A Methodology for Assessing a Football Club-Based Male Engagement Intervention to Increase Partner Attendance at Antenatal Care in Blantyre, Malawi

Male partner involvement in antenatal care is linked to improved maternal and neonatal outcomes in sub-Saharan Africa, yet effective engagement strategies are needed. This paper describes the methodology for evaluating an intervention using community football clubs to promote male partner attendance at antenatal care in Blantyre, Malawi. The purpose is to detail the methodology for a cluster-randomised trial assessing a football club-based male engagement intervention. The primary objective is to determine if the intervention increases the proportion of pregnant women attending at least one antenatal care visit with a male partner. Secondary objectives include assessing changes in male knowledge and attitudes regarding antenatal care. A two-arm, cluster-randomised controlled trial design is employed. Community football clubs are randomised to an intervention or control arm. The intervention comprises structured educational sessions delivered by trained coaches during football training, covering antenatal care importance, pregnancy health, and partner communication. The control arm receives standard health information leaflets. Data are collected through surveys with male club members and their female partners, and via antenatal care clinic records. The primary outcome is partner attendance, verified by clinic records. As a methodology article, no empirical trial results are presented. This section details the developed and piloted intervention protocol. The pilot phase demonstrated successful recruitment and training of football coaches and indicated high acceptability, with a high proportion of approached clubs agreeing to participate. This methodology provides a rigorous framework for evaluating a community-based, sport-for-health intervention aimed at increasing male involvement in antenatal care. The use of existing football club structures offers a potentially scalable model for male engagement in public health programmes in similar settings. Future research should consider the intervention’s cost-effectiveness and explore adaptations for other health topics and cultural contexts. Programme planners should consider integrating such community-based approaches into broader health promotion strategies. male engagement, antenatal care, participation, football clubs, cluster-randomised trial, Malawi, methodology This article contributes a detailed methodological protocol for a novel, community-embedded intervention trial, providing a template for rigorous evaluation of sport-for-health initiatives aimed at improving male involvement in maternal health services.