Women’s Participation in Communicating Primary Healthcare Policy in Selected Local Government Areas of Kebbi State

Women’s Participation in Communicating Primary Healthcare Policy in Selected Local Government Areas of Kebbi State

Abstract

This study set out to explore Women’s Participation in Communicating Primary Healthcare Policy in Zuru and Danko-Wasagu Local Government Areas of Kebbi State, to assess the extent of women‟s participation being that the extent of women’s participation in Primary Healthcare is, however, unclear or seems to be lacking. The study is premised on its advocacy to engender policymakers to see the necessity of involving women in active participation, communication and formulation of primary healthcare policy. The study employed the Participatory communication theory which advocates for peoples participation in development interventions and as such giving voice to the voiceless. Methodology for data gathering included Focus Group Discussions (FGD), in-depth interview (IDI) and Documentary Observation (DO). Furthermore, a total of 138 women and men were sampled using the Purposive Sampling Technique to include 100 members of FGD and 38 interviewees. The findings of this research according to the FGD and IDI revealed that women‟s participation in formulation and communication of primary healthcare policy in Kebbi state is still at its lowest ebb. This is a challenge that has development implications. The study also uncovered factors responsible for women‟s participation to include conservative adherence to customs and traditional beliefs, a high rate of illiteracy, as well as a communication barrier between women and health workers/experts. The study recommended that for sustainable women participation in Kebbi State, women should take an active role and be involved in Primary Health Care Formulation and Communication. Appropriate communication strategies should be intensified as well as genuine women‟s participation should be encouraged by health policymakers.

CHAPTER ONE

GENERAL INTRODUCTION

1.0 Background to the Study

Since the evolution of the concept of development, participation has become a popular discourse in Development communication. Development experts have come to realise the need for the stakeholders to be associated with all phases of development intervention either directly or indirectly. This singular act has necessitated the quest for people to be active participants in development. People‟s participation is at the heart of achieving success in any development effort, either at the primary level or the secondary level. The incorporation of people‟s knowledge and perspectives into the development research process could enhance the relevance of development effort.

Over the decades, national and international agencies have developed and are still developing programmes to assist in effective communication and participation of people most especially that of women in development intervention. Frantic efforts at different levels have been made to address the marginalisation of women in development intervention, but unfortunately, these efforts have yielded little or no result. Despite the

efforts of many agencies and organizations, and numerous inspiring success stories on paper, the picture is still disheartening, as it will take the active participation of women in the decision making environment in health policy formulation and communication to bring about sustainable development.

Even though the poor and marginalised have always been at the centre of development communication, they are, however, most often the subject of communication rather than the originators. Women have poor access to communication and the channels of communication respectively rural women fit into this group.

Participation, for women, whether it is in agriculture, health, or politics serve immediate instrumental goals such as the identification of felt needs as well as the mobilization of local resources to meet needs. It requires the direct face-to-face involvement of women in social development and ultimate control over decisions that affect their welfare. The essence is to empower the disadvantaged to take an active part in the social and community process. Women are mostly the disadvantaged majority in most of the actions and inactions of the government. This is because there are obstacles that cut across institutional, socio-cultural, logistic and technical limitations that prohibit their participation (Botes and van Rensburg 2000:4).

In policy development, economic planning, and key political inter-governmental arrangements around the world, the role of women has been very minimal especially when compared with the exertions of men. The reason for this drawback hinges on both the socio-cultural and institutional obstacle that patriarchy has created over time and the obliviousness of women to tumble the status quo. However, international development occasioned by globalization has placed women in positions where they can sue for their development and self-growth even though their development is still being hampered by the vaulting over of women in the development process given mostly due to the deeply patriarchal system in Africa and indeed Nigeria. The Primary Health Care system is a conscious strategy to meet the Millennium Development Goals, MDGs, 4, 5 and 6 targeted at women and children (Vanguard Newspaper, 2014). Goal 5 is―improve maternal mortality. The goal was arrived at in the pre-2015 discussions given that women die in large numbers following poor prenatal, antenatal, and post-natal care. According to the United Nations (2013), only half of the pregnant women in developing countries receive the recommended minimum of four antenatal care visits.

In Nigeria as well as in Africa, women constitute about half of the population.

The female population in Nigeria was measured at 49.36 in 2011(World Bank Data, 2011).

They make an essential and largely unacknowledged contribution to economic life and play a crucial role in all spheres of society. Nonetheless, established restrictive practices and constraints have not allowed them to take advantage of their numbers and position to significantly influence the decision-making process of almost all the sectors in Nigeria. They are still recipients of hollow government‟s policies in different sectors of Nigeria‟s economic, political, and social life; one of which is primary health care. The development of primary healthcare policies can not be truly achieved without the effective participation of women.

The integration of women‟s perspectives and inputs in the formulation and implementation of primary healthcare policies could enhance the relevance and acceptability of health communication policies by rural women. The incorporation of women‟s inputs and knowledge in health policies is steeped in the participatory paradigm which requires a shift in the way individuals are considered, from passive recipients to active agents of development efforts. There are several reasons for this shift, a major one of which is presented by Ascroft and Masilela (1994;12), “If peasants do not control or share control of the processes of their development, there can be no guarantee, that it is their best interest that is being served”. The cardinal objective of participation is, to empower communities, groups or individuals to determine their directions, objectives, options for change, make well-informed decisions, take collective action to achieve their goals and monitor and evaluate the initiative if they are making progress (Van de Fliert 2007). This study is, therefore, justified on the premise that the involvement of women in primary health care policy formulation and communication is critical to the success of any health policy research.

Women, arguably, cannot be said to have had reasonable participation in communicating or developing Primary Health Care (PHC) Policy in Nigeria (Ojobo, 2012) World Health Organization, WHO (1978) and United Nations International Children’s Education Fund, UNICEF (1998) defined Primary Health Care as the essential healthcare based on practical, scientifically sound, and socially acceptable method and technology; universally acceptable to all in the community through their full participation; at an affordable cost; and geared toward self-reliance and self-determination, PHC policy in Nigeria have not effectively reflected the spirits of its international description and standard as many community women are still estranged from achieving the„full participatory status‟. For example, allowing women to be part of drafting documents, that can inform make health policies, be actively involved in Formulation, implementation, Monitoring and Evaluation of Primary Health Policies.

The above is ironic because national and international aid, agencies, governments, international organisations are putting in funds to enhance women‟s participation in development which does not seem to yield the required results. Development workers have the responsibility of incorporating women and improving the living standards of the people. The ample opportunity of the role of women in meeting the challenges of Primary Health Care communication is quite dominant and prominent. Their relevance and significance, therefore, cannot be overemphasised. The various contributions of women in health communication in Nigeria have been variously described in the literature but their role in the decision-making process with regards to primary health care has not been widely explored or at best, remains minimal.

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