NURHI Phase 1 (2009 – 2015)
Phase 1 of NURHI was implemented in sex cities(Federal Capital Territory, Ibadan, Ilorin, Kaduna, Benin and Zaria).It significantly contributed to increasing the contraceptive prevalence rate in these cities as indicated by the 2013 National Demographic Health Survey.
NURHI Phase 1 (2009 – 2015)
Phase 1 of NURHI was implemented in sex cities(Federal Capital Territory, Ibadan, Ilorin, Kaduna, Benin and Zaria).It significantly contributed to increasing the contraceptive prevalence rate in these cities as indicated by the 2013 National Demographic Health Survey.
Advocacy
The NURHI 2 advocacy approach creates an enabling environment for family planning through improved policy actions and favourable dialogue from the community, religious leaders and media. This approach complements service delivery and demand generation efforts by ensuring increased uptake of high-quality family planning services.
To implement the advocacy approach effectively, state-specific plans in Kaduna, Lagos and Oyo States are essential. In each state, advocacy stakeholders were trained using the Advance Family Planning SMART advocacy approach to plan, implement and evaluate an effective family planning strategy.
NURHI 2 Advocacy Plans in Kaduna State
The landscape in Kaduna State is promising with the State Ministry of Health fully leading the development of the partners and interventions coordination platform. Kaduna State Primary Health Care Under One Roof’ strategy where all the RMNCH continuum of care are integrated is gradually gaining momentum in structure and outlook, and the state’s Costed Implementation Plan for Family Planning (Blueprint) has been adopted. These two developments place the Saving One Million Lives initiative which is aimed at increasing the utilization and quality of high impact reproductive, child health, and nutrition interventions in a strategic place for repositioning family planning funding matters in Kaduna State.
The Kaduna advocacy intensify efforts to achieve and sustain full political commitment and policy actions for family planning. This will involve working closely with the Saving One Million Lives Initiative, the Primary Health Care Under One Roof strategy, partner agencies and domestic collaborating partners to leverage opportunities. These key stakeholders will be targeted to collaborate with NURHI 2 to strategically enhance dialogues on family planning and improve policy actions to support budgetary expenditures on family planning.
They will also ensure adequate availability, deployment and retention of skilled providers for a minimum of three years in each facility. Further efforts will be geared towards improving and elevating the social construct, understanding and accepting family planning in Kaduna State and institutionalising the role of media champions in family planning policy dialogues and advocacy.
NURHI 2 Advocacy Plans in Lagos State
Lagos State is the commercial centre of Nigeria. Although it is the smallest state in Nigeria in terms of land mass, It has the most dynamic population representing practically all of the country’s ethnic groups. Lagos State has a population of about 23 million people with an annual growth rate of 3.5%. Almost all (92%) of its population resides in urban locations, and the state experiences a high level of rural–urban migration and a large influx of people from other states in search of economic opportunities. The city of Lagos is one of the most densely populated and fastest growing cities in the world, with more than 100 slum communities.
Though the government funds family planning activities in Lagos State, there is need for improvement in areas such as infrastructure development, staffing and availability of consumables. Lagos State recently ordered that consumables must be provided for free, in contrast to the past practice of payment being required before services are rendered. However, most local government areas do not fund family planning services, so intenders still have to pay for the necessary services to get the free consumables. Another barrier to high-quality family planning services is the transfer of trained family planning staff from high-volume facilities to low-volume facilities where their skills cannot be fully leveraged.
Demand generation activities are limited in general, and few leaders speak publicly in support of family planning, especially among the religious and traditional leadership communities.
Child spacing and family planning are well accepted within the context of reducing maternal mortality, and stakeholders know and recognise the importance. The recent development of a costed implementation plan by Lagos State would go a long way once it is adopted. The plan should improve funding for family planning and help meet the goal of a 72% contraceptive prevalence rate by 2020.
NURHI 2 Advocacy Plans in Oyo
The NURHI 1 advocacy strategy was premised on several critical issues and challenges to family planning in Oyo State. These issues include a lack of clear policy and strategic plan for family planning, inadequate political will at the state and local government levels, insufficient infrastructure and equipment to facilitate the delivery of family planning, lack of family planning service providers, inadequate financial resources due to poor funding of family planning, lack of a budget line for family planning, recurring commodity stock-outs and lack of funding to support family planning commodity procurement and supplies.
At the community level, issues include prejudices, biases, myths and misconceptions that are fuelled by religious and traditional beliefs, mostly championed by both religious and traditional leaders. Specific key achievements and results of the NURHI 1 advocacy strategy included the following: five local government areas in the project cities integrated family planning into their annual budgets; funding for family planning increased from zero to over 13 million Naira, with a family planning budget line established at both the state and local government levels; and resistance to family planning significantly decreased at the community level, with many religious and community leaders making public pronouncements in favour of it.