Institute for Global Health


Influence of lay networks on care-seeking for maternal morbidity in Northern Nigeria: Preliminary findings from a qualitative study


Judith Yargawa

Supervisors: Dr Zelee Hill, Dr Ed Fottrell and Dr Joanna Morrison 


Maternal morbidity has received increasing attention in recent years. Previous research suggests that lay networks play important roles in care-seeking; however, little is known about the practical ways they influence care-seeking for maternal morbidity. This study reports preliminary findings from a PhD sub-objective on the influence of lay networks on women's care-seeking for maternal morbidity.


Seven focus group discussions were conducted and in-depth interviews are currently on-going in Yola, North-east Nigeria. Married women who delivered within the past two years were purposively sampled from the community to include a range of socio-demographic backgrounds and morbidity status. All discussions were semi-structured, tape-recorded and transcribed. Thematic analysis was used to code the data and generate preliminary themes.


The prominent members of women's lay networks include older women (mothers, mothers-in-law and others), friends, neighbours and husbands. They influence care-seeking by serving as facilitators or inhibitors. As facilitators, they recognise emergency situations and quickly summon expert care; discourage women from ingesting harmful local preventive remedies; notify women's gate-keepers to health care about observed abnormality; raise initial alarm that something is amiss; facilitate access to health services by physically taking women to the hospital; and explain the cause of an abnormality, which subsequently result in hospital visit. As inhibitors, they can discourage demonstration of vulnerability to morbidity and encourage stoicism; suggest harmful local preventive remedies; advice women to endure issues, making them to suppress what should be voiced out; suggest diverse treatment options for one particular morbidity; discourage care-seeking at hospital; and normalise a morbidity, assuring women not to worry.


The findings suggest that lay networks influence care-seeking for maternal morbidity positively or negatively. Health promotion implementers should actively acknowledge their facilitation efforts and involve them as partners, but should also dialogue with them to design appropriate, culturally-sensitive strategies to tackle their inhibitory roles.