|Year : 2017 | Volume
| Issue : 3 | Page : 62-68
Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria
Muhammed S Ibrahim, Kabir Sabitu, Muawiyyah B Sufiyan, Aisha A Abubakar
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
|Date of Web Publication||2-Apr-2018|
Muhammed S Ibrahim
Department of Community Medicine, Ahmadu Bello University, Zaria
Introduction: Reduction of workload on pregnant women has positive effect on pregnancy outcome. However, participation in household chores among husbands of pregnant women continues to be low. This study assessed the effect of a community-based health education intervention on men’s participation in household chores during their wives’ pregnancy in a rural community.
Materials and Methods: Its is a quasi-experimental study involving men whose wives were currently pregnant. Preintervention, quantitative, and qualitative data were collected from the men and selected community leaders. Then a three-component intervention was conducted in the study community as follows; interactive workshop with the men, a film show with interactive discussion, and distribution of Islamic calendar for the current year carrying messages on men’s participation in pregnancy care. Six months later, postintervention data were collected using the same approach as the preintervention survey. Quantitative data were analyzed using IBM SPSS Statistics 20.0 and qualitative data were analyzed manually.
Results: Mean age of men in the study group was 37.6 ± 10.5 years, and in the control group, it was 35.8 ± 10.8 years (P = 0.275). Men’s participation in household chores was low and showed no statistically significant change between pre- and postintervention data in study (P = 0.937) and control (P = 0.941) groups. Qualitative data showed most men perceived and treated household chores as women’s responsibility.
Conclusion: Participation in household chores by husbands of pregnant women was low, and health education intervention did not significantly increase it. Further studies should evaluate the effectiveness of engaging community and religious leaders in eliminating the norms of gender roles.
Keywords: Community, health education, intervention, men, participation, pregnancy
|How to cite this article:|
Ibrahim MS, Sabitu K, Sufiyan MB, Abubakar AA. Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria. Sub-Saharan Afr J Med 2017;4:62-8
|How to cite this URL:|
Ibrahim MS, Sabitu K, Sufiyan MB, Abubakar AA. Effect of a community-based health education intervention on participation in household chores among husbands of pregnant women in a rural community in Northwestern Nigeria. Sub-Saharan Afr J Med [serial online] 2017 [cited 2020 May 28];4:62-8. Available from: http://www.ssajm.org/text.asp?2017/4/3/62/228975
| Introduction|| |
Men’s action and inaction have significant effects on whether their wives would experience disability or death from complications of pregnancy and child birth. For example, it has been shown that the workload on a pregnant woman is reduced if her husband participates in household chores. Despite this evidence, men’s participation continues to be low.,,,
In a study conducted among men in Osun State, southwestern Nigeria, majority reported participating in household chores. But in another study conducted among men and women in the same state, the men mentioned participation in household chores as the role of an ideal husband. Similarly, opinions were varied among women in another part of southern Nigeria; although some said that men participate in household chores, others insisted that many men subjected their pregnant wives to heavy work. Only a few of the men in the study said they were relieving their wives of household chores.
Many factors affect men’s participation in household chores. In Guatemala, the factors reported include love, desire to avoid future costs, better knowledge, men’s work demands, husband being a witness to past suffering, and feeling of shame. In the same Guatemala, women’s educational status and ethnicity were reported to have no effect on their husbands’ participation in household chores. Orji et al. in southwestern Nigeria reported that norms affected men’s participation to the extent that more men than women thought that a man should participate in household chores.
Worldwide, some interventions have been explored to improve male participation in pregnancy care. They include clinic-based joint counseling of couples, media-based campaigns,, and empowerment of the leaders to promote male participation. Others include teaching women how to present relevant reproductive health information to their husbands, and integration of behavioral interventions into community development projects. A combination of community-based activities, clinic-based couple counseling, training, and monitoring activities of the healthcare workers involved in reproductive health care have also been tried. These interventions have produced varying degrees of successes, and there is no universal model for the involvement of men in maternal health. Thus, efforts are needed to identify interventions that address local needs and realities.
In Nigeria, few interventions have been tried, with limited successes. They include multimedia campaigns and organization of information sessions for community leaders and couples. This study assessed the effect of a community-based health education intervention on men’s participation in household chores during their wives’ pregnancy in a rural community in Kaduna State, northwestern Nigeria.
| Materials and methods|| |
The study design was quasi-experimental with pre- and postintervention components conducted among married men in Dinya, Soba Local Government (study community) and Garu, Kudan Local Government (control community). Dinya and Garu are rural communities with populations of 6206 and 4842, respectively, based on the 2006 national census, located in Kaduna State and inhabited predominantly by Hausa–Fulani Muslims. Each community is about 30 km from Zaria City Gate, and they are about 43 km apart. The main occupation of the men is farming and the women petty trading.
This article contains a synopsis of the materials and methods as the detail was presented in a previous article on knowledge of danger signs of pregnancy, and a conference presentation on determinants of participation in household chores. The main study collected data from men whose wives were pregnant in the last 3 years, including the time of the survey, and who were permanent residents of the study or control community. It excluded any man who, at any time during the last 3 years, did not live in the same home with his wife. The quantitative data for this study was extracted from the responses given about participation in household chores by men whose wives were currently pregnant. In each community, the qualitative data were obtained from two focus group discussions and two key informant interviews.
For the quantitative component, a multistage sampling technique was used to select the respondents. Participants for the two focus group discussions in each community were purposively selected from the eligible men to ensure homogeneity of age in each group that is, 18 to 35 years in one group, and 36 years and above in another. The participants for the two key informant interviews were also purposively selected based on their positions in the communities, community head and leader of community development association. Quantitative data were collected by trained research assistants using a structured interviewer-administered questionnaire containing questions on sociodemographic characteristics of respondent, sociodemographic characteristics of respondent’s wife, men’s participation in birth preparedness, spousal communication, men’s participation in household chores, joint decision-making, and husband’s presence at antenatal care clinic (ANC). The qualitative data were collected by the main researcher as the moderator, assisted by a note taker, using a recorder, writing materials, focus group discussion guide, and key informant interview guide. Data collection interviews were conducted in Hausa.
A three-component intervention was conducted in the study group − Dinya. This lasted for 1 month and involved the use of multiple media of communication. It included an interactive workshop on men’s participation in pregnancy care and a film show which culminated in a discussion based on the content of the film, all for a total of 8 days; 2 consecutive days per week for 4 consecutive weeks. Third, an almanac of Islamic calendar of the current year carrying textual and pictorial messages on men’s participation in pregnancy care was distributed to all participants as souvenirs. Six months after the intervention, a postintervention survey was conducted using the same approach, data collection tools and research team as in the preintervention survey.
The quantitative data were analyzed using IBM SPSS Statistics for Windows, Version 20.0, released 2011; IBM Corp, Armonk, New York, USA. Variables were tabulated using frequencies and percentages, and mean and standard deviation were calculated for the men’s age. A man was considered to have participated in household chores if he answered “yes” to the question on whether or not he personally engaged in household chores. The baseline participation in household chores for study and control groups were calculated and compared. Then, for each community, the change in participation in household chores was assessed by comparing the pre- and postintervention levels. Throughout, statistical significance of difference was assessed using Chi-square test at P < 0.05. Qualitative data were analyzed manually. Data collected on tape were transcribed, translated to English and separated according to themes. Under each theme, the pre- and postintervention findings were presented together in prose.
Before the research, ethical approval was sought and obtained from the researchers’ institutional ethical committee. Permission was obtained from the respective local government authorities and leaders of the communities. Finally, before being recruited into the study, the nature and objectives of the study was explained to each participant and assurance of confidentiality was given, following which verbal consent was obtained. Any participant who did not consent to participating in the study was exempted. After the postintervention data collection, the intervention was replicated in the control community using the same approach as in the study community.
| Results|| |
Preintervention, 88 men in the study group and 82 in the control group had wives who were currently pregnant and were studied. Although postintervention, 83 in the study group and 79 in the control group had wives who were currently pregnant and were studied. The mean age of participants in the study group was 37.6 ± 10.5 years and that of the control group was 35.8 ± 10.8 years, and there was no statistically significant difference between them (P = 0.275). There was no statistically significant difference between other sociodemographic characteristics of the men in the study and control groups [Table 1].
|Table 1: Sociodemographic characteristics of men in study and control communities|
Click here to view
Preintervention, there was no statistically significant difference in level of participation in household chores between the study group (50.0%) and the control group (48.8%) [Table 2]. The major reasons given for nonparticipation in household chores by the men in the study group who did not participate were lack of time 14 (31.8%), household chores not men’s responsibility 21 (47.7%), it was embarrassing one (2.3%), relatives or cowife were there to assist eight (18.2%). In both study and control groups, there was no statistically significant change in participation in household chores between pre- and postintervention [Table 3].
|Table 2: Preintervention levels of the men’s participation in household chores among study and control groups|
Click here to view
|Table 3: Pre- and post-intervention levels of men’s participation in household chores in study and control groups|
Click here to view
The study also looked at pre- and postintervention levels of the various ways the men in the study group reduced household chores on their pregnant wives irrespective of whether they participated by themselves. The major increase was observed in the proportion of men who made arrangement for someone else to do household chores or take care of their children. Only marginal changes were observed in proportion that participated in household chores or took care of the children by themselves [Figure 1].
|Figure 1: Pre-and post-intervention levels of the different ways through which the men reduced household chores for their pregnant wives in the study group|
Click here to view
Extent to which men showed concern about their wives’ general health
Study group: Preintervention, men only showed concern by providing money for wives’ upkeep, arranging for someone to relieve wives of household chores, taking wives to the hospital when sick and buying the drugs prescribed. Postintervention, they said men were paying more attention to their wives’ health, spending more money on their wives’ health, and ensuring adequate nutrition. A KII participant insisted that it could be better.
Control group: At both pre- and postintervention, most participants mentioned talking to her, encouraging her to go to the health facility or taking her there when ill, and buying the prescribed drugs. But a few said most men only show care when there is a complication. Major obstacles faced by men were poverty and unemployment.
Roles played by men in the care of their pregnant wives
Study group: At preintervention, they mentioned acts like helping to reduce the amount of household chores by participating or getting someone else to do them, in addition to other supportive actions. Postintervention, they added that more men were making sure their wives attend ANC and accompanying them when time permits.
Control group: Preintervention, work demand made it difficult for many men to cater for their wives. But in addition to other supportive actions, some men were managing to help by reducing household chores sometimes by doing it personally. In a few cases, all household chores were done by the wife even in advanced pregnancy until she delivers. Postintervention, situation was generally the same.
Husbands’ participation in household chores when their wives were pregnant
Study group: Preintervention, They rarely participated in household chores themselves, mostly arranging for someone to do it. Some participated in household chores themselves because they could not afford to hire a helper when pregnant wife was ill or frail. One participant said, Whenever she is pregnant, I assist in taking care of her children; I bath them, wash their cloth and do other things for them. All agreed that when pregnancy is advanced, the woman should do less household chores. However, some men allowed their wives to go ahead with her chores even in advanced pregnancy. At postintervention, the situation was the same and they added that household chores were not a problem because their wives were not complaining. But one man said, I now help her to fetch water from the well. But you cannot expect a man to enter the kitchen and start cooking. I cannot go out and suffer to get the money to buy the food stuff and firewood and then bring them home and cook for her to eat. What then is the use of having a wife at home?
Control group: Preintervention, most participants said a pregnant woman usually did her chores. But where there was “understanding” between she and her cowife, most husbands would assign the cowife to assist. One participant said, I make sure my two wives don’t get pregnant at the same time. They take turns to assist each other. Some husbands employed maids instead. A few of them were participating in household chores. Postintervention was mostly the same but no mention of husbands participating in household chores themselves.
| Discussion|| |
The proportion of participants who participated in household chores at preintervention was twice as high as the 22.1% recorded in a similar study in southern Nigeria. This could have been because the study in southern Nigeria was done in a semiurban community where the range of household chores differed from that of a rural community. For example, household chores such as chopping of firewood and fetching of water from boreholes (which requires going outside the house) and wells which are more common in rural areas are traditionally done by men in northern Nigeria. However, the study found a lower level of participation in chores than a similar one in Nepal, most likely because the study in Nepal was hospital-based done among ANC attendees whose husbands were present at their ANC and restricted to those in their second trimester. A husband who is present at his wife’s ANC is more likely to participate in household chores. In addition, it is possible that a husband may be more willing to participate in household chores when his wife’s pregnancy is advanced, probably because frailness is more apparent in advanced pregnancy.
More of the men made arrangement for their pregnant wives to be relieved, and findings from the qualitative data suggest that this was especially so whenever the pregnancies were advanced. Another possible reason for the higher level of men’s participation in Nepal was that, while our study was done among men, the Nepalese study was done among women, and past studies have observed that men report less participation in household chores than their wives do mention of them, most likely because of egos of both parties.
Many men who did not participate in household chores said that they did not think it was a husband’s responsibility, whereas some said it was due to lack of time caused by excessive work demand. Findings from the focus group discussion corroborate this claim. This finding of men saying that household chores were not a husband’s responsibility is similar to that of studies done in other parts of Nigeria,, and that of lack of time is similar to that of a study conducted at Ekiadolor in southern Nigeria. This reiterates that interventions to improve men’s participation in household chores must seek to eliminate the norm of gender roles while reducing work demands on men.
The study also looked at alternative ways by which the men reduced household chores on their pregnant wives. Those who arranged for someone to do household chores or take care of children were more than those who participated in household chores by themselves. These may be because about half of the participants in this study had more than one wife, and in most rural northern Nigerian communities, women are traditionally expected to help in relieving physical stress on their frail or ill cowives even without being asked to do so. Therefore, it may be ambiguous to count such situations as part of men’s effort to reduce household chores on their wives.
The lack of change in participation in household chores after the intervention is likely due to the norm of separation of gender roles, which was apparent during both pre- and postintervention focus group discussions, in which participants identified household chores as women’s responsibility. Such norms are reflected in how even the participants who said they had participated in household chores frequently referred to the chores using terms like her and their (women’s) and to their own (men’s) involvement as help.
Furthermore, the lack of significant change in men’s participation in household chores could be explained by the men’s claim to have been too busy, as the intervention did not include relieving the men of excessive work demand that kept them away from home. Thus, there is a chance that poverty alleviation may reduce work demands on the men, allowing them to have the time to do the chores. Further studies are necessary to confirm this.
The study has a few limitations. Previous studies have reported that men tend to understate their participation in household chores, and the accuracy of their responses were not independently verified. It is also possible that respondents in both study and control communities had received information (positive or negative) on men’s participation in household chores. In addition, the study did not characterize or quantify participation in chores by the men. Finally, a husband may be more willing to participate in household chores when his wife’s pregnancy is advanced, probably because frailness is more apparent in advanced pregnancy. Unfortunately, the study did not ask about the gestational age of the wives’ pregnancy. Nevertheless, this is the first attempt at developing a locally applicable intervention to improve participation in household chores by men. Also it has the additional strength of being a community-based study that involves only men whose wives were currently pregnant.
In conclusion, both study and control groups showed relatively low levels of men’s participation in household chores, and the intervention did not significantly increase this. However, there was increase in the proportion of men who were arranging for someone to relieve their pregnant wives. This is most likely because the men’s participation in household chores was limited by the norm of gender roles and their work demand. Further efforts must address such norms of gender roles. Considering the close link between culture and religion in such communities, the efforts should consider evaluating the effectiveness of engaging religious leaders in the campaign against the norms of gender roles relating to participation in household chores by husbands of pregnant women. Finally, there may be some benefit in combining such interventions with reduction of work demand on the men, possibly through poverty alleviation and empowerment programs.
The authors wish to acknowledge The Johns Hopkins University Center for Communication Programs’ Nigeria Field Office’s Ku Saurara! Project, for supporting this work with the home video Burina and the accompanying discussion guide for the film.
Financial support and sponsorship
Conflict of interest
There are no conflicts of interest.
| References|| |
Wall LL. Dead mothers and injured wives: The social context of maternal morbidity and mortality among the Hausas of northern Nigeria. Stud Fam Plann 1998;29:341-59.
Croteau A, Marcoux S, Brisson C. Work activity in pregnancy, preventive measures, and the risk of delivering a small-for-gestational-age infant. Am J Public Health 2006;96:846-55.
Adeleye OA, Chiwuzie J. He does his own and walks away perceptions about male attitudes and practices regarding safe motherhood in Ekiadolor, Southern Nigeria. Afr J of Reprod Health 2007;11:76-89.
Feyisetan BJ. Spousal communication and contraceptive use among the Yoruba of Nigeria. Popul Res Policy Rev 2000;19:29-45.
Orji EO, Adegbenro CO, Moses OO, Amos OT, Olanrenwaju OA. Men’s involvement in safe motherhood. J Turkish-German Gynecol Assoc 2007;8:240-46.
Orji EO, Adegbenro CA, Akinniranye BI, Ogunbayo GO, Oyebadejo AE. Spousal communication on family planning as a safe motherhood option in sub-Saharan African communities. J Chin Clin Med 2007;2:328-35.
Odimegwu C, Adewuyi A, Odebiyi T, Aina B, Adesina Y, Olatubara O et al.
Men’s role in emergency obstetric care in Osun State of Nigeria. Afr J Reprod Health 2005;9:59-71.
Carter MW. Because he loves me: Husbands’ involvement in maternal health in Guatemala. Cult Health Sex 2002;4:259-79.
Carter M. Husbands and maternal health matters in rural Guatemala: Wives’ reports on their spouses’ involvement in pregnancy and birth. Soc Sci Med 2002;55:437-50.
Najafi F, Rakhshani F. Increasing men’s knowledge, attitude and practice regarding family planning through their wives’ group counseling in Zahedan. Iran J Med Sci 2006;6:74-8.
Lundgren RI, Gribble JN, Greene ME, Emrick GE, Monroy M. Cultivating men’s interest in family planning in rural El Salvador. Stud Fam Plann 2005;36:173-88.
Marindo R. Mira Newako project: Involving men in pregnancy and ANC in Zimbabwe. Paper Presented at 2003 Reaching Men to Improve Reproductive Health for All International Conference, Dulles, Virginia.
Kiragu K, Krenn S, Kusemiju B, Ajiboye JKT, Chidi I, Kalu O. Promoting family planning through mass media in Nigeria: Campaigns using a public service announcement and a national logo. Johns Hopkins Center for Communication Programs, Baltimore, Maryland, 1996. IEC Field Report Number 5: 2–6.
Shehu D. Community participation and mobilization in the prevention of maternal mortality in Kebbi, Northwestern Nigeria. In: Berer M, Ravindran TKS, editors. Safe Motherhood Initiatives: Critical Issues. London: Blackwell Science Limited; 1999. p. 218–26.
Ibrahim MS, Idris SH, Umar AA, Bashir SS, Sufiyan MB, Kera HN. Effect of health education intervention on knowledge of danger signs of pregnancy among married men in rural north-western Nigeria. Caliphate Med J 2014;2:148-54.
Ibrahim MS, Idris SH, Abubakar A, Bashir SS, Sambo MN, Sabitu K. Determinants of involvement in household chores among husbands of pregnant women in a rural setting in Nigeria. Presented at the Global Women’s Research Conference, Birmingham, United Kingdom, 2013.
Mullany BC, Hindin MJ, Becker S. Women’s autonomy and male involvement in antenatal care: Associations and tensions. Proceedings of the 25th International Population Conference, Tours, France, 2005. Available from: http://iussp2005.princeton.edu/papers/52230
. [Accessed December 13, 2016].
Ogunjuyigbe PO, Ojofeintimi EO, Ayotunde L. Spousal communication, changes in partner attitude, and contraceptive use among the Yorubas of Southwest, Nigeria. Indian J Community Med 2009;34:112-6.
] [Full text]
Asiyanbola AR. Patriarchy, male dominance, the role and women empowerment in Nigeria. Proceedings of the 25th International Population Conference, Tours, France, 2005. Available from: http://iussp2005.princeton.edu/papers/50005
. [Accessed December 3, 2016].
Olawoye JE, Omololu FO, Aderinto Y, Adeyefa I, Adeyemo D, Osotimehin B. Social construction of manhood in Nigeria: Implications for male responsibility in reproductive health. Afr Popul Stud 2004;19:1-20.
[Table 1], [Table 2], [Table 3]