Demand for and utilization of women's health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women's health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region's population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women's health-seeking behaviors for themselves and for their children. Programs seeking to improve women's health outcomes in northern Nigeria should involve women's influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services. RésuméLa demande et l'utilisation des services de santé des femmes dans le nord du Nigeria sont toujours faibles et les indicateurs de santé dans la région sont parmi les plus pauvres du monde. Cette revue de la documentation se concentre sur les obstacles sociaux et culturels à l'utilisation de contraceptifs, les soins prénatals et les naissances dans des établissements dans le nord du Nigéria, et les influences du comportement de recherche de la santé des jeunes femmes. Une recherche approfondie de la documentation grise et évaluée par les pairs a permis d'obtenir 41 publications synthétisées et analysées. La population de la région est majoritairement musulmane, pratiquant l'islam comme toute une mode de vie. Tandis que la société au nord du Nigeria évolue lentement, la plupart des femmes manquent encore d'éducation formelle, avec une proportion importante mariée dans leur adolescence et la majorité n'étant ni socialement ni économiquement habilitée. Le mari prend en grande partie la plupart des décisions du ménage, y compris l'utilisation des services de santé par les membres de son ménage. Ces pratiques influent directement sur les comportements de recherche de la santé des femmes pour eux-mêmes et pour leurs enfants. Les programmes visant à améliorer les résultats de la santé des femmes dans le nord du Nigeria devraient impliquer les gens qui influencent des femmes pour affecter le changement de comportement, y compris les maris, les chefs religieux et d'autres. De plus amples recherches sont nécessaires pour identifier les voies d'information qui peuvent être utilisées par des programmes conçus pour accroître la demande de services de santé dans la région. (Afr J Reprod Health 2017;...

Over 90% of households in rural Uttar Pradesh, the most populous state of India, have at least one mobile phone. However, ownership of mobile phone among women is quite low. Implementation research was conducted in Uttar Pradesh to examine (a) whether providing information on selected maternal and child health (MCH) behaviors to a husband's mobile phone would enhance the man's knowledge and lead to discussions in their family, and (b) whether such discussions would help in the adoption of healthy practices. The m-Health intervention included biweekly voice messages in local language (Hindi) on MCH topics to the mobile phone of pregnant women's husbands. Using a quasi-experimental design, after four months of the m-Health intervention, in 2014, 881 husbands and 956 women from the study area were interviewed. Husbands' knowledge, controlling for their socio-demographic characteristics, were significantly higher among the listeners of the messages than the non-listeners. Multivariate logistic regression analysis showed that if husbands discussed the messages with family members, the odds of wives' practicing health behaviors improved significantly for three behaviors. These include one antenatal checkup in last trimester of pregnancy (odds ratio 1.72, p < 0.05), receiving a postnatal checkup within 7 days of delivery (odds ratio 3.02, p < 0.05), and delayed bathing of newborn (odds ratio 1.93, p < 0.05). Thus, communicating messages using m-Health was found to be an effective intervention for behavior change. The study demonstrated that mobile phones can be used effectively to reach men with MCH information and encourage them to promote healthy behavior in their family.

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The Population Council confronts critical health and development issues from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a non-governmental, nonprofit organization governed by an international board of trustees.

Despite the many advantages of the IUD as a method of family planning, it generally suffers from unpopularity worldwide, with the exception of a few countries like China, Egypt, Mexico and Turkey. The scenario in India is the same, with less than two percent of currently women adopting the IUD as a method of contraception. The USAID-funded FRONTIERS Program of the Population Council, in collaboration with the Department of Health & Family Welfare, Government of Gujarat and the Center for Operations Research and Training, Vadodara, conducted an operations research study to test the hypothesis that improving the demand for the IUD and simultaneously strengthening the technical competencies and counseling skills of the providers, use of the IUD use would increase. A pre and post intervention design with no control group was used. The study was carried out in both rural and urban areas with a population of 300,000 in Vadodara District, Gujarat. The package of interventions included: (a) strengthening counseling and technical skills of providers; (b) an educational campaign using field-tested behavior change communication (BCC) educational materials; (c) strengthening provision of IUD services in selected sub-centers and PHC; and (d) making the programmatic environment more supportive of spacing methods. The impact of the intervention was evaluated nine months after introduction of the interventions. Knowledge of providers on the critical steps for providing IUD services increased significantly, from 5 percent to 40 percent, and the proportion of women having poor knowledge (score of <7 out of 29) decreased significantly from 81 to 47 percent. Though the proportion believing in myths decreased significantly from the baseline, their prevalence was still high at endline. The proportion of IUD users who reported the quality of IUD services received to be good (score of ≥ 25 out of 34) increased from 26 percent to 73 percent. A majority (92 percent) of providers used the IEC materials developed during the project when counseling clients and 95 percent of them stated that their performance improved because of the IEC materials. Due to continuous monitoring and supportive supervision by the medical officers, over-reporting of IUD cases decreased significantly from 42 percent to 2 percent. Comparison of month-wise IUD insertion rates during the intervention period (2007), compared with 2006 showed significant improvement after adjusting for over reporting. A cost analysis shows that the additional cost of carrying out educational activities and strengthening provision using this model is approximately $3.37 per IUD user and to strengthen IUD services in one facility is approximately $74 per facility. These costs are for the pilot project; if the model is scaled up the per-site cost will be lower because of the scale of expansion. These are affordable costs and need serious consideration by the Family Welfare Department.