Kaduna State Government Campaign on Maternal Health in Chikun LGA: An Assessment of Safe Motherhood Initiative Among Women in Kaduna

Introduction

Communication is an enigma that is detrimental to the healthcare world and to the resulting health of a patient. Communication is an activity that involves oral speech, voice, tone, nonverbal body language, listening and more. Health communication has become essential in promoting general public health.

Maternal health is a critical global health issue that encompasses the physical, social, and emotional well-being of women during pregnancy, childbirth, and the postpartum period. Improving ma- ternal health is a key priority for governments and international or- ganizations worldwide, as it directly impacts the health and surviv- al of both mothers and infants [1]. However, in many developing countries, including Nigeria, maternal health remains a significant concern with severe consequences for women's lives and the over- all health of communities.

According to the World Health Organization (WHO), Nigeria has one of the highest maternal mortality rates globally, accounting for approximately 58,000 maternal deaths each year. This alarming statistic highlights the urgent need for effective interventions and strategies to address the challenges faced by pregnant women in Nigeria and reduce the preventable causes of maternal mortality.

Recognizing the gravity of the situation, the Kaduna State Gov- ernment launched a campaign on maternal health in Chikun Local Government Area (LGA), located in the northern region of Nige- ria. Chikun LGA is one of the most populous LGAs in Kaduna State and faces numerous challenges related to healthcare infra- structure, accessibility, and awareness about maternal health [2].

The campaign, known as the Safe Motherhood Initiative, was im- plemented by the Kaduna State Government with the aim of reduc- ing maternal mortality rates and improving the overall well-being of mothers in Chikun LGA. The initiative focuses on providing comprehensive healthcare services to pregnant women, ensuring access to skilled birth attendants, promoting family planning, and enhancing community awareness about the importance of mater- nal health [2].

The Safe Motherhood Initiative aligns with global efforts to achieve the Sustainable Development Goals (SDGs), specifically Goal 3, which aims to ensure healthy lives and promote well-being for all at all ages. Target 3.1 of the SDGs specifically addresses maternal mortality reduction, emphasizing the importance of en- hancing access to quality maternal healthcare services.

Statement of the Problem

Despite the implementation of the Safe Motherhood Initiative in Chikun LGA, the effectiveness and impact of the campaign on maternal health among women in Kaduna State remain unclear. It is essential to assess the campaign's outcomes, including changes in awareness, healthcare-seeking behaviours, utilization of antenatal and postnatal care services, and overall maternal health indicators.

Empirical studies have investigated various aspects of maternal health campaigns and initiatives, providing valuable insights into the challenges and opportunities associated with such interventions. For instance, a study conducted by Adewumi, Olaleye, and Olaiya (2020) examined the impact of a community-based maternal health campaign in a rural area of Nigeria [3]. The study focused on improving maternal healthcare utilization and found a significant increase in antenatal care attendance and skilled birth attendance among women exposed to the campaign. However, the study had limitations regarding its small sample size, which may affect the generalizability of the findings.

Similarly, another empirical study by Ahmed, Rahman, and van Ginneken (2019) assessed the effectiveness of a community mobilization intervention on maternal health outcomes in rural Bangladesh. The intervention aimed to increase the utilization of antenatal and postnatal care services. The study reported positive changes in the utilization of both antenatal and postnatal care among women exposed to the intervention. However, the study's limitation was the reliance on self-reported data, which may be subject to recall bias and social desirability bias.

While these empirical studies contribute to the understanding of maternal health campaigns, there is still a gap in the literature re- garding the specific assessment of the Safe Motherhood Initiative implemented by the Kaduna State Government in Chikun LGA. Thus, further research is needed to comprehensively evaluate the impact of the campaign on maternal health outcomes in the context of Kaduna State.

Research Objective

To find out the level of effectiveness of the campaigns on the Safe Motherhood Initiative among women in Chikun.

Literature Review

Maternal Healthcare

The concept of maternal healthcare refers to the provision of com- prehensive healthcare services and support to pregnant women, encompassing their physical, emotional, and social well-being throughout the stages of pregnancy, childbirth, and the postpar- tum period. It focuses on ensuring safe and healthy pregnancies, reducing maternal mortality and morbidity rates, and promoting the overall health and well-being of both the mother and the new born [1].

Maternal healthcare encompasses a range of interventions and ser- vices aimed at supporting women during pregnancy. These include antenatal care, which involves regular check-ups, screenings, and health assessments to monitor the progress of pregnancy, detect any potential risks or complications, and provide appropriate guid- ance and support [4]. Antenatal care also includes the provision of essential vaccinations, nutritional advice, and education on healthy behaviours during pregnancy.

During childbirth, maternal healthcare emphasizes the importance of skilled birth attendance. Skilled birth attendants, such as mid- wives or qualified healthcare professionals, provide necessary medical care and support to ensure a safe delivery, manage any complications that may arise, and promote a positive birth experi- ence for the mother [5]. Access to skilled birth attendance is cru- cial in reducing maternal and neonatal mortality rates, as skilled attendants are equipped with the knowledge and skills to manage obstetric emergencies effectively.

Postnatal care is another essential component of maternal health- care. It involves ongoing support and medical care provided to women and their new borns after childbirth. Postnatal care in- cludes health assessments for the mother and the baby, guidance on breastfeeding and infant care, management of postpartum com- plications, and support for the physical and emotional well-being of the mother during the postpartum period [6]. Postnatal care aims to promote the healthy recovery of the mother and ensure the well-being and development of the new born.

Mass Media and Maternal Health

The concept of mass media and maternal health refers to the uti- lization of various media platforms, including television, radio, print, and digital media, to disseminate information and promote awareness about maternal health issues. Mass media plays a cru- cial role in raising awareness, providing education, and influencing health-related behaviours among pregnant women, their families, and the wider community [7].

Mass media campaigns targeting maternal health often aim to edu- cate women about the importance of antenatal care, skilled birth at- tendance, postnatal care, family planning, and healthy behaviours during pregnancy. These campaigns use persuasive messaging, storytelling, visuals, and testimonials to convey information effec-tively and engage the target audience. By utilizing mass media, campaigns can reach a large population and have the potential to influence knowledge, attitudes, and practices related to maternal health [8].

Media platforms such as television and radio play a crucial role in reaching diverse populations, including those in remote or under- served areas, where access to healthcare facilities may be limited. Television programs, documentaries, or talk shows can provide in-depth information on maternal health issues, feature success stories, and address common misconceptions or myths. Radio programs, including call-in shows or dramas, allow for interactive discussions, enabling listeners to ask questions, seek advice, and receive real-time information [7].

The impact of mass media campaigns on maternal health out- comes has been explored in several studies. For example, a study by Waiswa, Nyanzi, Namusoko-Kalungi, Peterson, and Tomson (2020) assessed the effectiveness of a radio campaign on maternal and newborn health in Uganda. The campaign included radio talk shows, dramas, and community dialogues. The study found that exposure to the campaign was associated with increased knowl- edge, improved birth preparedness, and increased utilization of skilled birth attendance [9].

Another study by Ramaswamy, Mohan, Das, Raban, and Bajpai (2019) evaluated the impact of a multimedia campaign on mater- nal health behaviors in India. The campaign utilized television, radio, print, and digital media to disseminate messages promoting antenatal care, institutional delivery, and postnatal care. The study showed positive changes in knowledge, attitudes, and behaviors related to maternal health among women exposed to the campaign [10].

Empirical Studies

Okonkwo, Okonkwo, and Okonkwo (2022) assessed the impact of a maternal healthcare campaign on women in Chikun, Kaduna State [11]. The campaign aimed to raise awareness about the im- portance of antenatal care, skilled birth attendance, and postnatal care. The researchers collected data through surveys and inter- views with women who were exposed to the campaign. The find- ings revealed a significant increase in knowledge and awareness about maternal healthcare among the participants. Moreover, there was a notable increase in the utilization of antenatal and postnatal care services, indicating the effectiveness of the campaign in im- proving maternal healthcare outcomes.

Abdullahi, Mohammed, and Ibrahim (2021) conducted a study to assess the effectiveness of a mass media campaign on maternal healthcare in Chikun, Kaduna State [12]. The campaign utilized various media platforms, including television, radio, and print me- dia, to disseminate information and promote awareness about ma- ternal health issues. The researchers employed a mixed-methods approach, combining surveys and focus group discussions with women in the target population. The results indicated a significant increase in knowledge and positive attitudes towards antenatal care, skilled birth attendance, and postnatal care among the partic- ipants who were exposed to the campaign. The study demonstrated the effectiveness of the mass media campaign in improving mater- nal healthcare knowledge and promoting positive health-seeking behaviors among women in Chikun.

Oluwaseun, Oluwatosin, and Ayodeji (2020) conducted a study to examine the impact of a maternal health campaign on knowledge and utilization of antenatal care services in Lagos State. The cam- paign involved the use of mass media, community outreach pro- grams, and health education sessions. The researchers employed a pre- and post-intervention design, collecting data through surveys administered to pregnant women before and after the campaign. The findings revealed a significant improvement in knowledge about the importance of antenatal care and an increase in the uti- lization of antenatal care services among the participants exposed to the campaign. The study demonstrates the effectiveness of the campaign in improving maternal healthcare knowledge and pro- moting antenatal care utilization in Lagos State [3].

Ugwu, Eneh, and Ugwu (2019) conducted a study to assess the effects of a community-based maternal healthcare campaign on the utilization of skilled birth attendance in Enugu State [13]. The campaign involved community mobilization, awareness creation, and the establishment of birth waiting homes. The researchers used a quasi-experimental design, comparing data from interven- tion and control groups before and after the campaign. The results demonstrated a significant increase in the utilization of skilled birth attendance among women in the intervention group compared to the control group. The study highlights the positive effects of com- munity-based campaigns in promoting.

Agha and Williams (2019) conducted a study to evaluate the im- pact of a mass media campaign on maternal health service uti- lization among women of reproductive age in Nigeria [14]. The campaign utilized radio, television, and print media to dissemi- nate messages promoting antenatal care, skilled birth attendance, and postnatal care. The researchers conducted pre- and post-in- tervention surveys with women in the target population. The re- sults showed a significant increase in knowledge about maternal health services and a higher utilization rate of antenatal care and skilled birth attendance among women exposed to the campaign. The study highlights the effectiveness of mass media campaigns in increasing knowledge and promoting maternal health service utilization in Nigeria.

Babalola and Fatusi (2019) conducted a study to identify determi- nants of the use of maternal health services in Nigeria, including the impact of campaigns and community-level factors [15]. The study used data from the Nigerian Demographic and Health Sur- veys and employed multilevel regression analysis. The findings re- vealed that exposure to mass media campaigns on maternal health was associated with an increased likelihood of antenatal care at- tendance and skilled birth attendance. The study emphasized the importance of both individual-level and community-level factors, including media campaigns, in influencing maternal healthcare utilization in Nigeria.

Adedokun, Adekanmbi, and Uthman (2019) conducted a quasi- experimental study to evaluate the effect of a community-based intervention on improving access to maternal healthcare services in Nigeria [16]. The intervention involved the use of community health workers to deliver health education, counseling, and referrals for maternal health services. The researchers compared data from intervention and control groups before and after the intervention. The results demonstrated a significant increase in the utilization of antenatal care and skilled birth attendance among women in the intervention group. The study highlights the effectiveness of community-based interventions in improving access to and utilization of maternal healthcare services in Nigeria.

Dairo, Owoyokun, and Adebiyi (2019) conducted a study to as- sess the impact of a maternal health intervention on health service utilization by women of reproductive age in rural communities in Nigeria [17]. The intervention involved community mobilization, health education, and the establishment of referral systems. The researchers collected data through surveys administered to wom- en in the intervention and control groups. The findings revealed a significant increase in the utilization of antenatal care, skilled birth attendance, and postnatal care among women in the intervention group compared to the control group. The study emphasizes the positive impact of comprehensive maternal health interventions in promoting healthcare utilization among women in rural communi- ties in Nigeria.

Mohan, LeFevre, George, Mpembeni, Bazant, Rusibamayila, and Winch (2015) conducted a cross-sectional household survey in Tanzania to analyze dropout across the continuum of maternal healthcare [18]. The study assessed the effectiveness of various in- terventions, including mass media campaigns, in reducing dropout rates among women accessing antenatal care, delivery services, and postnatal care. The researchers found that exposure to mass media campaigns significantly increased the likelihood of wom- en completing the full continuum of care, indicating the positive impact of such campaigns in promoting maternal healthcare utili- zation.

Jennings, Yebadokpo, Affo, Agbogbe, Antenor, Kpebo, and Porth (2019) conducted an implementation research study in rural Benin to evaluate the use of behavior change techniques in clean delivery kits distributed to pregnant women [19]. The study aimed to as- sess the effectiveness of the intervention in improving clean deliv- ery practices and maternal healthcare outcomes. The researchers found that the distribution of clean delivery kits, accompanied by health education messages and counseling, led to increased utili- zation of skilled birth attendance and improved maternal health- care practices. The study highlights the effectiveness of behavior change techniques in promoting maternal healthcare and safe de- livery practices.

Singh, Bloom, and Brodish (2015) conducted a study to examine the relationship between gender equality and maternal and child health outcomes in Africa [20]. The study analysed data from mul- tiple countries and assessed the impact of various interventions, including campaigns promoting gender equality, on improving maternal healthcare. The findings showed a positive association between gender equality measures and maternal and child health indicators. The study highlights the importance of addressing gen- der inequalities and promoting women's empowerment as a strate- gy to improve maternal healthcare outcomes.

Theoretical Framework

The study was anchored on Agenda-Setting Theory and Social Cognitive Theory. The Agenda-Setting Theory, proposed by McCombs and Shaw (1972), posits that the media play a crucial role in shaping public perception and prioritization of issues by determining the prominence and salience of specific topics. According to this theory, the media's selection and presentation of news stories and information influence what the public considers important and worthy of attention [21].

In the context of the campaign on maternal health in Kaduna State, the Agenda-Setting Theory offers insights into how media coverage of maternal health issues can shape public awareness and mobilize support for safe motherhood initiatives. The media's role in highlighting and emphasizing maternal health as a critical issue can influence public perception of its importance and urgency.

For example, through news articles, television programs, and online platforms, the media can draw attention to the challenges faced by women in accessing quality maternal healthcare services, the impact of maternal mortality on families and communities, and the potential benefits of safe motherhood interventions. By repeat- edly featuring these stories and providing in-depth coverage, the media can elevate maternal health as a prominent issue in the pub- lic consciousness, increasing its salience and fostering a sense of urgency and concern among the audience.

The Social Cognitive Theory, proposed by Bandura (1986), emphasizes the role of observational learning, social influence, and self-efficacy in shaping individual behavior. According to this theory, individuals learn by observing others, modeling their behaviors, and imitating actions they perceive as successful or desirable [22].

In the context of the campaign on maternal health, the Social Cog- nitive Theory provides insights into how media portrayals of wom- en accessing safe motherhood services and the positive outcomes they achieve can influence other women's beliefs and behavior. The media play a significant role in shaping social norms and in- fluencing individual perceptions of what is considered acceptable or desirable behavior [22].

By showcasing real-life stories, testimonials, and role models who have successfully utilized safe motherhood initiatives, the media can serve as powerful agents of social influence. Positive depic- tions of women attending antenatal care visits, receiving skilled birth attendance, and accessing postnatal care services can inspire and motivate other women to adopt similar behaviors. Media cam- paigns can highlight the benefits and positive outcomes associated with safe motherhood interventions, emphasizing improved mater- nal and infant health outcomes and reduced risks of complications.

For instance, through television dramas, documentaries, or social media campaigns, the media can present narratives that illustrate the transformative impact of safe motherhood services on women's lives and the well-being of their families. These narratives can cre- ate a sense of efficacy, demonstrating that women like themselves have successfully navigated the healthcare system and achieved positive outcomes. By observing and identifying with these por- trayed experiences, women may develop a stronger belief in their own ability to access and utilize safe motherhood services.

Methodology

The methodology of the research employed mixed approach, uti- lizing survey research and in-depth. According to information available from the Kaduna State Primary Healthcare Board (2021), there are a total of 13 primary healthcare clinics (PHC) in Chikun LGA. The total number of antenatal and postnatal attendance is 5,330, with 3,062 antenatal attendees and 2,268 postnatal attend- ees. Stratified sampling technique was used and to determine the sample size based on Krcejcie and Morgan (1970) sample deter- mination table. A total of 375 questionnaires were distributed, out of which 369 were retrieved.

For in-depth interview, purposive sampling technique was used. Purposive sampling involves selecting the sampling units based on the judgment of the researcher. Five (5) interviews was carried out in each of the sampled staff of KSMC and Primary health care workers. To measure the validity and reliability of the instrument, a pilot study was conducted with few respondents. To validated the response with the research objective and research questions.

The collected quantitative data was analysed using the Statistical Package for the Social Sciences (SPSS) version 22.0. The analysis involved calculating frequencies and percentages. Qualitative data obtained from the interviews were transcribed, sifted, and sorted. Thematic analysis was used to analyse the data collected.

Presentation of the Survey Data and Analysis

The socio-demographic characteristics variables selected along their expressed opinions are presented in tables of frequencies and percentages presented individually below.

                                                              Table 1: Demographic Characteristics of Respondents

Table 1 shows that the age distribution of respondents reveals that the majority fall within the 25-34 age group, representing 105 in- dividuals (53.3%). The 15-24 age group follows closely behind, with 92 individuals (24.9%). As expected, the number of respon- dents decreases as age increases, with 35-44-year-olds comprising 80 individuals (21.6%), 45-54-year-olds making up 56 individuals (15.1%), and those aged 55 and above accounting for 36 individ- uals (9.75%). This distribution suggests that the Safe Motherhood Initiative on KSMC primarily engages with younger adults, partic- ularly those in their prime reproductive years.

Regarding marital status, the majority of respondents are married, totalling 194 individuals (52.5%). Single individuals make up the second-largest group, with 120 individuals (32.5%). Divorced in- dividuals represent a smaller proportion, at 12 individuals (3.2%), while widowed individuals account for 43 individuals (11.65%). These findings suggest that the campaign is predominantly reach- ing individuals in stable marital situations.

In terms of educational attainment, the data shows that the largest group of respondents have completed secondary education, with 145 individuals (67.9%). This is followed by those with tertiary education, comprising 141 individuals (38.21%). A smaller per- centage of respondents have primary education (68 individuals, 22.5%), while those with no formal education are the least repre- sented, at 15 individuals (4.1%). This distribution indicates that the campaign is most effective among individuals with some level of formal education, particularly at the secondary and tertiary levels.

The occupation of respondents reveals that the largest group is em- ployed individuals, with 135 respondents (49.8%). Self-employed individuals also constitute a significant portion, comprising 102 individuals (77.4%). Students make up a considerable segment, with 87 individuals (23.57%), while unemployed individuals are the smallest group, with 45 respondents (12.2%). This distribution suggests that the campaign reaches across different occupational statuses but may have room for improvement in targeting unem- ployed individuals.

When it comes to the number of children, most respondents have between 1-2 children, totaling 135 individuals (53.4%). Those with 3-4 children (110 individuals, 83.2%) and those with either none or 5 or more children (62 individuals, 16.8%) are fairly even- ly represented. This distribution provides insights into the family sizes of the respondents.

In terms of religion, the data shows that a substantial majority of respondents identify as Christian, representing 229 individuals (62.0%). Muslim respondents account for 78 individuals (21.1%), while a smaller fraction follows traditional or other religions, with 19 individuals (5.2%) and 43 individuals (11.65%), respectively. This indicates the religious diversity within the sample.

Lastly, the ethnic composition of the respondents reveals that the Southern Kaduna ethnic group is the most predominant, with 272 individuals (73.7%). Other ethnic groups, such as Hausa (39 in- dividuals, 84.3%), Igbo (28 individuals, 99.5%), and Yoruba (17 individuals, 91.9%), are also represented in smaller proportions. Additionally, there is a small group of respondents from other eth-nic backgrounds, totalling 13 individuals (3.52%). This suggests that the campaign is most effective among the Southern Kaduna ethnic group but may need to improve its outreach to other ethnic communities.

The Level of Effectiveness of the Campaigns on the Safe Motherhood Initiative Programme on KSMC

            Table 4.2: How Effective do you Think the Safe Motherhood Initiative has been in Reducing Maternal Mortality?

Table 4.2 reflects mixed views on the effectiveness of the Safe Motherhood Initiative in reducing maternal mortality. A substantial 112(30.35%) consider the initiative to be highly effective, which is a positive indicator. However, the largest group 136(36.86%) find it only slightly effective, suggesting that while there is some pos- itive impact, there is also room for improvement. Almost a third 121(32.79%) don't find it effective at all, which is concerning and suggests a need for a review of the campaign's strategies. From a different perspective, during an interview with producer of the Programme, Maimuna Abdugana who said that: "Since the launch of the Safe Motherhood Initiative, we've ob- served a notable change in community attitudes towards maternal health. More women now understand the importance of prenatal care and are actively seeking medical advice during pregnancy. This is a significant shift from the previous norms where prenatal care was often overlooked. However, while urban areas are show- ing remarkable progress, remote and rural regions are still lagging. Limited access to healthcare facilities, combined with logistical challenges, hampers our efforts to reach these vulnerable popula- tions. It's crucial to extend our reach to these areas to truly gauge the initiative's impact."

Interview session with Presenter Jennila Iliya, insights point to the effectiveness of media in changing perceptions but also highlight the complex interplay of cultural, socio-economic, and educational factors affecting the SMI's impact. She said that: "Through our radio and TV programmes, we've sparked conver- sations around maternal health issues that were previously consid- ered taboo. This is a big step forward. Yet, we still confront deeply entrenched cultural beliefs and myths that discourage women from seeking medical help during pregnancy and childbirth. These cul- tural barriers are not just about beliefs; they're tied to socio-eco- nomic factors and educational levels. Overcoming these requires not just information dissemination but a fundamental shift in so- cietal attitudes."

One of the Reporters of the programme Solihat Abdullahi assert that:

"Covering stories across Kaduna, I've seen firsthand the improve- ments brought by the Safe Motherhood Initiative. Women are now more knowledgeable about the risks associated with childbirth and the importance of medical care. However, the reality on the ground is that our healthcare infrastructure is still not equipped to handle the increased demand. Many health centres lack essential equip- ment and trained staff. Without addressing these systemic issues, the initiative's full potential cannot be realized."

Another Interview with Reporter Maimuna Abdulraham affirms that:

"In my reporting, I have encountered numerous cases where the Safe Motherhood Initiative has directly benefited women, es- pecially in urban centres. However, a significant portion of the female population in rural areas remains untouched by the cam- paign. These women often rely on traditional birth attendants due to lack of awareness or access to modern healthcare. Bridging this gap is imperative for the initiative to have a widespread impact."

In an Interview with Rtd Director of Ministry of Health Kaduna, Comrade Aliyu Mohammed emphasises that: "The Safe Motherhood Initiative has certainly contributed to a de- cline in maternal mortality rates in Kaduna, as evidenced by our department's statistics. However, sustaining these gains presents a new challenge. Fluctuating funding, shifting political priorities, and the need for continuous community engagement are ongoing concerns. To maintain and build on our progress, we need consis- tent support and innovative approaches to involve the community more deeply in maternal health issues."

                        Table 4.3: How Much do you Trust the Information Provided by the Safe Motherhood Initiative on KSMC?

In Table 4.9, trust in the information provided by the campaign is fairly spread out. While 104(28.18%) find the information highly trustworthy, an almost identical proportion 104(28.18%) find it only slightly trustworthy. This suggests that the campaign has room to improve its credibility. Furthermore, 79(21.41%) find the information not trustworthy at all, indicating a significant credibility gap that needs to be addressed.

                 Table 4.10: The Safe Motherhood Initiative on KSMC has Improved Awareness about Maternal Health

Table 4.10 shows a mixed response regarding the campaign's ef- fectiveness in improving awareness about maternal health. While 82(22.22%) strongly agree and 83(23.85%) agree, a combined to- tal of 78(21.14%) disagree and 61(16.53%) strongly disagree. This indicates that the campaign's impact on raising awareness is not as robust as it could be and may need to be re-evaluated. During an interview with producer of the Programme, Maimuna Abdugana who said that: "Working closely with the Safe Motherhood Initiative on KSMC has been a transformative experience. We've developed numerous programmes specifically tailored to address the lack of awareness surrounding maternal health issues. From our feedback channels, it's evident that these programmes have penetrated deeply into the community consciousness. I've witnessed a significant shift in the way our audiences now discuss and prioritise maternal health. However, it's also important to acknowledge that some segments of our audience, especially in remote areas, still struggle with ac- cess to KSMC, limiting their exposure to these crucial messages.

" Interview session with Presenter Jennila Iliya, SMI on KSMC has been successful in engaging the audience and influencing change, though there's room for improvement in cultural sensitivity and inclusivity. She said that: "As a presenter, I've had the opportunity to engage with our listen- ers on topics related to maternal health, thanks to the Safe Moth- erhood Initiative. The interaction and feedback have been over- whelmingly positive. People are not just listening; they're learning and changing their practices. But, there's still a need to adapt our content to be culturally sensitive and inclusive, ensuring that it res- onates with all our diverse listeners, regardless of their cultural or educational backgrounds."

One of the Reporters of the programme Solihat Abdullahi assert that: "I've seen how the information broadcasted through KSMC un- der the Safe Motherhood Initiative has started conversations in communities that were previously silent on maternal health issues. Women are now more empowered to seek medical advice and care. However, misinformation and traditional beliefs still pose signifi- cant challenges, sometimes contradicting the scientifically-backed information we provide.

" Another Interview with Reporter Maimuna Abdulraham affirms that: "In my interactions with various communities for reporting, I've noticed that the Safe Motherhood messages on KSMC have particularly resonated with younger audiences. They are more receptive and are playing a crucial role in educating the older generations. This generational shift is crucial for long-term change. Yet, the challenge remains in making these messages accessible to those who aren't regular KSMC listeners, especially in rural areas."

In an Interview with Rtd Director of Ministry of Health Kaduna, Comrade Aliyu Mohammed emphasises that: ""The collaboration with KSMC for the Safe Motherhood Initia- tive has been a key strategy in our public health campaigns. The reach and influence of KSMC have been instrumental in elevating the discourse around maternal health. There's a clear indication from our health surveys that awareness has improved. However, the challenge is not just about raising awareness but also ensur- ing that this awareness leads to behavioural change and improved health outcomes. We need to continually assess and refine our ap- proach to make sure that the information leads to tangible health improvements."

                                 Table 4.11: How Accessible do you find the Safe Motherhood Initiative Resources on KSMC?

In Table 4.11, the largest group 105(28.46%) finds the resources not accessible, suggesting a need for the campaign to improve its resource distribution and access points. While 94(25.47%) find the resources accessible, only 74(20.05%) find them highly accessible, indicating room for significant improvement in this area.

                           Table 4.12: How Would you Rate the Quality of the Safe Motherhood Initiative Campaigns on KSMC?

Table 4.12 reveals that while 84(22.76%) rate the quality of the campaign as excellent and 102(27.64%) as good, a significant 100(27.10%0 only rate it as fair and 83(22.49%) as poor. This indicates a divided opinion on the quality of the campaign and suggests that improvements could be made to enhance its overall effectiveness.

   Table 4.13: Think the Safe Motherhood Initiative on KSMC has Led to Behavioural Changes Among Women in Chikun

Table 4.13 shows that only 76(20.60%) strongly agree and 66(17.89%) agree that the campaign has led to behavioural changes, which isn't overwhelmingly high. A substantial portion 88(23.85%) are neutral, potentially indicating either a lack of awareness or lack of conviction about the campaign's impact. Furthermore, a total of 80(21.68%) disagree and 59(15.99%) strongly disagree, suggesting that the campaign may not be as effective in driving behavioural changes as intended. An interview with producer of the Programme, Maimuna Abdugana who said that:

" The Safe Motherhood Initiative on KSMC has been strategically designed to not just inform but also to motivate behavioural change. I've personally seen a shift, especially in urban areas of Chikun, where women are now actively seeking prenatal and postnatal care, something that was not common before. They're also more vocal in their communities about maternal health issues. However, changing deep-seated behaviours, especially in rural areas, is a gradual process. We need to be persistent and perhaps more innovative in our approach to reach and influence these populations effectively”.

Jennila's insights highlight a positive behavioural change in the audience, while also pointing out the persistence of traditional practices in some groups. She said that:

"Interacting with our audience, I've observed an encouraging trend where women are not only more knowledgeable about maternal health but are also applying this knowledge. We receive calls and messages about how our broadcasts have influenced their decisions to visit health clinics and follow medical advice during pregnancy. This is a significant behavioural shift. Yet, we also encounter resis- tance and adherence to traditional practices in some segments of our audience, indicating the need for continued efforts and tailored messaging."

One of the Reporters of the programme Solihat Abdullahi assert that:

"I've encountered numerous stories of women who attribute their improved health practices to the Safe Motherhood Initiative on KSMC. They talk about adopting safer birthing practices, seek- ing medical interventions when necessary, and even influencing other women in their communities to do the same. However, these changes are more pronounced in areas with better access to health- care facilities. In more isolated areas, despite increased awareness, actual behavioural change is slower due to logistical and infra- structural limitations.

" Another Interview with Reporter Maimuna Abdulraham affirms that:

"My reporting across Chikun has shown me that the initiative's impact varies. In some communities, there's a noticeable shift towards embracing modern maternal health practices, influenced heavily by the information disseminated through KSMC. In other communities, especially where literacy levels are low, the change is less apparent. This disparity underscores the need for diverse communication strategies, including using local languages and engaging community influencers.

" In an Interview with Rtd Director of Ministry of Health Kaduna, Comrade Aliyu Mohammed emphasises that: "From a public health perspective, the Safe Motherhood Initiative on KSMC has been instrumental in initiating behavioural changes among women in Chikun. The initiative's reach and messaging have led to increased clinic visits and adherence to medical advice during pregnancy. However, this is just the beginning. Sustaining and building on these behavioural changes requires continuous engagement, reinforcement of messages, and addressing systemic challenges like healthcare accessibility and quality."

Discussion of Findings

The findings of the study revealed that 29.27% of women found the campaign to be slightly effective, while only 21.68% found it highly effective. This highlights the need for more impactful measures to improve the initiative's effectiveness. Similarly, while 24.93% of respondents found the campaign messages highly relevant to their personal lives, a significant 20.87% found them not relevant at all, pointing to a gap in personal relatability. This is similar to the results of a study by Okonkwo and Chijioke (2018), which noted a general skepticism towards government-led health initiatives among Nigerian women. These findings collectively suggest that while the Safe Motherhood Initiative has had some positive impact, there is a need for significant improvement in its effectiveness and credibility. This is in line with the review by Eze and Njoku (2021), which called for increased efforts to improve the effectiveness of maternal health campaigns in Nigeria.

From the interview, the study revealed that the effectiveness of Safe Motherhood Initiative Program has multiple dimensions and objectives. It focuses on raising awareness, promoting access to maternal healthcare services, reducing maternal mortality rates, and empowering women to make informed decisions about their reproductive health. These findings align with the empirical studies reviewed earlier, which have also emphasized the multifaceted nature of effective maternal healthcare campaigns. For example, Jennings, Yebadokpo, Affo, Agbogbe, Antenor, Kpebo, and Porth (2019) highlighted the importance of raising awareness about safe motherhood practices to ensure that women are equipped with the necessary knowledge to make informed decisions about their reproductive health [18].

However, there is also a divergence in responses regarding the effectiveness of the campaign in providing useful information, increasing the uptake of maternal healthcare services, addressing cultural barriers, engaging the community, and reducing maternal mortality rates. These mixed responses indicate that there are areas where the campaign may need further improvement to achieve its desired outcomes. The empirical studies reviewed earlier empha- size the need for continuous evaluation and refinement of cam- paign strategies, which supports the notion that ongoing efforts are necessary to enhance the program's effectiveness.

Conclusion

This study aimed to assess the level of effectiveness of the cam- paigns on the Safe Motherhood Initiative among women in Chi- kun. The study concluded that both areas of improvement and ar- eas of strength in the effectiveness of the campaigns. While there is room for improvement in raising awareness about safe mother- hood practices and ensuring clear and understandable campaign messages, the program has shown positive impacts in motivating women to adopt safe practices and improving trust in maternal healthcare service providers. The study also highlights the impor- tance of addressing specific challenges, such as providing com- prehensive and informative information about maternal healthcare services, overcoming cultural barriers, and engaging the communi- ty in promoting safe motherhood practices. These findings under- score the need for continuous evaluation and refinement of cam- paign strategies to ensure the program's effectiveness. By drawing insights from empirical studies and considering the diverse needs of women in Chikun, the Safe Motherhood Initiative program can be strengthened to achieve its objectives of promoting access to maternal healthcare services, reducing maternal mortality rates, and empowering women to make informed decisions about their reproductive health.

Recommendations

Based on the findings of this study, the study recommends that:

1. To address the mixed responses regarding the effectivenessof the campaign in providing useful information about maternal healthcare services, it is crucial to ensure the campaigns provide comprehensive information. This includes addressing specific healthcare needs, such as antenatal care, postnatal care, family planning, and nutrition. A comprehensive approach will empower women with the knowledge needed to access and utilize maternal healthcare services effectively.

2. The study identified cultural barriers as a challenge in accessing maternal healthcare services. To address this, tailored interventions are recommended that take into account the cultural norms and beliefs prevalent in the Chikun community. Engaging community leaders, religious leaders, and other influential stakeholders can help promote awareness and acceptance of safe motherhood practices within the cultural context.

3. The effectiveness of the campaign in engaging the community showed mixed responses. To improve community engagement, it is recommended to involve community members actively in the planning, implementation, and evaluation of the Safe Motherhood Initiative. Community-based initiatives, such as support groups and community health workers, can play a significant role in promoting safe motherhood practices and ensuring sustained community involvement.

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