Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria.

Background: Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior.

Methods: A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria. Attitudes to gender norm statements were assessed on a 3-point scale of agree (3 points), partially agree (2 points), and disagree (1 point). Mean attitude scores were estimated for each statement and the predictors of attitudes were determined through multiple linear regression analysis with p-value set at .05.

Results: Majority of the health workers held gender biases regarding male control over sexual decision-making, men's higher desire and value for sex, and the woman's responsibility to prevent pregnancy. Over 40% of the respondents associated women carrying condoms with promiscuity, and 39.6% believed that only men have the "social" rights to purchase condoms. Urban residence predicted health workers' attitudes to adverse gender norms related to sexuality (β = -.179, p = .003).

Conclusions: Findings from this study provide a basis for in-service training programs that are designed to change the attitudes of health workers to adverse gender norms and transform their practices.