Table 3.

Summary of main findings.

Topic area	Status with respect to fathers	Barriers	Facilitators
Fathers’ caregiving behaviors
Discipline	- Central role of fathers - Fathers commonly use harsh disciplinary practices and viewed as effective for helping child learn	- Cultural norms - Intergenerational traditions (reflect disciplinary styles that were used against fathers during their childhood) - Young age of child (belief that inappropriate to physically punish infants) - Lack of knowledge - Lack of time (despite the greater perceived effectiveness of paternal discipline, mothers spent more time at home with the child)	- Fathers abstained from using violence, so children did not fear them - Positive couples relationships reduced use of harsh discipline
Play and communication	- Most fathers reported engaging in some form of play and communication with young children - Several mothers and community stakeholders reported that fathers were uninvolved in play or communication activities	- Lack of time - Lack of knowledge - Restrictive gender norms (childcare roles viewed as responsibility of mothers) - Young age of child (belief that infants are too young for fathers to play with)	- Joy and love brought to both children and fathers - Strengthened father-child bond - Defining characteristic of a “good father”
Other childcare and household responsibilities	- Primarily perceived as maternal responsibility, but with many fathers engaging indirectly through their financial roles (e.g., purchasing foods) - Any paternal engagement was circumstantial (e.g., mothers were sick or too busy) but not a regular role of fathers - Care seeking for child illness seen as joint responsibility, but fathers’ involvement was again primarily indirect (e.g., providing money)	- Restrictive gender norms (viewed as mother’s responsibility, father who did such activities viewed as “bewitched”) - Social stigma and fear of community perceptions - Intergenerational traditions - Lack of time - Engagement in such activities viewed as having high opportunity costs - Young age of child (belief that infants are too fragile to be held by fathers)	- Defining characteristic of a “good father” - Desire to reduce burden on partners, give them time to rest, and show love - Beneficial for children to build stronger relationships with father - Increasing fathers’ knowledge, awareness & community sensitization can facilitate greater acceptability
Couples’ relationships
Couples’ communication	- Fathers discussed child-related, family livelihood, and financial matters with their partners - Few fathers discussed sexual relations or intimacy with their partners - Many mothers were dissatisfied about the ways their partners (i.e., fathers) communicated with them - Mothers and fathers believed that more positive communication with their partner benefited their children	- Lack of time spent at home - Fathers’ alcohol consumption - Lack of trust in partner or loyalty in marriage	- Beliefs about benefits of couple’s communication - Mutual respect and understanding between partners in relationship - Understanding of the benefits of positive communication on child’s development
Partner support	- Fathers’ support for partner included financial, practical, emotional, and childcare-related support - Fathers’ practical and childcare-related support were largely circumstantial to the mothers being unavailable; however, some fathers described such support to reduce the burden on their partners - Many parents believed fathers’ financial support was not sufficient and emotional support was also required - Fathers and mothers described the benefits of supportive and loving relationships on their child’s wellbeing and development	- Lack of time spent at home - Lack of money - Restrictive gender norms	- Belief that partner support is an expression of gratitude & brings couples closer together - Desire to be a good role model for child - Community support for supportive relationships - Perception that partner support is associated with behaviors of “good fathers” - Couples with mutual respect had more shared decision-making
Decision-making	- Fathers are the primary decision makers especially over financial and household matters - Childcare-related decisions seen as primarily mother’s responsibility - Some fathers and mothers believed that the decision making process should be shared between partners	- Patriarchal gender norms - Intergenerational traditions - Religious beliefs and Tanzanian law justify fathers’ decision-making - Idea that primary breadwinner is de facto the decision-maker	- Shared decision-making more likely when both parents generated income - Values that support gender equity in decision making
Male partner violence	- Fathers were reported as using physical, emotional, and sexual violence against their partners - Many fathers justified the use of physical and emotional violence as a way of reprimanding their partners - Intimate partner violence had direct negative consequences on child wellbeing and development	- Patriarchal gender norms - Fathers’ alcohol consumption	- Parental values of peaceful approaches to conflict resolution - Perception that non-violence is associated with behaviors of “good fathers” - Desire to be a good role model for child - Awareness of adverse impact of violence on child wellbeing and development
Fathers’ mental health
Mental health	- Many fathers reported experiencing symptoms of stress and anxiety, and some endorsing depression and even suicidal ideation	- Common sources of mental health concerns included poverty, marital issues, unmanageable child behaviors - Negative coping strategies included fathers’ increased use of alcohol, withdrawal/isolation from family	- Positive coping strategies included turning to social support networks (friends, partner, parents), spiritual practices, exercise