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Niger Report HS Gender ENG Final

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Niger Report HS Gender ENG Final Study of the Effects of the Husbands’ School PASSAGES PROJECT Intervention on Gender Dynamics to Improve Reproductive Health in Niger AUGUST 2019 PREPARED BY: FODIÉ MAGUIRAGA, DJIBO SALEY, MARIAM DIAKITÉ, AND SUSAN IGRAS © 2019 Institute for Reproductive Health, Georgetown University Recommended Citation: Study of the effects of Husbands’ School intervention on gender dynamics to improve Family Planning and Reproductive Health in Niger. August 2019. Washington, D.C.: Institute for Reproductive Health, Georgetown University, for the United States Agency for International Development (USAID) This report was developed by IRH as part of the Passages Project. This report and the Passages Project are made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of cooperative agreement No AID-OAA-A-15-00042. The contents are the responsibility of the Project and do not necessarily reflect the views of USAID or the United States Government. The authors would like to especially thank Issa Sadou of UNFPA-Niger and Mohamed Haidara of SongES for their important contributions to the development of the protocol and to the review of different versions of this report before its finalization. Passages Project Institute for Reproductive Health | Georgetown University 3300 Whitehaven St, NW - Suite 1200 Washington, DC 20007 [email protected] www.irh.org/projects/Passages 2 TABLE OF CONTENTS PREFACE ........................................................................................................................................ 5 EXECUTIVE SUMMARY ............................................................................................................... 6 THEORETICAL FRAMEWORK .................................................................................................... 8 THE CONTEXT OF THE IMPLEMENTATION OF HUSBANDS’ SCHOOLS ............................................................ 8 GENDER, SOCIAL NORMS AND RH ............................................................................................................ 11 DESCRIPTION OF THE HUSBANDS’ SCHOOLS INTERVENTION ..................................................................... 12 ACTIVITIES IMPLEMENTED AS PART OF THE HS INITIATIVE ........................................................................................ 13 THEORY OF CHANGE OF THE HS INITIATIVE .............................................................................................................. 13 OBJECTIVES OF THE STUDY ...................................................................................................................... 15 METHODOLOGY ....................................................................................................................................... 15 THE STUDY’S TARGET GROUPS AND THE SAMPLE ........................................................................................................ 15 SELECTION OF THE RESPONDENTS ............................................................................................................................. 16 CATEGORIZATION OF RESPONDENTS .......................................................................................................................... 17 DATA COLLECTION AND ANALYSIS .............................................................................................................................. 17 ETHICAL CONSIDERATIONS ....................................................................................................................... 18 STUDY RESULTS ......................................................................................................................... 19 DESCRIPTION OF THE RESPONDENTS ........................................................................................................ 19 DIRECT BENEFICIARIES: HUSBANDS WHO ARE MEMBERS OF HS ................................................................................ 19 INDIRECT BENEFICIARIES: WIVES WHOSE HUSBANDS ARE MEMBERS OF HS; HUSBANDS WHO ARE NON-MEMBERS; AND THEIR WIVES ..................................................................................................................................................... 20 MODEL HUSBANDS VERSUS HUSBANDS WHO ARE NON-MEMBERS OF HS: ATTITUDES AND BEHAVIORS TOWARDS RH THAT DISTINGUISH MODEL HUSBANDS AS CHANGE AGENTS ...................................................................................... 20 EXPOSURE TO THE INTERVENTION ........................................................................................................... 21 DIRECT EXPOSURE TO INTERVENTIONS ...................................................................................................................... 21 INDIRECT EXPOSURE TO INTERVENTIONS .................................................................................................................. 23 COMMUNITY ACCEPTABILITY OF HS ......................................................................................................... 24 WOMEN'S PERCEPTION OF MEN REGARDING USE OF RH SERVICES BEFORE AND AFTER THE INTERVENTION…. .................................................................................................................................... 24 EQUALIZING MEN AND WOMEN’S ACCESS TO RH INFORMATION .............................................................. 25 GENDER DYNAMICS AND DISTRIBUTION OF DECISION-MAKING POWER IN RH ........................................... 26 CHANGE IN COMMUNICATION WITHIN COUPLES ON RH SERVICES .............................................................................. 27 POWER RELATIONS BETWEEN MEN AND WOMEN IN RH DECISION-MAKING ................................................................ 27 NORMATIVE PERCEPTIONS AND ROLES OF MEN AND WOMEN REGARDING RH ISSUES ................................................ 28 WOMEN'S DECISION-MAKING POWER REGARDING RH SERVICES ............................................................................... 29 DECISION-MAKERS BASED ON REGION: WHO GENERALLY DECIDES ON THE USE OF ASSISTED DELIVERY AND FAMILY PLANNING…… ............................................................................................................................................................ 31 DECISION-MAKERS FOR FP BASED ON THE NATURE OF THE COUPLE: MODEL COUPLES VERSUS NON-MODEL COUPLES….. .............................................................................................................................................................. 32 3 DECISION-MAKERS FOR ASSISTED DELIVERY BASED ON THE TYPE OF THE COUPLE: MODEL COUPLES VERSUS NON- MODEL COUPLES ....................................................................................................................................................... 34 MEN'S PERCEPTION OF WOMEN'S DECISION-MAKING POWER .................................................................... 37 MAGNITUDE OF THE CHANGE .................................................................................................................. 37 DISCUSSION ............................................................................................................................... 39 CONCLUSIONS ............................................................................................................................ 41 BIBLIOGRAPHICAL REFERENCES .......................................................................................... 42 ANNEX 1: MAIN DECISION-MAKERS IN ASSISTED DELIVERY AND FAMILY PLANNING, BY REGION, AND BY CATEGORY OF RESPONDENTS .............................................................................................................. 45 TABLE OF FIGURES Figure 1: Map of Niger showing study locations in Dosso, Tahoua, and Zinder……………………………………..8 Figure 2: Reproductive Health Service Indicators and Total Fertility Rate, Dosso…………………………………10 Figure 3: Reproductive Health Services Indicators and Total Fertility Rate, Tahoua……………………………..10 Figure 4: Reproductive Health Service Indicators and Total Fertility Rate, Zinder………………………………..11 Figure 5: Husbands School Program Theory of Change, 2016……………………………………………………………..14 Figure 6: Direct and Indirect Beneficiaries of the Husbands’ School Intervention………………………………………………..17 Figure 7: Logic and Schema that Guided Analysis………………………………………………………………………………18 Figure 8: Barometer of decision-making in the couple among all respondents……………………………………..36 TABLE OF TABLES Table 1: Evolution of RH indicators in Niger……………………………………………………………………………………..9 Table 2: Summary of sample and sample size…………………………………………………………………………………….16 4 PREFACE This study report represents one of several studies commissioned by the Passages Project to explore evidence gaps in understanding how community-based norms-shifting interventions lead to normative change. Husbands Schools were designed to address the significant barrier of men not allowing their wives to access health services, in the context of a patriarchal society where women have minimal personal decision-making power and financial resources. The reasoning in the initial 2007 design of Husbands Schools was to engage men in understanding the importance of reproductive health for their couple and families and supporting wives’ use of reproductive health services. The informal village-level schools focused on civic engagement, shared leadership between ‘Model husbands’ and oriented members to sensitize others on reproductive health issues
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