NURHI Phase 1 (2009 – 2015)
Phase 1 of NURHI was implemented in six cities (Federal Capital Territory, Ibadan, Ilorin, Kaduna, Benin and Zaria). According to the 2013 Nigeria Demographic and Health Survey, it contributed to significant increases in contraceptive prevalence in these cities.
Life Planning for Adolescents and Youths (LPAY)
To inform its strategy for adolescents and youth, NURHI 2 conducted a literature review, net mapping exercises and study tours of civil society organizations implementing programs for adolescents and youth in Kaduna, Lagos and Oyo States. Net-Map is an interview-based mapping tool that helps people understand, visualize, discuss, and improve situations in which many different actors influence outcomes. Key learnings from the formative research are summarized here.
Nigeria has the highest rates of adolescent fertility in sub-Saharan Africa with more than 900,000 births to adolescents in 2013. Most young women delayed sexual debut until after marriage, although the proportion varied by State. Most adolescent girls and young women remained unmarried until they reached 18 years of age. Almost all married women began childbearing within the first year of marriage, as this was a strong societal expectation. It is not surprising then that 41% of 19 year old women in Nigeria had begun childbearing.
Despite the need for contraception, only 22% of Nigerian girls and young women 15 – 24 years were using modern contraception in 2013. The proportion who used contraception was highest in Lagos, and lowest in Kaduna and Oyo.
There were a variety of reasons why adolescent girls and young women did not use modern contraception. By far, the most common reasons were fertility related concerns, and accessibility issues. Many believed that modern contraceptives can cause infertility; and women younger than 18 years of age required parental or spousal consent to access family planning services. Societal disapproval of young women using contraception, and judgmental attitudes among many family planning providers toward young women who use contraception further reduced use. For young married women, societal pressure to bear children soon after marriage was another barrier to use.
Recognizing these unique needs of adolescents and youth, NURHI 2 introduced a special focus on 15-24 year olds. Life planning helps adolescents and youth understand how their bodies work, equips them with information to make informed decisions, and provides improved access to reproductive health services. The aim: to increase demand for sexual and reproductive health services among this age group, particularly in urban poor areas. NURHI 2 did this by integrating a focus on young people into its advocacy, demand generation and service delivery approaches.
For further information on Formative research carried out on Youth and Adolescent Programming by NURHI 2, kindly see the links below.