Key Social Norms Takeaways Gender norms—particularly those governing division of labour, decision-making, and gender-based violence—are deeply embedded drivers of maternal health outcomes but can be transformed through participatory, household-level interventions that engage both women and men. The study shows that shifting norms requires addressing power dynamics within couples and fostering joint reflection, communication, and shared responsibility, rather than focusing solely on women’s behavior.

Objectives This study qualitatively evaluated the gender equity impacts of a universal home visits programme targeting pregnant women and their spouses in Bauchi State, Nigeria, with a focus on how the intervention influenced gender norms and dynamics related to maternal health.

Methods A qualitative design using 14 focus group discussions and 9 key informant interviews was employed, involving community members, home visitors, supervisors, and policymakers. Data were analyzed using deductive thematic analysis guided by an adapted gender analysis framework examining division of labour, access to resources, decision-making, and social norms. Social norms were assessed indirectly through reported changes in attitudes, behaviors, and household dynamics, including gender roles, spousal communication, and violence.

Intervention Details The intervention consisted of universal, bi-monthly home visits to pregnant women and their spouses by trained female and male community visitors. The programme used participatory discussions to address gendered risk factors such as heavy workload during pregnancy, domestic violence, and limited male involvement. It emphasized separate but complementary engagement with women and men, supported by community and religious leaders, to promote shared responsibility for maternal and child health.

Results Participants widely reported positive shifts in gender norms and practices. Men increased participation in household labor and maternal care, including accompanying women to health services and providing financial and nutritional support. Women experienced greater autonomy in accessing healthcare, and spousal communication improved significantly. A substantial perceived reduction in domestic violence was reported, alongside broader community-level changes in attitudes toward gender roles and relationships. These outcomes were attributed to increased awareness and reflection stimulated by the intervention.

Conclusions The study concludes that the home visits programme was gender-transformative, effectively shifting harmful gender norms and improving relational dynamics within households. By engaging men and women together and fostering critical reflection on norms, the intervention addressed underlying power imbalances that affect maternal health. Sustainable improvements require continued attention to the broader social ecosystem in which gender norms are embedded.