Investigating Gender Transformative Approaches in Community Health Worker Programmes in Bauchi State

Community health worker (CHW) programmes are a cornerstone of primary healthcare delivery in Nigeria, yet their design rarely addresses the gender norms that drive health inequities, limiting their transformative potential. This study investigates the integration and outcomes of gender-transformative approaches in CHW programmes in Bauchi State. A quasi-experimental design was employed, comparing health and gender attitude outcomes in 160 households in communities where gender-transformative CHW training was implemented against 160 households in control communities with standard CHW programmes. Pre- and post-intervention surveys were administered, with analysis using difference-in-differences estimation and descriptive statistics. Findings demonstrate that communities with gender-transformative CHW training show significantly improved female health-seeking rates, higher male involvement in antenatal care, and more egalitarian household gender attitude scores at endline. Female CHWs in gender-transformative programmes also demonstrate higher self-reported professional confidence and community status. Importantly, male CHWs who undergo gender-transformative training become effective advocates for changed household health practices among male community members. This study fills an important gap in the gender-transformative health intervention literature by providing quasi-experimental evidence from North East Nigeria. Recommendations address scale-up of the gender-transformative model within the Bauchi State Primary Healthcare Development Agency. Keywords: gender-transformative approaches, community health workers, Bauchi State, gender norms, health