RESILIENT & ACCELERATED SCALE-UP OF DMPA-SC/SELF INJECTION IN NIGERIA
Family Planning investment has been identified as a “best buy” in accelerating achievement of the Sustainable Development Goals (SDGs). The Government of Nigeria updated its commitment at the International Family Planning Summit in London, 2017, to achieve a modern contraceptive rate of 27% among all women by 2020 through working in collaboration with its partners and the private sector. Part of the commitments made is to remove regulatory barriers and scale up access to new contraceptive methods such as the sub-cutaneous DMPA injections and increase the number of health facilities providing family planning services at all levels.
It is against this backdrop that ARFH received funding from the Bill and Melinda Gates Foundation (BMGF) and Children Investment Fund Foundation (CIFF) to implement the Resilient & Accelerated Scale-up of DMPA-SC/Self Injection in Nigeria (RASuDiN Project). ARFH is the principal recipient of the grant and will work with the Centre for Communication and Social Impact (CCSI) Nigeria, who is the Social Behavioural Change Communication (SBCC) partner.
The RASuDiN project aims to contribute to reducing maternal and infant morbidity and mortality by presenting opportunities to expand voluntary access to contraceptives and family planning services through introduction and scale up of DMPA-SC injection within a broader contraceptive method mix among women of reproductive age in Nigeria.
To enhance the resilient and sustainability of the project, ARFH will work with key government agencies and partners at the state and national level, especially the Federal Ministry of Health. At the state level, the project activities will be conducted in collaboration with the State Ministry of Health, SPHCDA, the media (for SBCC) and key community stakeholders comprising of traditional and religious leaders, youths and male community members. The joint stakeholders’ inclusion is anticipated to promote maximum support, commitment, active local involvement, improve community-health facility linkages and sustainability of the project.
Project states: Lagos, Oyo, Ogun, Enugu, Anambra, Delta, Rivers, Kwara, Niger and Plateau states
Project duration: Four years
Project Goal: To increase acceptance, utilization, availability and accessibility of DMPA-SC as a family planning method within a broader contraceptive method mix among women of reproductive age in Nigeria.
- To enable the introduction and scale up of DMPA SC – by maximizing and supporting government stewardship and key stakeholders in creating a favorable policy and community environment for health facility, community and self-injection (SI) based service delivery of DMPA-SC.
- To optimize service delivery channels – through capacity building of different cadres of health workers (Nurses, Midwives, CHEWs), community resource persons (CORPS) and women who wish for self-injection. This is to ensure DMPA-SC reaches new users and expands method choice and access for women in hard-to-reach areas.
- To generate demand for service uptake – by promoting information and social behavioural change communication on contraceptives and family planning service, supporting women who chose to self-inject DMPA-SC and improving efficient referral linkage between the community and primary health center for other methods and health services. This is to ensure increase in new acceptors and continuation rate for existing users towards increasing the Modern Contraceptive Prevalence Rate in Nigeria.
- To optimize the use of data – by ensuring proper capturing and documentation of project service implementation data, self-injection rates and capturing of essential indicators for result tracking for efficient and evidence based programming.
Key project activities: The following activities will be conducted to ensure successful implementation of the project.
- Project Roll-Out and Stakeholders Engagement & Buy-in: This is targeted at key agencies and community stakeholders crucial to project implementation in selected project LGAs in the states where stakeholders will be enlightened about the project implementation details and their opinions for effective implementation of the project.
- Facility and Community Audit: This is to establish a broad overview and detailed information including community resource mapping, as well as contextual factors affecting contraceptive and family planning uptake and utilization, including perception on DMPA-SC Self injection in the project states.
- Capacity Building: The project will involve three levels of training; training of trainers Trainers/Supervisors, training of family planning service providers at tertiary, secondary and primary health care facilities and the training of Community Resource Persons (CORPs), Market agents, Community Based Volunteers, Male advocates and Youths.
- Service Delivery: With supervision from ARFH team and State FP Coordinator, the health facility FP providers will provide FP services at their respective facilities while the trained CORPs provide DMPA-SC injection administration, non-prescriptive FP services, conduct counseling and outreach activities, and refer clients to public health facilities for prescriptive FP methods in their respective communities. They will also monitor and follow up DMPA-SC self-injection clients.
- Social Behavioural Change Communication: Routine community mobilization, dialogue and outreach activities will be conducted on the project to increase awareness, promote uptake and utilization of contraceptive and family planning services especially on DMPA-SC in respective project communities.
- Referral and linkages: The trained community resource persons (CORPS) will be attached to a trained Nurse/Midwife/Supervisor in a health facility close to their respective communities to strengthen existing referral systems and ensure that clients desirous of methods such as IUDs, Implants etc., are referred to health facilities with trained providers.
- Monitoring and Supervision: The State & LGA Family Planning Coordinators, M&E officers and Supervisors trained on the project will work with ARFH team to ensure regular supportive visits and supervision of service delivery and documentation by the different cadres of service providers.
With successful implementation, it is anticipated that this project will contribute to Nigeria’s efforts towards achieving and exceeding its targeted modern contraceptive prevalence rate of 27% by 2020 and a reduction of its undesirable high maternal mortality rate, regulation of its rapid population growth, towards achieving the sustainable development goals.