Impact of home visits to pregnant women and their spouses on gender norms and dynamics in Bauchi State, Nigeria: Narratives from visited men and women

Mudi, Hadiza; Dutse, Umar; Belaid, Loubna; Ansari, Umaira; Omer, Khalid; Gidado, Yagana; Baba, Muhd Chadi; Mahdi, A H; Andersson, Neil; Cockcroft, Anne

doi:10.1177/1757975920986703

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…In other cases, gender roles were unchanged, but men had improved knowledge and attitudes about what actions could be protective for the health of their wives and children [57]. We undertook a separate analysis focussing on the effect of the home visits on gender norms and dynamics [58].…”

Section: Discussionmentioning

confidence: 99%

“I had to change my attitude”: narratives of most significant change explore the experience of universal home visits to pregnant women and their spouses in Bauchi State, Nigeria

et al. 2021

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Background Universal home visits to pregnant women and their spouses in Bauchi State, northern Nigeria, discussed local evidence about maternal and child health risks actionable by households. The expected results chain for improved health behaviours resulting from the visits was based on the CASCADA model, which includes Conscious knowledge, Attitudes, Subjective norms, intention to Change, Agency to change, Discussion of options, and Action to change. Previous quantitative analysis confirmed the impact of the visits on maternal and child outcomes. To explore the mechanisms of the quantitative improvements, we analysed participants’ narratives of changes in their lives they attributed to the visits. Methods Local researchers collected stories of change from 23 women and 21 men in households who had received home visits, from eight male and eight female home visitors, and from four government officers attached to the home visits program. We used a deductive thematic analysis based on the CASCADA results chain to analyze stories from women and men in households, and an inductive thematic approach to analyze stories from home visitors and government officials. Results The stories from the visited women and men illustrated all steps in the CASCADA results chain. Almost all stories described increases in knowledge. Stories also described marked changes in attitudes and positive deviations from harmful subjective norms. Most stories recounted a change in behaviour attributed to the home visits, and many went on to mention a beneficial outcome of the behaviour change. Men, as well as women, described significant changes. The home visitors’ stories described increases in knowledge, increased self-confidence and status in the community, and, among women, financial empowerment. Conclusions The narratives of change gave insights into likely mechanisms of impact of the home visits, at least in the Bauchi setting. The compatibility of our findings with the CASCADA results chain supports the use of this model in designing and analysing similar interventions in other settings. The indication that the home visits changed male engagement has broader relevance and contributes to the ongoing debate about how to increase male involvement in reproductive health.

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Section: Discussionmentioning

confidence: 99%

“I had to change my attitude”: narratives of most significant change explore the experience of universal home visits to pregnant women and their spouses in Bauchi State, Nigeria

et al. 2021

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The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial

Cockcroft,

Belaid,

Omer

et al. 2024

Community Health Equity Research & Policy

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Background Socio-economically disadvantaged women have poor maternal health outcomes. Maternal health interventions often fail to reach those who need them most and may exacerbate inequalities. In Bauchi State, Nigeria, a recent cluster randomised controlled trial (CRCT) showed an impressive impact on maternal health outcomes of universal home visits to pregnant women and their spouses. The home visitors shared evidence about local risk factors actionable by households themselves and the program included specific efforts to ensure all households in the intervention areas received visits. Purpose To examine equity of the intervention implementation and its pro-equity impact. Research design and study sample The overall study was a CRCT in a stepped wedge design, examining outcomes among 15,912 pregnant women. Analysis We examined coverage of the home visits (three or more visits) and their impact on maternal health outcomes according to equity factors at community, household, and individual levels. Results Disadvantaged pregnant women (living in rural communities, from the poorest households, and without education) were as likely as those less disadvantaged to receive three or more visits. Improvements in maternal knowledge of danger signs and spousal communication, and reductions in heavy work, pregnancy complications, and post-natal sepsis were significantly greater among disadvantaged women according to the same equity factors. Conclusions The universal home visits had equitable coverage, reaching all pregnant women, including those who do not access facility-based services, and had an important pro-equity impact on maternal health.

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Factors Working against Exclusive Breastfeeding among Working-Class Women Living around Dagiri Gwagwalada Area Council, Abuja

Olorunfemi,

Awe,

Ogbeye

et al. 2023

Indian Journal of Medical Specialities

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Background: Many human rights issues addressed by various right conventions center on breastfeeding. One of these is the Convention on the Rights of the Child, which outlines fundamental human rights for children, such as the right to life, the right to develop to their full potential, and the right to be protected from harmful influences. Aims: The aim of this study was to evaluate the elements affecting working-class women's exclusive breastfeeding. Materials and Methods: The sample size (n = 196) for a descriptive cross-sectional study that ran from September 2022 to December 2022 was determined using a multistage sampling procedure. Tables, percentages, and Chi-square test statistics were employed at the 0.05 level of significance to examine the data using the Statistical Package Service Software (SPSS) version 23.0. Results: 48% of the respondents were within the age of 30 and 39 years. The majority of respondents (98%) identified the following factors as influencing the practice of exclusive breastfeeding among working-class women: job (93.9%), sore nipple (86.2%), insufficient lactation (43.9%), nipple not prominent (15.8%), not allowed by work (93.9%), breast milk alone before 6 months does not satisfy my baby (58.7%), lack of support from husband (67.9%), mother-in-law (76.5%), as well as inadequate maternity leave (67.9%) as the factors influencing the practice of exclusive breastfeeding among working-class women. In addition, this study shows a significant correlation between working-class women's Knowledge of exclusive breastfeeding and age (Chi-square = 6.016, df = 3, P = 0.024) and the number of children they had (Chi-square = 5.816, df = 3, P = 0.011). Conclusions: This study therefore suggests, among other things, that the state and federal Ministries of Labor and Employment set up childcare for the infant close to the mothers' places of employment to allow their babies to be brought to the workplace or breastfeeding mothers to go to the childcare facility at the time of breastfeeding.

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Impact of home visits to pregnant women and their spouses on gender norms and dynamics in Bauchi State, Nigeria: Narratives from visited men and women

Cited by 3 publications

References 19 publications

“I had to change my attitude”: narratives of most significant change explore the experience of universal home visits to pregnant women and their spouses in Bauchi State, Nigeria

“I had to change my attitude”: narratives of most significant change explore the experience of universal home visits to pregnant women and their spouses in Bauchi State, Nigeria

The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial

Factors Working against Exclusive Breastfeeding among Working-Class Women Living around Dagiri Gwagwalada Area Council, Abuja

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