Causes of short birth interval (kunika) in Bauchi State, Nigeria : systematizing local knowledge with fuzzy cognitive mapping

In Bauchi State (northern Nigeria), “kunika” describes a short interval between successive births, understood as becoming pregnant again before the previous child is weaned. Participants of the study mapped common causes of kunika: frequent sex; not using modern or traditional contraception; and family dynamics. Women indicated forced sex as an important cause, but men focused on lack of awareness about contraception and fear of side effects. Promoting contraception is unlikely to be enough on its own to reduce kunika. The summary maps can help local stakeholders to co-design culturally safe ways of reducing kunika

The impact of universal home visits with pregnant women and their spouses on maternal outcomes: a cluster randomised controlled trial in Bauchi State, Nigeria

In Bauchi State (Nigeria) maternal morbidity is associated with domestic violence, heavy work in pregnancy, ignorance of danger signs, and lack of spousal communication. This cluster randomized controlled trial tested the impact of universal home visits where risk factors were discussed with pregnant women and their spouses, to precipitate household actions that protect pregnant women. Universal home visits which share evidence and provoke discussion between pregnant women and their husbands can reduce maternal morbidity without an increased load on facilities for antenatal and delivery care

Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial

Abstract Background Maternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in pregnancy, lack of knowledge about danger signs, and lack of spousal communication about pregnancy and childbirth. This cluster randomized controlled stepped-wedge trial will test the impact of universal home visits to pregnant women and their partners, and the added value of video edutainment. Methods The trial will take place in six wards of Toro Local Government Area in Bauchi State, Nigeria, randomly allocated into three waves of two wards each. Home visits will begin in wave 1 wards immediately; in wave 2 wards after one year; and in wave 3 wards after a further year. In each wave, one ward, randomly allocated, will receive video edutainment during the home visits. Female home visitors will contact all households in their catchment areas of about 300 households, register all pregnant women, and visit them every two months during pregnancy, after delivery and one year later. They will use android handsets to collect information on pregnancy progress, send this to a central server, and discuss with the women the evidence about household factors associated with higher maternal risks, using video clips in the edutainment wards. Male home visitors will contact the partners of the pregnant women and discuss with them the same evidence. We will compare outcomes between wave 1 and wave 2 wards at about one year, between wave 2 and wave 3 wards at about two years, and finally between wards with and without added edutainment. Primary outcomes will be complications in pregnancy and delivery, and child health at one year. Secondary outcomes include knowledge and attitudes, use of health services, knowledge of danger signs, and household care of pregnant women. Discussion Demonstrating an impact of home visits and understanding potential mechanisms could have important implications for reducing maternal morbidity and mortality in other settings with poor access to quality antenatal care services. Trial registration Registration number: ISRCTN82954580. Registry: ISRCTN. Date of registration: 11 August 2017. Retrospectively registered

Impact of universal home visits with pregnant women and their spouses on the maternal outcomes : a cluster randomized controlled trial in Bauchi state, Nigeria

This 3-minute video is part of the wider project, Innovating for Maternal and Child Health (IMCH). It describes an intervention that raised awareness of “upstream risk factors” which contribute to pregnancy complications: heavy work; domestic violence; inadequate communication between spouses; and health danger signs. The study comprised 8,000 households with data collection via mobile device from home visitors, separating male and female participants. Data analysis showed a marked improvement in women’s pregnancy health as compared to the control study group. The videography provides a level of information that cannot be translated into written reports.Global Affairs Canada (GAC)Canadian Institutes of Health Research (CIHR)Quebec Population Health Research Networ