Behavioral Sentinel Surveillance Survey in Nigeria: Endline Technical Report for Couples

The survey aimed to assess changes in indicators targeted by the integrated social and behavior change (SBC) activities of the USAID-funded Breakthrough ACTION/Nigeria's project. The project focuses on malaria, family planning (FP), and maternal, newborn, and child health plus nutrition (MNCH+N) in Kebbi and Sokoto states, as well as malaria-only SBC activities in Zamfara State. The BSS survey employed a multi-stage sampling design to gather information from women of reproductive age and their husbands on health behaviors and the factors that shape them. The survey collected data on psychosocial influences across cognitive, emotional, and social domains, which have been identified by behavioral theories as drivers of behavioral outcomes. These influences include an individual's beliefs, attitudes, perceptions of social norms, and sense of self-efficacy, which can all play a strong role in shaping their actions. A total of 3,144 women between the ages of 15 and 49, each with a child under 2 years old, were randomly selected from wards within Breakthrough ACTION/Nigeria program areas. Interviews were conducted with both wives and husbands in all three states, providing a comprehensive understanding of health knowledge, attitudes, beliefs, perceived norms, and behaviors related to malaria, FP, and MNCH+N. The survey results show that wives and husbands have different health knowledge, attitudes, and behaviors related to malaria, FP, and MNCH+N. For example, wives reported higher levels of knowledge about FP methods and their benefits, while husbands reported higher levels of knowledge about malaria prevention and treatment. The survey also found that concordance and discordance on health-related factors within couples are related to priority behaviors targeted by Breakthrough ACTION/Nigeria. The BSS survey provides valuable insights into the effectiveness of integrated versus vertical SBC approaches. The survey results suggest that integrated SBC approaches may be more effective in promoting positive changes in behavior, particularly when addressing the psychosocial influences that shape health behaviors. The survey also highlights the importance of addressing the perceptions and attitudes of both wives and husbands in promoting positive changes in health behaviors. The survey results have implications for the design and implementation of SBC programs in Nigeria. The findings suggest that SBC programs should focus on addressing the psychosocial influences that shape health behaviors, particularly the perceptions and attitudes of both wives and husbands. The survey also highlights the importance of integrating SBC approaches with other health interventions to promote positive changes in health behaviors. The BSS survey was conducted in collaboration with the Center for Research, Evaluation Resources, and Development (CRERD) and the Population Council. The survey was funded by the USAID through the Breakthrough RESEARCH cooperative agreement. The survey results provide valuable insights into the effectiveness of SBC approaches in promoting positive changes in health behaviors in Nigeria.