Creating Demand for Antenatal Care Service Through Community Gate Keepers Involvement in Ede, Nigeria

Presenter: Ademola Adelekan, Public Health Promotion Alliance

Men in Nigeria have traditionally not been involved in the reproductive health care of their partners and they are key players influencing the reproductive health outcomes of their wives and children. This intervention therefore designed to create demand for Antenatal Care (ANC) service through Community Gate Keepers (CGKs) involvement in Ede, Nigeria.  A total of 60 male CGKs who are royal chiefs, religious and community based leaders within the age of 25–60 years were selected and trained on ANC education, importance of Male Involvement (MI) in ANC, barriers and strategies for promoting MI in ANC. Royal chiefs promoted MI during towns or house of chiefs meeting, religious leaders (Islam and Christianity) discussed the issue during religious activities while community based leaders also promoted this during community development meetings. All the trained CGKs jointly developed information and communication materials (Drama, Handbills and Posters) with local language and were used for educating married men in the study area.  Utilization of ANC service increased from 43.3% to 65.3% within 6 months and 83.2% after 12 months. Maternal mortality rate decreased from 8.1% to 3.2% within 12 months. Percentage of men who attend ANC with their wives increased from 5.2% to 43.6% within 6 months and 64.3% after 12 months. The percentage of men who provided money for food and drugs prescribed at the hospital for the wife increased from 34.9% to 64.8% within 6 months and 87.7% after 12 months. Identified facilitating factors for MI in ANC included public awareness on MI, enforcement of MI in ANC, motivation from wife and men economic status.   This intervention promoted male involvement in ANC and utilization of ANC among pregnant women also significantly reduced maternal mortality. Informing men about maternal care and involving them in decision-making played an important role in improving maternal health.