The Influence of Multi-stakeholder Health Promotion Interventions on Maternal and Infant Mortality Outcomes in Lagos State, Nigeria
Abstract:
Maternal and infant mortality rates in peri-urban Lagos State, Nigeria, persist at critically elevated levels despite improvements in health infrastructure. In the Epe and Ibeju Lekki Local Government Areas (LGAs), a trust deficit rooted in sociocultural disconnection between formal health systems and community governance structures drives high rates of unbooked deliveries and late-stage obstetric emergencies. This study evaluates the influence of a structured Multi-Stakeholder Health Promotion Intervention (MSHPI) on maternal health service utilization, emphasizing the roles of traditional leaders, religious authorities, male household decision-makers, and narrative media in driving behavioural change. A convergent parallel mixed-methods design was employed. A structured questionnaire was administered to 500 women of reproductive age (15 to 49 years) across Epe and Ibeju Lekki LGAs using multi-stage stratified sampling, with data analyzed via logistic regression and Chi-square tests. Qualitative data from 25 Key Informant Interviews and 4 Focus Group Discussions were analyzed through thematic content analysis. Results revealed that women receiving antenatal care (ANC) counselling endorsed by traditional rulers were 3.42 times more likely to book care in the first trimester (OR = 3.42; 95% CI: 2.15, 5.43; p < 0.001). Husband's approval was the strongest individual predictor of skilled birth attendance (OR = 4.42; p < 0.001). Exposure to the 'Man of the House' edutainment intervention produced a 68.4% increase in facility-based deliveries (p = 0.004). Postnatal care uptake remained critically low at 29.6%. Integrating traditional, religious, and male stakeholders into a coordinated advocacy framework significantly improves health-seeking behaviour, highlighting the value of institutionalizing Community Health Advocacy Councils.References:
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