Sustaining family planning advocacy: The NURHI approach

Observers opine that effective family planning plays a fundamental role in reducing infant mortality.

In their views, efficient family is the bedrock of women’s better health and a tool for tackling poverty.

In spite of its values, they note that women are unable to access family planning services because of cultural or religious beliefs.

Medical experts believe that when women cannot access family planning, they are unable to delay conception, space or limit their pregnancies resulting in a large family.

They, nonetheless, observe that some family planning methods such as using modern prescribed contraceptives could prevent unplanned pregnancies and abortions.

They observe further that other methods, including the use of calendars to calculate women’s ovulation period, have contributed to family planning, especially where access to contraceptives is hindered.

Whatever methods adopted by couples, medical experts believe that family planning affords couples to anticipate a desired number of children with enough spacing in giving births.

They observe that the importance of family planning underscores the inauguration of several initiatives at promoting advocacy for its practice by government and non-governmental organisations.

They cite the example of Nigerian Urban Reproductive Health Initiative (NURHI), a non-governmental organisation that has inaugurated family planning related projects in FCT, Ibadan, Kaduna, Ilorin, Benin City and Zaria.

Funded by the Bill and Melinda Gates Foundation, the project is set to increase contraceptive prevalence rate in Nigeria by 20 per cent.

NURHI notes that at the inauguration of the project, the use of modern contraception among women in union was between six per cent and 33 per cent in the project cities while fertility was high.

“Many low-income women living in urban areas were unlikely to receive pre-natal care or skilled care during delivery, heightening their risk of maternal morbidity and mortality.

“As such, expanding access to family planning information and services in urban communities will improve maternal health and save mothers’ lives,’’ it says.

NURHI Project Director Moji Odeku says the organisation’s mid-term assessment notes great improvement in the use of family planning methods.

“Scientific evidences have shown for more than seven years that by providing quality family planning service, it will reduce mothers’ death by 30 per cent.

“It will also improve child survival by 25 per cent; and such an improvement in maternal and child survival will avert about half of the deaths in women and children in Nigeria.

“Based on the successes that we have made, the Bill and Melinda Gates Foundation have shown intention to scale up the project.

“We have only been working in the urban slum for the past years but the foundation says it will scale up this to both urban and rural communities,’’ she said.

Sharing similar sentiments, Mrs Enyiola Awoniyi, the Head of Family Planning Unit, Family Clinic, Abuja, said that with the assistance of NURHI, there had been improvement in family planning services of the clinic.

She said that with the presence of NURHI, staff of the centre received refreshers training and training on direct and close supervision.

“The NGO supplies us with information communication materials which we use to enlighten our clients and they are always prompt with delivery of materials,’’ she said.

According to her, family planning is for both women and men as men are also enlightened on its benefits.

She said that NURHI, through its social mobilisers, distributed leaflets to men on the importance of family planning and also carried out radio prorammes to that effect.

She, however, noted that the “only contraceptive for men is the condom whereas there are a range of family methods for women.’’

Explaining the commitment of the Federal Government to family planning, Prof. Onyebuchi Chukwu, the former Minister of Health, said that the government would encourage all the family planning methods to achieve a contraceptive prevalence rate of 36 per cent by 2018.

“To achieve this goal, there is need to aggressively promote all family planning methods so as to meet the needs of women of reproductive age.

“The Federal Government had taken steps towards promoting unhindered access to family planning commodities and supplies.

“It has initiated the declaration of the policy on free family planning commodities and services in all public health facilities,’’ he said recently in a forum.

Chukwu noted that the policy on free family planning commodities was also backed up with annual budgetary allocation of three million dollars for the procurement of contraceptive commodities since 2011.

“This was followed up with approval of policy on task-shifting for Community Health Extension Workers to provide injectable contraceptive and the Saving One Million Lives Initiative,’’ he said.

He, nonetheless, observed that in spite the efforts by government, significant improvement had not been recorded in the relevant health indices over the years.

“There has only been slight improvement in the maternal and child health indices with maternal mortality ratio at 545 per 100,000 live births and average total fertility at 5.7

“The contraceptive prevalence rate at 10 per cent for modern methods and all methods at 15 per cent while the unmet need for family planning stands at 20.2 per cent,’’ he said.

All in all, concerned believe that this record is a challenge to stakeholders to ensure that family planning advocacy is promoted and sustained by all and sundry.