Use of the most significant change technique to evaluate intervention in promoting childbirth spacing in Nigeria

Background: Childbirth spacing (CBS) or Family Planning (FP) methods are considered an essential component of sexual and reproductive health. It refers to the resting period between pregnancies that provides the mother with time to recuperate from pregnancy, labour and lactation. To evaluate the impact of these methods, a storytelling evaluation approach was used. Objectives: The aim of this study was to assess the outcome of behaviour change communication intervention on demand and uptake of modern CBS methods. Method: Most significant change story technique was used to evaluate the outcome of behaviour change communication intervention in two north-western Nigerian states. Impact story template was used to collate 57 stories from the field through group discussions and in-depth interviews with women of reproductive age. Transcripts from the group discussions and interviews were analysed using qualitative analytical software. Results: One story was unanimously selected. The story was about a married 15-year-old with a history of three pregnancies and two live births, who suffered pregnancy complications and miscarriage during her last pregnancy. She had learnt about CBS methods through the community volunteers working on the social and behaviour change communication (SBCC) intervention. As a result, her husband and mother-in-law were convinced and agreed that she take up a modern FP or CBS method from the primary health facility in the community. She eventually took an implant method. Conclusion: Acceptance and uptake of modern CBS methods in north-western Nigeria has been low, and this is largely because of myths and misconceptions, and religious and cultural beliefs amongst others.