Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria

Abstract

Background In Nigeria, anecdotes abound that female clients, particularly within northern Nigeria, have gender-based preferences for frontline health workers (FLHWs) who provide healthcare services. This may adversely affect uptake of maternal newborn and child health services, especially at primary healthcare level in Nigeria, where a huge proportion of the Nigerian population and rural community members in particular, access healthcare services. This study explored female clients’ gender preferences for frontline health workers who provide maternal, newborn and child healthcare (MNCH) services at primary healthcare level in Nigeria. Methods The study adopted a cross-sectional quantitative design with 256 female clients’ exit interviews from 66 randomly selected primary health facilities within two States - Bauchi (northern Nigeria) and Cross-River (southern Nigeria). Data was collected using Personal Digital Assistants and data analysis was done using SPSS software. Descriptive analysis was carried out using percentage frequency distribution tables. Bivariate analysis was also carried out to examine possible relationships between key characteristic variables and the gender preferences of female clients involved in the study. Results Out of 256 women who accessed maternal, newborn and child health services within the sampled health facilities, 44.1% stated preference for female FLHWs, 2.3% preferred male FLHWs while 53.5% were indifferent about the gender of the health worker. However only 26.6% of female clients were attended to by male FLHWs. Bivariate analyses suggest a relationship between a female client’s health worker gender preference and her pregnancy status, the specific reason for which a female client visits a primary healthcare facility, a female client’s location in Nigeria as well as the gender of the health worker(s) working within the primary healthcare facility which she visits to access maternal, newborn and child health services. Conclusions The study findings strongly suggest that female clients at primary healthcare level in Nigeria possibly have gender preferences for the frontline health workers who provide services to them. There should be sustained advocacy and increased efforts at community engagement to promote the acceptability of healthcare services from male frontline health workers in order to have a significant impact on the uptake of MNCH services, particularly within northern Nigeria.

Effect of Gender on the Utilization of Maternal and Child Health Services among Pastoralist Caregivers in Somali Region of Ethiopia

“…Our study shows that caregivers visited the health facilities to seek health services for their children more than for themselves and one of the reasons mentioned during the focus group discussions was because of fear of being attended to by male health extension workers when they go to the health facilities which is regarded as a social taboo which makes the use of traditional birth attendants preferred option for care and delivery when pregnant This corroborates findings reported in other studies that female clients tend to prefer accessing maternal, newborn and child health services from female health workers, especially in primary healthcare settings [30][31][32]. A study in India reported that health facilities with higher availability of female health workers were found to be associated with higher maternal health care utilization than child health care utilization and suggested that improving gender parity in the health workforce especially in rural areas may improve maternal health care use [33].…”

Correlates of Health Care Workers’ Knowledge and HIV-Exposed Infant Immunization Counseling Practice in Northern Nigeria

“…The predilection of mothers towards consulting female health workers could also challenge them to seek knowledge about HIV-exposed infant immunization. 35 The predictive role of age and work experience could be attributed to the impact of cumulative experience and in-service training opportunities. Further, the finding of knowledge disparity between the professions, though this conflicts with reports from Ghana, 26 could reflect differences in pre-service curricula, roles, and responsibilities as well as access to continuing education opportunities.…”

“…For instance, in the study setting, immunization services tend to be dominated by nurse/midwives, who are predominantly female. 34 , 35 Similarly, respondents who received prior training in infant immunization are more likely to counsel mothers living with HIV. In contrast, those without such training may avoid such encounters or refer mothers to their experienced colleagues.…”