Associations Between Male Partner Participation, Women's Autonomy, and Postpartum Care Seeking Among First Time Mothers, 15-24 Years, in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Analysis.

The Democratic Republic of the Congo (DRC) has high maternal and neonatal mortality rates and only a third of mothers and newborns have a postpartum or postnatal care visit. Increasing male participation and enhancing women's autonomy are strategies to increase maternal healthcare utilization, but their applicability to first-time mothers (FTMs) in Kinshasa, DRC is unknown. We conducted a secondary analysis using cross-sectional survey data from a maternal and child health project among FTMs and their male partners in Kinshasa. The sample consisted of 1750 FTMs aged 15-24 years. The outcome variables were (1) a postpartum care visit within six weeks of facility discharge for the mother, (2) a postnatal care visit within six weeks of facility discharge for the neonate, and (3) either a postnatal or postpartum care visit within six weeks of facility discharge. Two logistic multivariate regression models were run for each outcome. The first model included all explanatory and demographic variables, and the second model added two interaction terms to test for mediation by in-union status. The male participation in maternal care index was negatively associated with all outcomes and the male participation in childcare index was positively associated with all outcomes. In-union status moderated the relationship between the male involvement indices and postpartum care for the mother but not for postnatal care for the newborn. Our findings show that the type of male participation may be meaningful for increasing postpartum and postnatal care-seeking and male partner participation initiatives need to be contextualized to prevent adverse outcomes.