Exploring the experiences of women accessing care during a pandemic in Nigeria: A Qualitative Feminist Phenomenological Study
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.