Thesis Format
Integrated Article
Degree
Doctor of Philosophy
Program
Health Promotion
Supervisor
Elysee Nouvet
Abstract
This thesis explored the impact of the COVID-19 pandemic on women’s health-seeking behaviour in Nigeria, particularly focusing on women’s decisions to seek or avoid maternal and infant healthcare. It is an integrated article thesis, with each of its three articles stemming from original qualitative research conducted in Sokoto, Ebonyi, and Ogun states of Nigeria from August to November 2022 by the first author. Primary data were generated through in-depth interviews. The methodological approach integrated an interpretive phenomenological analysis approach with a feminist lens. The first original paper highlights the pervasive role of the COVID-19 pandemic in deprioritizing non-COVID-19 healthcare needs, leading to delays for women seeking medical attention. The paper identifies four themes illustrating the complex interplay between environmental factors, societal norms, and women’s decisions regarding health-seeking. For this paper, I adopted a health systems responsiveness conceptual framework to explain the impact COVID-19 had on women’s behaviour and the potential implication for a health system that fails to respond adequately. The second original paper provided an in-depth analysis of women’s experiences with healthcare during the pandemic, exploring the social structures and health system perspectives. This paper discusses several themes, such as women’s experiences with personal health behaviours, the pandemic as a temporal equalizer for marginalized individuals, and the impacts of COVID-19 on maternal health care. The third original paper is a secondary analysis inspired by study data. It captures and renders the author’s reflections available to others, evolving throughout and because of this PhD research on dominant discourses in global health that construct women in Africa as historically and persistently powerless, especially in marital relationships. The paper emphasizes the importance of recognizing women’s agency within patriarchal structures and calls for a nuanced understanding of gender dynamics in health planning and interventions. In summary, this thesis contributes to understanding the complex reality of gender dynamics in Nigeria during the pandemic. It underscores the need for a change in thinking in global health approaches, advocating for inclusivity and respect for women’s varied experiences and voices in Nigeria.
Summary for Lay Audience
This original qualitative research explored how the COVID-19 pandemic influenced women’s healthcare decisions in Nigeria, focusing on maternal and infant health. It included twenty-four interviews and three focus group discussions with women of reproductive age (15-49 years) who were i) pregnant or had a child during the pandemic; ii) had a need to use a health service and did not use it; iii) used health services in the period. These interviews and focus group discussions were conducted in Ebonyi, Ogun, and Sokoto states. The findings are presented in chapters 5, 6, and 7. Together, and with supporting quotes from the women who gave their time to share their experiences, these uncover the complexities of women’s experiences during this unprecedented time. The first original article (chapter 5) focused on where women turned for healthcare during the pandemic and women’s stated motivations behind these choices in Nigeria. The findings emphasize common challenges women faced across different socio-economic backgrounds, including transportation difficulties, fears related to COVID-19, and a general distrust of the healthcare system. The second original research paper (chapter 6) provided a deeper understanding of women’s encounters with healthcare during the pandemic, highlighting the impact of COVID-19 on personal health behaviours. The paper identified key themes, including adopting new health behaviours in response to the pandemic and the pandemic’s effects on maternal healthcare. The paper underscored the importance of innovative approaches, such as leveraging technology, to address access issues and ensure quality care. The last original article (chapter 7) considered the evolving dynamics of gender roles and the enduring influence of colonial legacies on health-seeking behaviours in Nigeria. Drawing attention to three Nigerian women’s accounts of their economically unequal yet not clearly oppressive relationships with their husbands, the article challenges stereotypes about oppressed African women. This research sheds light on the multifaceted challenges faced by women in Nigeria during the pandemic. It emphasized the need for a comprehensive and innovative approach to global health strategies, recognizing and respecting women’s diverse experiences and voices in the country.
Recommended Citation
Ndu, Mary, "Exploring the experiences of women accessing care during a pandemic in Nigeria: A Qualitative Feminist Phenomenological Study" (2024). Electronic Thesis and Dissertation Repository. 10233.
https://ir.lib.uwo.ca/etd/10233
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
COVID-19 Commons, Maternal and Child Health Commons, Public Health Education and Promotion Commons, Women's Health Commons