance was obtained from Institutional Review Board of the St. Paul’s Hospital Millennium Medical College. An official letter was obtained from St. Paul’s Hospital Millennium Medical College to the respective city administration/study setting. Permission from the city administration health bureau was secured to carry out the study. Informed written consent was obtained from each individual respondent. The information collected from study participant was kept confidential.