Dr Aiyenigba said cultural norms hampering women’s access to malaria services could be tackled by engaging all stakeholders – women groups, men’s groups, youth and traditional leaders.

“The value of the change is promoted and benefits accruing from modifying the norms widely disseminated. The use of trusted advocates can also be used to promote new norms,” she said.

She said that where feasible, use of social structures, such as dance troops, drama groups and the mass media, especially radio, in rural places, could also be utilised to communicate the message.

“Religious leaders are also proven agents of change. They can be engaged in promoting the positive behaviour that will empower women and improve their access to care,” she advised.

Aiyenigba added that the health system could also be adaptive to the culture.

“Where feasible, local women with the right qualification can be engaged to man the clinic and open in the evenings when women will be around. That way, utilisation and access are guaranteed,” she said.

She said Breakthrough ACTION-Nigeria was working in 11 states and the Federal Capital Territory to increase women’s knowledge and access to malaria prevention and care.

“We support women empowerment initiatives in five states, so the women have some financial power to transport themselves or their neighbours to the health facilities. We also have funding though the United States president’s malaria initiative to educate the populace, including women during mass distribution of mosquito bed nets,” she added.

Also, Dr Ntadom said efforts by the government to tackle the impact of cultural norms included making recommended anti-malarial medicines come in age specification and colour-coded packs.

“They are made available free or at highly subsidised costs. Awareness creation and sensitisation of communities are also important,” he said.

Mrs Sanni Adeniyi of the National Malaria Elimination Programme said cultural norms were among the reasons her organisation was taking advocacy messages to state governors, religious and traditional leaders, market women’s groups and civil society organisations.

She said, “When we get everyone on board, there will be less cultural norms hampering access to malaria services. Women will benefit a lot from attending antenatal care during pregnancy and sleeping under insecticide-treated nets.

“Right now, a lot of my staff members are in the streets doing advocacy. In fact, even ministers, governors, market women and medical professionals are involved.

“The essence is to prevent an increase in malaria cases because we are working towards a malaria-free Nigeria.”

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