"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

被引:3
作者
Belaid, Loubna [1 ]
Ansari, Umaira [2 ]
Omer, Khalid [2 ]
Gidado, Yagana [3 ]
Baba, Muhammed Chadi [3 ]
Daniel, Lois Ezekiel [4 ]
Andersson, Neil [1 ,2 ]
Cockcroft, Anne [1 ,2 ]
机构
[1] McGill Univ, Dept Family Med, Participatory Res McGill PRAM, Suite 300,5858 Cote Neiges, Montreal, PQ, Canada
[2] Univ Autonoma Guerrero, Ctr Investigac Enfermedades Trop CIET, Acapulco, Mexico
[3] Federat Muslim Women Assoc Nigeria FOMWAN, Bauchi Chapter, Bauchi, Nigeria
[4] Bauchi State Primary Hlth Care Dev Agcy, Bauchi, Nigeria
基金
加拿大健康研究院;
关键词
Behavior change; Maternal health; Child health; Narratives; Home visits; Thematic analysis; Male involvement; HEALTH LITERACY; CARE; STRATEGIES; COUNTRIES; BEHAVIOR; QUALITY;
D O I
10.1186/s13690-021-00735-9
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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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页数:10
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共 61 条
[1]   THE THEORY OF PLANNED BEHAVIOR [J].
AJZEN, I .
ORGANIZATIONAL BEHAVIOR AND HUMAN DECISION PROCESSES, 1991, 50 (02) :179-211
[2]   The women made it work: fuzzy transitive closure of the results chain in a dengue prevention trial in Mexico [J].
Andersson, Neil ;
Beauchamp, Mario ;
Nava-Aguilera, Elizabeth ;
Paredes-Solis, Sergio ;
Sajna, Mateja .
BMC PUBLIC HEALTH, 2017, 17
[3]   Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (Camino Verde, the Green Way): cluster randomized controlled trial [J].
Andersson, Neil ;
Nava-Aguilera, Elizabeth ;
Arostegui, Jorge ;
Morales-Perez, Arcadio ;
Suazo-Laguna, Harold ;
Legorreta-Soberanis, Jose ;
Hernandez-Alvarez, Carlos ;
Fernandez-Salas, Ildefonso ;
Paredes-Solis, Sergio ;
Balmaseda, Angel ;
Juan Cortes-Guzman, Antonio ;
Serrano de los Santos, Rene ;
Coloma, Josefina ;
Ledogar, Robert J. ;
Harris, Eva .
BMJ-BRITISH MEDICAL JOURNAL, 2015, 351
[4]   Building the community voice into planning: 25 years of methods development in social audit [J].
Andersson, Neil .
BMC HEALTH SERVICES RESEARCH, 2011, 11
[5]   Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states [J].
Andersson, Neil ;
Omer, Khalid ;
Caldwell, Dawn ;
Dambam, Mohammed Musa ;
Maikudi, Ahmed Yahya ;
Effiong, Bassey ;
Ikpi, Edet ;
Udofia, Etuk ;
Khan, Amir ;
Ansari, Umaira ;
Ansari, Noor ;
Hamel, Candyce .
BMC HEALTH SERVICES RESEARCH, 2011, 11
[6]   Evidence-based discussion increases childhood vaccination uptake: a randomised cluster controlled trial of knowledge translation in Pakistan [J].
Andersson, Neil ;
Cockcroft, Anne ;
Ansari, Noor M. ;
Omer, Khalid ;
Baloch, Manzoor ;
Foster, Ari Ho ;
Shea, Bev ;
Wells, George A. ;
Legorreta Soberanis, Jose .
BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS, 2009, 9
[7]  
Andersson Neil, 2008, Pimatisiwin, V6, P65
[8]   Community health workers can improve male involvement in maternal health: evidence from rural Tanzania [J].
August, Furaha ;
Pembe, Andrea B. ;
Mpembeni, Rose ;
Axemo, Pia ;
Darj, Elisabeth .
GLOBAL HEALTH ACTION, 2016, 9
[9]  
Bauchi State Ministry of Health, 2013, SOC AUD PRIM HLTH CA
[10]   Effects of community health worker interventions on socioeconomic inequities in maternal and newborn health in low-income and middle-income countries: a mixed-methods systematic review [J].
Blanchard, Andrea Katryn ;
Prost, Audrey ;
Houweling, Tanja A. J. .
BMJ GLOBAL HEALTH, 2019, 4 (03)