Negotiating Gender Roles and Male Involvement in Maternal Healthcare: A Qualitative Study of Low-Income Communities in Chiniot, Pakistan

Abstract

The global academic community has universally recognized that men’s participation in maternal health care is a core element to improve women’s access to antenatal, intrapartum, and postnatal services. However, Pakistan’s patriarchal family structure has imposed long-term limitations on the development of local maternal health care. This qualitative study was conducted in low-income communities in Chiniot, Punjab Province, using purposive sampling and involving 20 husbands, 20 wives, and 5 healthcare workers. Data were collected through in-depth interviews and focus groups, and inductive thematic analysis was used to explore participants’ perceptions and negotiation processes. The findings indicate that male participation in maternal health affairs exists but is characterized by clear selectivity. Men commonly provide financial support, transportation, medication purchases, and emergency assistance, yet rarely accompany pregnant partners to antenatal care appointments, offer emotional support, or share household chores. Maternal health care is widely regarded as a female responsibility, with men expected primarily to fulfill the roles of financial provider and decision-maker. Women’s experiences of male involvement were mixed; some appreciated the support received from their husbands, while many reported discomfort with male presence due to modesty norms, privacy concerns, and fear of social judgement. Maternal-healthcare utilisation was further constrained by poor roads, transport costs, long distances, limited public services, and negative experiences with healthcare providers. The study concludes that encouraging men to attend health facilities with women alone is insufficient. Interventions should promote joint decision making, women’s autonomy, dignity and respect during maternity care, gender-sensitive counselling by trained personnel, and improved access to maternal-health services while respecting women’s privacy and their right to make free and independent healthcare choices.