THE PRACTICE OF SAFE MOTHERHOOD: CAN EDUTAINMENT BE THE WAY FORWARD?
INTRODUCTION
The Safe Motherhood concept was delivered worldwide to bring about reduction in maternal mortality. This concept has been successful to some extent but it has been discovered that Nigeria is yet to meet its 75% target of curbing mortality by year 2015 to its lowest ebb. Despite the Safe Motherhood initiative in Nigeria, pregnant and Post-partum women especially those in the rural communities still do not have a favorable disposition to practicing safe motherhood. This could be as a result of poor knowledge of these women about the concept of safe motherhood (Igbokwe and Adama, 2011).
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However, Mass Media as channels of mass communication is to inform, educate and persuade its audience to accept new ideas and technologies to enhance their living conditions. Edutainment is a form of communication used for the purpose of entertaining and education to create social change. Edutainment uses popular entertainment such as dramas, folklores, documentaries, talk shows and discussions to tackle social issues for the purpose of inciting change and promote positive attitude. Soul City Institute (2013) further defines edutainment as:
any communication project that sets out to use popular culture to educate and challenge people. Edutainment is not a theory but a strategy to bring about individual and social change. It uses popular entertainment formats to tackle serious social issues in an innovative and entertaining way
Singhal and Rogers (1999) points out that “Entertainment-through television, radio and music is one of the most effective communication strategies for reaching the public to promote family planning and other public health issues”. Therefore, mass media can shape health beliefs of people while promoting knowledge and awareness of health messages. The Mass media play a major role in people’s everyday lives. This is evident in how routine it has become to watch television, listen to the radio, surf the internet, and read newspapers and magazines. Television as a major tool of information dissemination and entertainment programs is a veritable tool for mass education. Since it is a visual medium, women can see examples of the various family planning methods available and safe health practices can be demonstrated during edutainment programmes. Also, television has the capacity to reach larger groups of women simultaneously thus, helping to facilitate and create awareness amongst women on prevention and ways to handle health issues they are plagued with.
STATEMENT OF THE PROBLEM
Reduction in maternal deaths has become the major preoccupation of stakeholders in maternal health today as evidenced by its frequent appearance in most developmental objectives in the world today. It is also the 5th goal in the Millennium Development Goals (MDGs).
World Health Organization (WHO) citing Graham indicates that “the women dying are in their prime of life: they are crucial to society and the economy; they sustain the next generation; they make up more than half the workforce”. The discussion paper of Tinker et al (2000) reported that “women’s low socioeconomic status and reproductive role expose them to risks of poor health and premature death”. They assert, further, that Women’s reproductive biology, combined with their lower socioeconomic status, results in women bearing the greater burden from unsafe sex which includes both infections and the complications of unwanted pregnancy.
Over the years, women in Nigeria and Africa, at large, have been plagued with health issues such as high mortality in childbirth. To combat maternal morbidity/mortality and other health issues that women face, there is the need for quality reproductive health services, such as medical care which includes family planning, safe pregnancy, delivery care, treatment and prevention of sexually transmitted infections, such as HIV and AIDS. Kalyani (2007) notes that while health issues on women are rampant and on the increase, the attitude of women towards seeking information on their health is low with little done in research about how women seek information pertaining to their health.
Studies have revealed further that not all women understand and are able to process the health messages they come across. An example is the Findings from the National Adult Literacy Survey which indicate that “almost half of the U.S. adult population has limited literacy skills, and one-quarter is functionally illiterate”. Flores, Weber, Kilker, Dang and Lindsey (2007) observe that this is so as Health information often includes “technical terms and concepts that are hard to understand, regardless of one’s level of education or literacy”. However, reading, understanding, and using health information can be a difficult task for those with limited literacy skills. Thus, the need for media programmes on health, as media cut across literacy level. To reduce these health challenges to their lowest ebb, television as a medium of entertainment and information seek to keep the ‘woman’ educated and informed. There is the need for media education on health as a result of the complexity and population of the Nigerian society which health workers cannot handle alone.
Objectives of the study
The general objective of this study is to examine the extent to which edutainment programmes on the broadcast media have helped in promoting the practice of safe motherhood. Other objectives are:
- To determine if pregnant and post-partum women through Health edutainment programmes on the broadcast media have the knowledge of Safe Motherhood.
- To find out if pregnant and post-partum women practice the health messages on Safe Motherhood they watch or listen to.
Research Questions
- To what extent do pregnant and post-partum women have the knowledge of Safe Motherhood as a result of health edutainment programmes on the broadcast media?
- What is the attitude of pregnant and post-partum women to the practice of Safe Motherhood?
Scope of the study
This thrust of this study is to investigate the extent to which edutainment programmes on the broadcast media have helped in promoting the practice of safe motherhood. This study will cover pregnant and post-partum women in Ilisan Community within the ages 15 to 49 years of age. Ilisan community is a town located in Ikenne Local government area of Ogun state. It is a community that has a number of her female populations is either illiterate or semi-literate. It is also a community that has a high rate of teenage pregnancy.
LITERATURE REVIEW
Safe Motherhood
Geefhuysen (2000) defines Safe Motherhood as is the “culmination of services for women from the beginning of life and the ability to choose when to become pregnant”. The concept of safe motherhood includes taking necessary steps when preparing to get pregnant such as adequate preparation for the well- being of the mother and the growing fetus before conception and taking appropriate measures to ensure successful delivery. The purpose of Safe Motherhood initiative is to decide when to get pregnant through the use of contraceptive to promote family planning, prevent maternal mortality by saving for possible maternal emergency while receiving healthcare delivery service from a trained provider. This is affirmed by Igbokwe and Adama (2011) who pointed out that “safe motherhood is aimed at preventing maternal and prenatal mortality and morbidity. It also enhances the quality and safety of women’s live through the adaptation of combination of health and non- health strategies”
Maternal mortality
The issue of maternal mortality has been a growing concern to world leaders and stakeholders in this field. “Maternal mortality is a single most important health issue facing obstetricians, gynecologists and Nigerians” (Society of Obstetric and Gynecology of Nigeria- SOGON). This problem arises from unequal power between men and women in sexual relationships which expose women to involuntary sex, unwanted pregnancy, and sexually transmitted infections including HIV and AIDS (Tinker, Finn and Epp, 2000). The world maternal ratio also necessitated the 5th Millennium Development Goals to have reduced maternal mortality ratio (MMR) by year 2015. The recent report by United Nations Fund for Population Activities UNFPA (2014) shows that:
Globally, the maternal mortality ratio dropped by 45 per cent between 1990 and 2013, from 380 to 210 deaths per 100,000 live births. Worldwide, almost 300,000 women died in 2013 from causes related to pregnancy and childbirth. Maternal death is mostly preventable and much more needs to be done to provide care to pregnant women.
Health Messages and Edutainment Programmes
Yahaya, Fadairo and Ogunele (2009) explain that information, entertainment and education are very important to women. Therefore, health communicators should always include some elements of information, education and entertainment in their health and other development messages targeted at women in order to attract or gain their attention. They summarised from their study in Lagos that women experienced a serious improvement in knowledge and a positive change in their health behaviour as a result of watching and listening to various health programmes on Entertainment-Education channels. For instance, 61.2% indicated serious improvement in knowledge, while 59.8% had a positive change in their health behaviour due to programmes on family planning on television and radio respectively. Also Farhana & Ahmed (2008), in their report, affirms that mass media techniques that combine entertainment with health education are particularly effective in producing behaviour changes. This they discovered in their findings on a soap opera in Tanzania “Twende na Wakati” (Let’s Go with Times) “which has influenced about one- fourth of its listeners to adopt family planning methods and HIV/ AIDS prevention while 65.5% of the participants said they discussed pregnancy and maternal health issues after the campaign”
Also, several studies, Singhal and Rogers, 1999; Brown and Singhal, 1999 and Tufte, 2002 point out that Entertainment-through television is one of the most effective communication strategies for reaching out to the public to promote social change. Singhal and Rogers (1999) also notes that television soap operas, popular music, street theatre and comic books have all been used to educate the public about such health issues as family planning, HIV and AIDS prevention, environmental health, female equality, improved sanitation, female genital mutilation (Singhal, Rogers, 1999). Findings from their study showed that entertainment-education in developing countries confirm that the strategy changes behavior.
Methodology
Design: The structured questionnaire for the survey was designed in English but the data collectors were trained to interpret the questions in the local dialect. The design is considered appropriate because the study will essentially focus on people.
Setting: The study was carried out in Ilisan Remo, Ogun State. Ilisan is a community located in Ikenne local government area of the state. It has a primary health care center, a teaching hospital owned by Babcock University and a few other privately owned hospitals that provide medical care. Ilisan also have a couple of Traditional Birth Centers which a great number of pregnant women visit.
Procedure: a total of 110 copies of the questionnaire were distributed. The copies of the questionnaire were administered at homes, shops, the market place, private offices, hospitals, institutions, churches and mosques. 100 were returned and analysed using descriptive statistics such as frequency tables and percentages.
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