It is also possible that
couples accustomed to shared decision-making in other life domains were more likely to view pregnancy care as
a shared domain. In addition, women who were sole
decision-makers may also be more capable of soliciting
spousal antenatal assistance than women excluded from
participating in other aspects of family life. Conversely,
women with limited say or participation may select not
to invite spouses who may otherwise restrict their careseeking
choices. In a recent review, Ditekemena et al.,
[34] found that some African women feared violence
from spouses who accompanied them to ANC, particularly
as a result of antenatal HIV testing. The significant
positive observations imply that male involvement efforts
may benefit from both empowerment initiatives that
promote women’s participation in social and economic
spheres and male-centered approaches that focus on
new male norms. In addition, increased male involvement
in ANC may spur changes in social norms for
women and men. Such efforts may be most impactful
in settings where women’s empowerment scores are
lowest, as was the case in Burkina Faso.