“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

Abstract 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 t...

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Autores principales:	Loubna Belaid, Umaira Ansari, Khalid Omer, Yagana Gidado, Muhammed Chadi Baba, Lois Ezekiel Daniel, Neil Andersson, Anne Cockcroft
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Behavior change Maternal health Child health Narratives Home visits Thematic analysis Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/edac38cceda54b1996cfe395931c0a75
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spelling	oai:doaj.org-article:edac38cceda54b1996cfe395931c0a752021-11-21T12:12:13Z“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, Nigeria10.1186/s13690-021-00735-92049-3258https://doaj.org/article/edac38cceda54b1996cfe395931c0a752021-11-01T00:00:00Zhttps://doi.org/10.1186/s13690-021-00735-9https://doaj.org/toc/2049-3258Abstract 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.Loubna BelaidUmaira AnsariKhalid OmerYagana GidadoMuhammed Chadi BabaLois Ezekiel DanielNeil AnderssonAnne CockcroftBMCarticleBehavior changeMaternal healthChild healthNarrativesHome visitsThematic analysisPublic aspects of medicineRA1-1270ENArchives of Public Health, Vol 79, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Behavior change Maternal health Child health Narratives Home visits Thematic analysis Public aspects of medicine RA1-1270
spellingShingle	Behavior change Maternal health Child health Narratives Home visits Thematic analysis Public aspects of medicine RA1-1270 Loubna Belaid Umaira Ansari Khalid Omer Yagana Gidado Muhammed Chadi Baba Lois Ezekiel Daniel Neil Andersson Anne Cockcroft “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
description	Abstract 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.
format	article
author	Loubna Belaid Umaira Ansari Khalid Omer Yagana Gidado Muhammed Chadi Baba Lois Ezekiel Daniel Neil Andersson Anne Cockcroft
author_facet	Loubna Belaid Umaira Ansari Khalid Omer Yagana Gidado Muhammed Chadi Baba Lois Ezekiel Daniel Neil Andersson Anne Cockcroft
author_sort	Loubna Belaid
title	“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
title_short	“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
title_full	“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
title_fullStr	“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
title_full_unstemmed	“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
title_sort	“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
publisher	BMC
publishDate	2021
url	https://doaj.org/article/edac38cceda54b1996cfe395931c0a75
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“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

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