First cycle: Maternal health
The social audit on maternal health for the began in 2009. Field teams visited 180 representative communities in two states in Nigeria, Bauchi and Cross River. They interviewed 25,745 women aged 15-49 years to gather information on recent birth history, knowledge and attitudes related to safe birth, and deliveries in the previous three years.
This first evidence-gathering cycle collected information on:
Maternal Health Findings
The study found that lack of knowledge and unfavourable attitudes and beliefs put women at risk during pregnancy and childbirth. In Bauchi and Cross River, 41% of all pregnant women continue to do intensive heavy work during their pregnancy. Most people believe that this work is beneficial for pregnant women and helps them deliver easily. Knowledge about danger signs during pregnancy and childbirth is low. Almost one half of people, men and women, could not correctly identify any danger signs during pregnancy and childbirth.
Importantly, the study identified intimate partner violence as the most consistent and prominent risk factor for pregnant women. Women who had suffered physical intimate partner violence were more likely to suffer from complications during pregnancy and childbirth. Other risk factors included not discussing pregnancy with the spouse, shortage of food in the previous week and female genital mutilation.
These and other findings are the subject of an article in a special supplement of Biomed Central Health Services Research: Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states. Some of these findings are also covered in IDRC’s Overview of Universal Health Coverage.
A short video in which Dr. Neil Andersson elaborates on the theme of safe birth in cultural safety in Nigeria is available: What role does equity play in maternal mortality? For more on CIET’s work on this theme in Mexico, visit our Safe Birth and Cultural Safety website.
Based on the information from household interviews, teams led focus group discussions with men and women in all our sample communities.
Results from the maternal health social audit are also linked to the development of a community surveillance system focused on door-to-door visits with pregnant women.
For more detailed information on the maternal health survey findings and focus group discussions, visit our pages on knowledge and attitudes towards maternal health, antenatal care coverage, use of skilled birth attendants and intimate partner violence. Photos from our fieldwork are available in our maternal health photo gallery.
For more on this initiative, visit IDRC’s project website.