 All right. Next up, I'd like to introduce our speaker for today. Our speaker for today is Dr. Hadidza Mohamed Sami. And she is an experienced academic that is interested in community health nursing. And that is community maternal and child health nursing to be specific. Hadidza has worked in Amadou Bello University Teaching Hospital of nursing as a senior nurse tutor from 2009 to 2013. And we are very, very happy to have her with us on our panel. Without further ado, Dr. Hadidza. Hello, Dr. Hadidza. Hi. Can you hear us? Yes, I can. Fantastic. You have the floor. Can you move the slides now? Okay. I made your presenter. Thank you very much. As introduced, Hadidza Mohamed Sami from Zaryam, Nigeria. I'll be presenting on husbands health education and decision of the Libby police and the human state. The risk of maternal death is 1 in 41 and 1 in 3,300 live pets in developing and developing countries respectively. With the largest body in South Southern Africa and Asia. Nigeria is a leading contributor of maternal deaths in South Southern Africa. Not only because of the size of population, but because of a high maternal mortality issue. Look at the maternal mortality rate in Nigeria is about 512 for 1,000 live pets. So look at the issue of skilled birth attendants. The evidence-based research has clearly established the inverse relationship between skilled birth attendants and births. Presence of the skilled birth attendants and births and the occurrence of maternal death. According to World Health Organization 2017, the SBAs are related health professionals such as midwives, doctors or nurses who have been educated and trained proficiently to manage normal. That is uncomplicated pregnancy, childbirth and the immediate postpartum period. As well as handle the identification, management and referral complications in women and new husbands. In most African families, the men are empowered financially and are the main decision makers in all issues regarding the productive health. They decide whether their wife seeks maternity service or arrange for skilled care within the delivery. Meanwhile, these husbands are privileged to be influenced by their knowledge of the relevance of their involvement in maternal care. Thus, when these husbands attend health education sessions, they know the danger signs of pregnancy and delivery and they may act as life-saving agents. Thereby ensuring their wives get appropriate attention during childbirth. The objectives of this study are as follows. Number one, to determine the opinion of couples on who decides the place of baby's birth. And the second one is to determine the opinion of the couples on the preferred place of the before and after the health education intervention. Then the materials and methods. The study was used across the experimental research design. It was used in non-randomised group design. The study had two groups. It had the study and the control group, whereby the study group had a pre-test group and intervention, which is the health education session, and a post-intervention. While the control group had only the pre-test and post-intervention tests. The area of the study. The area of the study is Kaduna State, which was created on the 17th of May, 1976, out of Burma, northern region. By the then-region of the General Muntala Muhammad. Its capital is Kaduna. Kaduna State is located at the centre of the northern Nigeria. Kaduna State has three senatorial zones. Namely, the Kaduna North, the Kaduna South, and Kaduna South. Hadid, I think you're cutting off. Yes, the slides are off. No, no, no, the slides are okay. Please continue. Okay, I have a blank slide here. Can you tell us which slide it is so that we can continue, Frida? The slide that is on the screen right now is sample size estimation. Okay. Is that the slide that you're on? Yes, absolutely. So, sample size estimation formula for experimental. I think her sound's gone out. So, this sounds like a very interesting cultural study, does it not? I don't know how the role of the partner is in where you're all from. I don't know if you've got a minute to talk about that while we're waiting for Haditha to come back. Is it similar that the men in other countries are deciding all the decisions for the household? Well, looking at it from the Kenyan perspective before, this is about 10, 20 years ago, that was the case and in some cases right now it's still the case in rural areas in Kenya. But in the more modern areas in Kenyanya capital cities, we have Nairobi, Mombasa, Kisumu, Nakuru, most areas we do have some modernization and urbanization where women now make their own decisions as to the financial element. But I'd also be very happy to hear from Aisha. I'm sorry to call you out. I can see you have your microphone on. You could tell us or share some insights from your country and how their workings are. Hello. Hi Aisha, we can hear you. Okay. Thank you so much. Would you control the slides for me so that I continue to present? Or you are co-presenting with Haditha? Yes. Oh, okay. Let me do that. Yes. Will that be possible? Just give me one second. Yes. So we are currently on sampling technique. Yes, I can see that. All right, please proceed. Okay. What's happening? The sampling technique, we did a multi-stage sampling technique where we had four different stages so that we try as much as possible to cover the area of the district. We select local government areas from the natural zones. Then from there, we selected wards from each local government area. And from there, we selected polling units. And from the polling units, that is where we selected the corpus. And particularly the husbands that we are interested in. Next slide. Thank you. Prior to the commencement of the research data collection, we did an application for ethical clearance through the International State Ministry of Health and also the Amadebele University's area research and ethics committee. So a series of activities took place where we were able to get approval from the local government area. And informed consent was also obtained from the participants that participated in the particular study. Thank you. Next slide. Question here. There are two structured questionnaires that we use. That is one for the wives and that is a questionnaire for the husbands which we use. And the questionnaires were made up of several sections so that we get the demographic data of the respondents. We also took their opinions on the various objectives of the study that cover the decision on who decides and their preference of the corpus in the place of delivery. This where the questionnaires were given before the health education session. After we did the health education session, we also give them the seven questionnaires. We did a pre and a post test questionnaire. Next slide. Statistical analysis. After the collection of the data, the data was entered into the statistical package of software version 26. And you know, various descriptive statistics was used to do the analysis. You are particularly interested in frequency and percentage during the analysis. Thank you. Next slide. On the decision on who decides on the place of the corpus, this is a very important aspect of our study. And we can see the results as outlined here. As soon as they are actually very small, they can see the particular area of interest there. I'm really having difficulty seeing the slide. Hello, Frida. Yes, Adiza, you're back. Adiza, you're back. Yes. My colleague is Haisha. So sorry, Haisha has been bold informed. Thank you very much. And we are currently on the slide that's in front of you. On the table one, yes. Okay. So, Adiza, are you taking over? Yes, I can take over. Thank you very much. Thank you. You're welcome. Adiza, do I make you present how do I continue controlling the slides? Yes, you can make me present her, please. Okay. Okay, I've made you present her, please proceed. Okay. Thank you very much. I'm so sorry for the loss in connection. So, on table one here, talking about the decision on who decides the place of the baby. The decision or the content of the table. Realize that decision on place of birth of the baby is mostly done by both of the couple. That is both the husband and the wife make the decision. The husband for single handedly make this decision. But the decisions are usually made by both the husband and the wife. Please, can you take me to the next slide? It's like I'm finding it difficult. Okay. I'm talking about the opinion of couples on preferred place for delivery and the choice of their husbands. This is pre-interventional. Oh, look at it. We'll see that the choice of birth at home with the use of the TBA or SBA for wives in the study group is about 0.7%. While for the husbands in the study group is about 2%. Likewise, the use of hospital or clinic would see that for the wives, it's about 30.8% in the study group. And for the husbands, it's about 39%. Please, can you take me to the next slide? Yes. Moving to the next slide is the problem. Okay. I still can't see the next slide. We're currently on table three. Okay. Yeah. I'm saying it now. So, table three, you're talking about the opinion of the couple on their preferred place of delivery and the choice of their husbands post-interventional. Here, we would see the wives in the study group now have about 4.4% for the choice of delivery place. But home birth with the use of TBA as the choice of delivery place. So, also, when we look at the clinic or the hospital, the wives in the study group have now improved to about 34.6% while the husbands are now 36.0%. Next slide, please. So, this is just saying something about table three. Here, about 30.1% and 34.6% of models in the control and study groups prefer to have their babies delivered in clinics or hospitals. So, are the husbands with about 30.1% and 36% for the study, for the control and the study group. Those who prefer home delivery with TBA have also improved in the study group from 1.5% and 0.4% for both husbands and wives. Wives and their husbands who have been exposed to the training therefore had a relatively higher preference for deliverance of their babies in the clinics or hospitals and at home with SBE then was observed for those in the control group. Next slide, please. So, you can add the result of this story. We go to the discussion. Here, there is no question that home deliveries are the norm in rural houses society. So, unless a day emergency arises, many families simply assume that childbirth would take place at home. Nevertheless, these communities have enough collective experience with complications and pregnancy, labor and delivery to have had direct experience with the needs of family members. Next slide. Yes, the slides. She's taking the mic. Can you see it? We've moved to discussion too. Yes, it is not showing here. Okay. Ayesha from your end, can you see it? No, not yet. Dr. Ayesha from your end, can you see it? I can see it. All right. I can see where she is. Okay, we have lost her. That's okay. I'm still available, but I have a blank screen. Okay. Yes. Okay, the slides are you couldn't see? Yes. So the study revealed that the decision of place of birth for the baby is mostly done by both husband and wife in the two groups. Husbands could single-handedly make such decisions, but the couples were the major decision makers on where the baby is to be delivered. This contradicts most studies that shows that men are socially and economically dominant, especially in northern Nigeria. The exact is strong influence over their wives, the timing and conditions of sexual relations, their family size and access to healthcare. Only 7% of currently married women make decisions themselves on their own healthcare. While three in five women report their husbands mainly make such decisions. This is according to National Demographic Health Survey of 2018. Next slide, please. Yes, husband's participation in health education was found to have increased their choices of place of delivery for their spouses. Wives of husband who participated in the training intervention are more positive choice on place of delivery than was observed among those whose husbands did not participate in the training. The implication was that the training have positive effects on the wives. Whose husbands were exposed to the intervention? The finding here is in accordance with a report by Taku et al. Which shows that the health education intervention was able to effectively increase the level of spousal participation, involve preparedness and intervention in the intervention group. The participants in the intervention group were four times more likely to participate in the delivery plans of their wives in his study. Next slide, please. Because I cannot move this slide. I can, are we now on discussion four, slide discussion four? Yes. I'm still waiting for the slide, sorry. Okay. Just give it a second. The slide is right there. If you could just tell her which one it is with the small summary. I'm assuming the network is the one that's bringing an issue from her end. Hadidza, can you see it now? Okay, Aisha, can you see the slide? I can see discussion four. Okay, please proceed as Hadidza. That's okay. Please proceed as discussion four. My own slide is now showing. Hadidza, carry on. Okay, it is also in accordance with the findings of 20 million in 2020 in a study, which says the report is talking about those male, involved male partners in maternal care, improved healthcare utilization. We discovered a beneficial significant, significant impact of male involvement in antinatal care or utilization of an SBA and relieving stress and anxiety during labor. So husband's participation through attending antinatal services positively affects the use of skill bud attendance by women to re-delivery. Meanwhile, husband's approval could be affected by their knowledge of the relevance of their involvement in maternal care. When husbands attend ANC, you know the danger signs of pregnancy are delivery. They may act as life-saving agents, ensuring that their wives get appropriate attention in obstetric emergencies. Next slide, please. So in conclusion, husbands exposure to training or rehabilitation improved their decision positively on the choice of place of births of their spouses in Kareuna State, Nigeria. Next slide. Next slide, please. I've moved to the next slide. We are on recommendation. Can you see the recommendation slide? This seems to have dropped off. Aisha, please take over. Yes, I can see the recommendation. Please take over. Okay, thank you. Thank you. Based on the findings of our study, we recommended that with the local health education should be organized periodically, considering the impact that it has on the husband. So we recommend that it should be done, especially by health agencies and healthcare settings, so that husbands and wives should be educated from time to time. Another recommendation is that there is the need for enlightenment campaigns also. This should be within the traditional settings, like in places of worship, using our media awareness can be made, should be made by the government and other agencies that are concerned with male participation in their wives' reproductive health services. Another recommendation is that it's for the need to de-emphasize traditional practices that emphasize on issues like place of delivery, place among couples, so that our women have a greater hand to decide when, where, and how they should take care of themselves during issues, especially during pregnancy and delivery. Thank you. Next slide. So these are some of our references on the study that we are using along the course of the study. Another slide. Thank you so much for listening to us. Thank you so much. I can't see. Yes, I can see. Thank you so much, Ayesha Abdelahi for holding forth on that one. Thank you so much, Ayesha, for your internet mishaps. It happens to the most of us. Thank you so much. All right. Thank you so much. I'd like to open up the floor to questions. Do we have any questions for Dr Hadiza? Noting that the session was recorded. Do we have any questions? Please put them on the chat feature. Please raise your hand if you have any questions regarding today's presentation. Questions from the audience? Yes, Jane, you can ask a question. Please unmute your mic. Thank you so much, doctors, and sorry for your internet issues. So I'm very interested having been in different countries, would you say? Obviously you're very experienced mothers, perhaps, as well as midwives and scientists. Anecdotally, would you say that the role of women as mothers is changing? Do you feel yourselves that there's more empowerment where mothers and women are more able to make their own choices? Or do you think it's still the same as maybe when you were younger in school and high school or something like that? Or do you think the role for women is improving in your state? Thank you. Great presentation. Okay. Thank you very much for the presentation. The role of women with productive health in general is really changing because women are becoming more empowered in this part of the world. Oh, but previously, when we were young or from stories we've heard earlier, a woman has no right in her own house. She doesn't partake in making any form of decision. But from the study here, we can see that even the decision of place of birth and the rest that was initially taken by husbands only is now being shared among the couple. Both of them decided where they want their child to be delivered. Thank you. Thank you so much, Adiza. Thank you so much, Jane.