Figure 1 presents four of the study’s key takeaways about intra-household decision-making. In identifying three decision-making pathways that entail varying degrees of involvement and agency for women, these results suggest the importance of amplifying female participation. Expanding on the role that women often play in initiating health-related conversations, these interviews signal the importance of shifting toward a dynamic of joint or collaborative decision-making and power-sharing. Understanding the varying roles of spouses, family members, and others depending on health topic reinforces the importance of employing flexible, tailored engagement and communications approaches— for instance, while grandparents may be closely involved in child nutrition decisions, family planning decisions are often made between couples or spouses. Closely related, our findings indicate that male engagement groups are a promising approach to increase men’s knowledge and awareness on health-related issues and increase spousal communication. Reaching couples through home-based counseling could prove a valuable complementary approach. Finally, community-level SBC interventions that de-stigmatize malnutrition by sharing strategies with all parents could help support child health and nutrition in food-scarce settings and facilitate better communication between spouses.
Creating reproductive and maternal health behavioral profiles for women of reproductive age
Effective SBC interventions frequently incorporate audience segmentation, the practice of dividing an audience into subgroups based on demographic, psychographicMarket research or statistics classifying population groups according to psychological variables (such as attitudes, values, or fears), and/or behavioral factors to develop customized approaches. While widely used in FP and HIV interventions, audience segmentation for reproductive and maternal health SBC programs (beyond socio-demographic characteristics) has been limited . Breakthrough RESEARCH interviewed over 2,700 married women of reproductive age in Niger, then used a latent class analysis incorporating five socio-demographic and behavioral determinants (knowledge, attitudes, norms, self-efficacy, and partner communication, as described in Figure 2) to develop profiles related to three healthcare-seeking behaviors: antenatal utilization, facility-based delivery, and use of modern FP.