title: Appraisal of observance of behaviour change communication programme for maternal and child health at first level of midwifery practice in kaduna state Nigeria.
abstract: BACKGROUND
  Behaviour Change Communication (BCC) is a key component of the roadmap adopted by the Nigerian government to address the high maternal and child mortality in the country.
  
  
  OBJECTIVE
  The purpose of the study was to appraise the participation of midwives in BCC at the first level of health care in Kaduna State, Nigeria before planning a context specific and sustainable BCC capacity building programme.
  
  
  METHODS
  In-depth interviews were conducted with nine midwives selected by maximum variation technique across Kaduna State. Content analysis of the interviews was performed using a priory codes derived from the integrative framework.
  
  
  RESULTS
  The integrative framework provided a comprehensive appraisal of BCC in the facilities. Health talks were unplanned, difficult and more task-oriented than being behaviour change focused. The required skills, integrated services to enhance behaviour change by clients, and enabling environment, were missing. The findings were used, in collaboration with the midwives to develop and implement a context specific and efficient capacity building programme.
  
  
  CONCLUSIONS
  The framework was adequate in identifying the gaps in the BCC activities of midwives at the facilities. There is a need to understand and support midwives with their BCC activities. Government policies should be brought closer to frontline staff who would implement them, by engaging such staff all through the process of developing the policies.
authors.affiliation: School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Bridget Omowumi
authors.initials: BO
authors.lastname: Akin-Otiko
authors.affiliation: School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Busisiwe Rosemary
authors.initials: BR
authors.lastname: Bhengu
keywords: Appraisal; Behaviour change communication; Integrative framework; Midwife