Table 3.

Summary of characteristics of the articles included in the meta-synthesis

Authors, Publication date and Setting	Purpose	Design	Field of study	Sample’s characteristics (Men or Women)	Type of data analysis	Method of data collection	Findings	Sample size
Nesane, K., S.M [15] (2016) Guatemala	Exploring men's views about their participation in the maternal health center	exploratory descriptive	Maternal healthcare	Husband of women who became pregnant 2 years ago	thematic analyze	individual interviews	Them: Maternity care issues are viewed as a Femininity domain. Three sub-themes of culture and involvement in childbirth, job status of male partners, and the unwillingness of men to involvement in maternal health issues	15
Teklesilasie, W. [16] (2020) Ethiopia	to determine the barriers of men participate in maternity health care	exploratory descriptive	maternity care	Men who have had a child in the last 5 years	thematic analyze	individual interviews,face-to-face discussions	parturition is a natural procedure Pregnancy and childbirth is a women's issue Prefer to receive TBA care spouse participation in maternity care as a new idea	102
3 Gibore, N.S [17] (2020) Tanzania	Determining social perspectives on barriers that potentially prevent men from participating in pregnancy care	qualitative approach	maternal health care	Couples with children 2 years and younger, society leaders, Rural health workers, Health professionals	thematic analyze	focus group discussions in-depth interviews	in pregnancy care Behavior based on gender expectations set in culture in pregnancy care, Extramarital pregnancy, Fear of HIV testing, Economic and family instability-unawareness-Health system issues	66
4 Ongolly, F.K [20] (2019) western Kenya	Determining barriers to the presence of men in antenatal and postpartum care	mixed methods	Antenatal care postnatal care	Men who had children in the past year key informant	thematic analyze	focus group discussions	Barriers to men's participation included cultural issues, economic issues, health system issues. Sub-themes included: Maternal health is a women's issue, existence the traditional maternal care (cultural issues), men's jobs, low income, care's costs (economic issues) and lack of services related to men, time-consuming services, health care providers' perspective, lack of space For men, lack of privacy in the centers (health system)	44
Kwambai, T.K., et al. [30] (2013) Kenya	exploring the Men's perceptions of antenatal Care	qualitative approach	antenatal and childbirth care	married men	thematic analyze	focus group discussions	Supporting pregnant women as a female duty, Men as the provider, Men as decision maker, The negative attitude of health providers about male participation, Unfriendly structure of maternal care centers for couples	68
6 Nyondo, A.L., A.F.,et al. [31] (2014) Malawi	Determining of promoting and hindering factors for men's participate in preventing of transition of HIV from mother to child	exploratory qualitative study	preventing of transition of HIV from mother to child	men AND women AND Medical Assistant	thematic analyze	Focus Group discussion face to face Interviews	Unawareness of men about PMTCT, socio-economic issues, communication issues Being shy about issues related to women, unwanted pregnancy or extramarital Pregnancies, Fear of finding out of his HIV status, Reluctance to communicate with the service, Issues related to health facilities, peer effects and cultural Issues	41
7 Adongo, P.B., et al. [32] (2014) Ghana	Exploring the community perceptions about vasectomy and its influences on vasectomy acceptance	qualitative approach	vasectomy	Health workers and health nurses and community members including men, women and health volunteers	thematic analyze	focus group,interviews	Considering Vasectomy as an action against the will of God and subject to the death penalty or accountability on the Day of Judgment, Perception of vasectomy as castration leads to weakening of men in female sexual satisfaction, Concerned about the negative side effects of vasectomy on men, Using the alternative medicine as contraception	148
8 Kabagenyi, A., et al. [33] (2014) Uganda	Exploring women's and men's perspectives on components that prevent men from supporting and using the contraception methods	A cross-sectional qualitative study	contraceptive uptake and reproductive health	Men, women, Government and society leaders	thematic analyses	Focus group interviews	Components that prevent men from participating include: negative Side effects of feminine methods of contraceptives that cause sexual dysfunctionRestriction of available manly contraceptive methods, considering family planning as a femininity issue through perceived gender norms and traditional interaction in reproductive health care, The tendency to have a large family is hindered by the distance between births, Men's concern about their spouse's extramarital sex after taking contraceptives	162
Dral, A.A., et al.[34] (2018) Malawi	Determining the effective components on participation of men in family planning	qualitative study	Family Planning	men, women and health surveillance assistants	Inductive content analysis was performed	semi-structured interviews	Components that motivate people's health behaviors, Gender norms governing relationships, health behavioral proficiencies, Awareness about health behaviors, socio-economic, socio-economic components	23
Adejoh, S.O., A, et al. [65] (2017) Nigeria	Determining the components that influenced men's involvement in maternity health issues	A cross-sectional qualitative study	Maternal Health	married men	thematic analyze	in-depth interview	Health care price, Downturn, and job responsibility as the Cause of non-active involvement of men in antenatal care	30
Auvinen, J., et al. [35] (2013) Zambia	Exploring men's views on the components that prevent participating them to the program of preventing the transit of HIV from mother to child	qualitative descriptive study	preventing the transit of HIV from mother to child	men	Described Content Analysis by Miles and Huberman (1994)	in-depth interview	The barrier of men involvement: Conditions such as poverty, refugee, lack of supportive preparations, and the prevailing culture of prenatal care, passivity, unawareness, marital disagreement, stigma caused by HIV-related conditions, and cultural issues, including patriarchy and religious beliefs prevented men from participating	21
Mohlala, B.K., S.et al. [36] (2012) South Africa	Exploring men and pregnant women's experiences, feelings, beliefs, attitudes, and about men's participation in antenatal care	qualitative studies	Antenatal care	pregnant women and men	Inductive(Goss & Leinbach, 1996) and Deductive (White & Thomson, 1995) analysis	Focus group discussions	unawareness about the male role in antenatal care, Employment Social reasons, Facility and staff attitudes, and Cultural reasons were Obstacles to the presence of men in the antenatal clinic	60
Falnes, E.F., et al. [37] (2011) Tanzania	Determining the acceptance factors of the preventing of transition of HIV from mother to child program and identifying the challenges associated with male participation	Mixed methods	preventing of transition of HIV from mother to child	Women and Men and health personnel	Thematic content approach, (Graneheim and Lundman)	focus group and interview	The main barriers reported: Women were not allowed to ask their husbands for HIV testing. The antenatal Clinic, where HIV testing is performed there, was known as the female environment that men had no presence there	46
Gill, M.M., et al. [38] (2017) Congo	Determining factors affecting the presence of men in antenatal care and identify interventions that potentially improve men's participation	qualitative study	Antenatal services	Men and Women and public health and medicine key informants	thematic analyze	focus group discussions and in-depth interview	Common obstacles include: Lack of time due to job issues, The unfriendly environment of the clinic for men and couples, Considering pregnancy as a female domain and Men were afraid of testing for HIV	38
Jungari, S.et al. [39] (2019) India	Evaluation of men's participation in antenatal care, childbirth, postpartum care (PNC), housework, and food supply	mixed-method	maternity care	Women with children under 2 years old men whose wives gave birth health care providers village head trained/untrained dais	thematic analyze	Interviews focus group	Men believed that their presence in maternal care was not necessary and also they believed that maternity care is a feminine issue that prevented them to participate in maternity care	385
MirzaiiNajmabadi, K., et al. [40] (2019) Iran	Determining the barriers to men's participation in reproductive and sexual health education	conventional content analysis	Sexual and Reproductive Health Education	Men, religious scholars, health professionals, officials of health organizations	conventional qualitative content analysis	individual in-depth semi-structured interview	perceived threat less than usual, reluctance to learn, socio-cultural taboos, inadequate knowledge of family and Poor performance in family, policy barriers, executive barriers, and health systems deficiency under three topics including individual problems, socio-cultural issues, and structural problems as barriers to participation Men were identified	34
Dovel, K., et al. [41] (2020) Malawi	Investigating the systematization of health institutions and determining the men s perspective of participating in HIV testing	mixed methods ethnography	HIV testing	healthcare workers national key informants rural health facilities observational journals	deductive and inductive technique Based on technique Atlas. Tivol version 6	In-depth interviews in direct observation	Gender expectations intertwined with health organizations at three levels: organizational policy, organizational performance, and structural	29
Kashaija, D.K [42] (2020) Tanzania	Exploring the men's perceptions and experience of their spouse support in maternity care	Qualitative descriptive study	supporting the wives during childbirth	Men	qualitative content analysis	in-depth interview	Problems in transferring spouses to health centers due to poor road infrastructure, lack of support for men's accommodation in health centers, the financial instability of men, the attitude of the health care provider prevented men from participating to support their wives	9
Ladur, A.N. et.al [43] (2015) South Africa	Exploring the perspective of men, women, and health care providers about men's participation in preventing of transition of HIV from mother to child program	exploratory qualitative	preventing of transition of HIV from mother to child	Men Women HIV-positive couples service providers	Two methods: summative Content and Thematic Analysis	focus group interviews	Fear of stigma, Staff shortages, negative attitudes of health providers, tiny space of health centers, worrying about privacy, Time consuming services, and discomfort from being in the feminine environment of the health centers prevented men from participating in PMTCT services	25
Kaida, A., et al.[44] (2005) Uganda	Exploring men's perspectives about family planning and determining how they tend to involve in the family planning program	Qualitative study	family planning	key informants married men	Thematic analysis	Interviews focus group discussion	Inadequate information, misconceptions, fear of side effects of contraceptive methods, insufficient access to family planning services, mistrust of service providers, Distrust between couples, failure to consult between the couple, and cultural-religious issues were barriers for participation of men in family planning programs.	31
Maluka, S.O [45] (2018) Tanzania	Determining context-based perspectives on men's participation in maternity care	Qualitative study	pregnancy and childbirth care	Women who were pregnant or gave birth in the past year, men who accompanied their spouse to care center, health center staff, society leaders, social assistant, traditional birth service providers	Thematic analysis	In depth interviews	The determining gender roles in the family, fear of HIV testing, and inappropriate health centers environment for men's presence prevented them from participating	53
McEvoy R. et al. [23] (2018) Burkina Faso	Exploring the viewpoints of men and women on hindrances to use of family planning method	qualitative study	family planning	men and women opinion leaders adult men and Married women	constant comparative technique	focus groups in-depth interviews	The barriers to men's participation in family planning included the negative attitudes of men, ignorance of modern methods of contraception, misconceptions about modern methods of contraception, concerns about side effects of contraceptive methods, cultural norms, and social preferences for having large families	52 20 focus groups
Lowe, M [46]. (2017) Gambia	Determining some basic socio-cultural issues effective on men's participation in maternity health issues	qualitative study	maternal health	Men, Traditional birth attendant	thematic analysis	focus group discussion in-depth interviews	Maternity issues were perceived as female issues. Competition of job responsibilities with issues related to maternity care. Competition between the wives of polygamous men, fear of stigma	56
Reuben Mahiti, G, et al. [66] (2017) Tanzania	Determining men's viewpoints of cultural actions during postnatal care	qualitative study	Postnatal care	man	content analysis (Griesheim and Lundman)	focus group discussion	Embarrassing about participating in pregnancy care, Belief in Bing the femininity of reproductive issues, Bing unusual the Accompanying of men with their spouse in reproductive health clinics socially were barriers of male participation in reproductive health	93
Aborigo, R.A., et al. [19] (2018) Ghana	Determination of the causes of men's resistance to the acceptance to play the active role in maternity care and their effects in the decision-making process for emergencies	qualitative study	maternal health	health staff society leaders	content analysis	focus group interviews	Men believe that accompanying spouses in maternity care are Unnecessary practiced. Men's involvement in maternity cares an embarrassing practice. Men believe that expressing affection to the spouse is embarrassing. Inappropriate clinical infrastructure to the presence of men	136
Mkandawire, E. et al. [47] (2018) Malawi	Determining the perception of rural people about the concept of men's participation in maternal and child health. Exploring the effective factors for men's participation in maternal and child care	qualitative study	maternal and child health	Informants community members	thematic analysis	focus group interviews	Sociocultural issues, fear of social stigma, costs of male participating in antenatal care prevent men from participating in antenatal care	70
Firouzan, V., et al. [18] (2019) Iran	Explore the factors that prevent men from participating in prenatal care	qualitative research	Perinatal care	Pregnant women, women who have given birth recently spouse of pregnant women Health staff	conventional content analysis	interviews, focused group	Cultural issues, personal issues, personal preferences, interpersonal issues, infrastructure issues in the health system, and socio-economic issues were the main obstacles for men	45
Greenspan, J.A., et al. [48] (2019) Tanzania	Determining factors to increase men's participation in maternal and infant health services	qualitative research	Maternal and newborn health	Men	inductive analyzed	in-depth interviews	Factors associated with men's non-participation in maternal and infant care were inadequate knowledge, preference for economic activities, costs associated with care, and limiting the presence of men in health centers due to the policies governing these centers	27
Ganle, J.K., et al. [49] (2015) Ghana	To determine the limiting and encouraging factors of men's participation in maternal care	qualitative research	maternal healthcare	adult men and his wife and key informants	thematic analysis	Focus group interviews	Male-dominated gender roles in society and related issues, cultural issues and practices, the financial burden of accompanying women in maternal care, and the structure of health services such as negative attitudes of health personnel, small space, inadequate working hours were factors that limited men's participation in maternal care	80
Sakala, D., et al. [50] (2021) Malawi	Exploring the main factors preventing men from participating in antenatal care and determining the importance of facilitator of male participation	qualitative study	Antenatal care including HIV testing	men and women	Thematic analysis	focus group interviews	The men's preference for economic activities, fear of being seen by their friends, discomfort with being in the feminine environment of center, health center environment issues, and providing HIV related services along with other maternity services caused reducing the men's presence in antenatal services	60
Gopal, P., et al. [51] (2020) Uganda	Exploring the perspectives and experiences of stakeholders on male participation in reproductive health by considering economic and political factors	qualitative study	reproductive health	Men participating in maternity health care, their spouses, organizations, and people involved in male participation in reproductive health	thematic analysis	focus group and interviews	Lack of accurate conversion of policies into action, Problems with resources in the health system and lack of skills to involve men in her reproductive health care, ‘inadequate participation by key actors’, and ‘types of dissemination’
Shahjahan, M, et al. [52] (2006) Bangladesh	Exploring the men's awareness and viewpoint on reproductive health and how to increase men's participation	qualitative study	Reproductive health	Men	Dot tell	focus group	Men's lack of motivation to participate in reproductive health care, Feeling no need for reproductive health services Not encouraging men to participate in reproductive health services Lack of understanding of women's reproductive health issues due to interaction problems between couples Lack of companionship with the spouse in health services due to the prevailing culture in the community Reluctance to associate with health workers	38
Sharma V,et al. [53] (2019) Nigeria	To investigate engagement of men in maternal and infant health	qualitative study	maternal and newborn health	Husbands community leaders community health workers	Thematic analysis	Interviews focus group	Inadequate knowledge, Men's gender viewpoint on issues associated with maternity care, fear of mockery, and a negative viewpoint of health's staffs, led to the limited participation of men in maternity care	82
Vermeulen, E., et al. [54] (2016) Tanzania	Exploring the rural men's Perception, perspective, and behavior on participating in maternity care	Mixed method approach	pregnancy	men and health worker	Don’t tell	focus group interviews observation	A traditional gender perspective on pregnancy and maternity care, inadequate knowledge, insufficient access to prenatal care due to unavailable facilities to join the pregnancy care, and the negative experience of attending health centers	112
Sharma, S.et al. [55] (2018) Nepal	Exploring the gender attitudes of health workers and teachers about the components involved in men's participation in reproductive health care	qualitative study	reproductive health	Male teachers Health professionals of the health post	content analysis	focus group and interviews	The institutionalized socio-cultural norms, lack of training about reproductive health, misconception, predomination of women as health care workers in health centers hindered the participation of men in reproductive health	20
Dumbaugh M [56] (2014) Ghana	Exploring perceptions, attitudes, and barriers of male participation in newborn care in Ghana	qualitative study	Newborn care	Men and women who recently became parents	Based on the guidelines for reviewing qualitative research	focus group and interviews	Barriers identified to increase male participation in newborn care include factors related to the division of labor and space based on gender and generation	59
Yeganeh N [57] (2017) Brazil	Exploring the barriers and facilitators of men's participation in prenatal care and HIV counseling in Brazil	qualitative study	prenatal care and STI	Men who did and who did not Meet whose wives and infants in the postpartum ward	Thematic analysis	interviews	Stigma against HIV-positive people and the conflict between men's work and pregnancy care planning were the main barriers to men's participation	35
Willcox ML [58] (2021) Uganda	exploring the barriers and facilitators of couples counseling programs on postpartum family planning and prenatal counseling in Uganda	qualitative study	family planning	Women who attend antenatal or postnatal clinics Men who attended the health facility Health workers who work in reproductive health care clinics	thematic analysis	Interviews and focus groups	The contradiction between work and attendance at the family planning clinic, transportation costs, and the feeling of stigma caused by attendance at the reproductive health clinics are some of the obstacles to the participation of men in the family planning counseling program after childbirth	338
Mapunda B [59] (2022) Tanzania	Exploring the men's views on participation in prenatal care and determining the factors involved in their participation	Mixed method approach	Antenatal care	Men whose female partners attended the antenatal clinic	Thematic analysis	focus group	The cultural factors and gender perspective, inadequate knowledge about antenatal care, factors beyond men's control, conflict in relationships between couples, and obstacles related to the structure of antenatal service were five factors that were identified as barriers to men's participation	18
Okafor IP [60] (2022) Nigeria	Assessing the participation of men in maternal and child health and Exploring the barriers and predictors of men's participation in maternal and child health	mixedmethod approach	maternal and child health	Adult men who have at least one child under the age of 5 living together in the family	Thematic analysis	focus group discussion	Socio-cultural factors, lack of time for participation, fear of being stigmatized, the views of health workers, and costs related to maternal and child health care were among the most important barriers to men's participation	11
Sakala D [50](2021) Malawi	Exploring the barriers and facilitators of men's participation in antenatal care and HIV testing	qualitative study	antenatal care and STI	women who attend ANC for the first time and their partners	Thematic analysis	ocus group discussion and interview	Social norms, gender perspective of antenatal care, peer's perspective, fear of HIV testing, and conflict between job commitment and participation in antenatal care were the most important obstacles to men's participation in antenatal care	62
Forbes F [61] 2021 Australian	Exploring the experiences, attitudes, and beliefs of recent Ethiopian immigrant families living in Australia about men's participation in perinatal care	qualitative study	perinatal care	Ethiopian migrant men and women living in Australia and attended maternity care	Thematic analysis	interviews	Employment in the form of paid work, Restrictions the paternity leave, prioritizing earning over participation in care, and cultural and social issues governing families were important obstacles to men's participation in prenatal care	13
Davis J [3] (2016) Pacific	Explaining the perspective of maternal and child health professionals about the benefits, barriers, and approaches to increasing men's participation in maternal and child health services	qualitative study	maternal and child health	Senior professionals in health sectors, UN agencies, hospitals, universities, regional NGOs	Thematic analysis	interviews	Social norms and cultural issues, difficulties in communicating the health system with couples before pregnancies, the physical environment of health service centers, the perspective of health center staff, and their heavy workload, were the important challenges of men's participation in maternal and child health care	17
Sharma V [53] (2019) Nigeria	Exploring men's participation in mother and child health	qualitative study	mother and child health	Men whose wives or children had complications or died Community leaders Health providers People who were present when complications occurred for the mother and baby	Interviews and focus group discussions	Thematic analysis	The absence of female health workers, lack of medicine and equipment, distant health service centers, attitudes and behaviors of health providers, and, misbehavior of health workers were identified as barriers to men's participation	58
Koffi TB [46] (2018) Togo	Exploring the perspectives to improve men's participation in future family planning programs in Togo	A qualitative study	Family planing	Married men include: professional workers, killed and unskillednskilled	focus group discussions	Thematic analysis	Fear of the side effects of contraceptives, concern about the potential threat of fertility, concern for the potential health risks of mother and child following the use of contraceptive methods, and misbeliefs about the use of contraceptive methods were the reasons why men avoid participating in family planning	72
Dychtwald DK [63] (2021) USA	Exploring men's experiences and perspectives about supplementary nutrition programs for women, infants, and children	qualitative study	mother and child health	Couples who enrolled in the supplementary nutrition program for mothers, infants, and children	thematic analysis	interview	Barriers to men's participation in WIC were potential threats to men's pride, fear, and distrust of welfare programs, fear of mandating the participation of men, the unknown role of men in the WIC program, men feeling of being ignored, conflict of working hours of the WIC program with men's working hours, disclosure concerns arising from the relationship between the administrative environment and the WIC program, and Ignoring men in program naming	16
Shongwe P [64] (2019) Eswatini	exploring the understanding of men's perspective on the acceptance of vasectomy and understanding the causes of their poor participation in vasectomy	Qualitative study	Family planing	The sample includes single and married men living in urban and rural areas	thematic analysis	focus group discussion	Ignorance, cultural beliefs, social issues, false beliefs were the barriers to accepting vasectomy	54