Qualitative Exploration of factors affecting Uptake and Demand for Contraception and other Family Planning Services in North-West Nigeria.

In spite of the improvements in knowledge about family planning (FP), the contraceptive prevalence rate and unmet need for FP remain poor in most parts of Northern Nigeria. This study sought to explore specific factors that influence contraceptive uptake and demand in North-West Nigeria. Key Informant and In-depth Interviews were conducted using guides among stakeholders in two selected states in North-West Nigeria, Kebbi and Sokoto States. Interviewees were selected purposively to include Reproductive Health Focal Persons at the local government level, service providers, Women of Reproductive Age (WRA) and FP coordinators. Factors inhibiting contraceptive uptake included lack of health education, religion, fear of spousal rejection and side effects. Poor government funding and inadequate number of health workers were also identified as systemic factors. Suggested methods of overcoming identified challenges include; task-shifting, increased stakeholder participation and political will.

Outcome of a reproductive health advocacy mentoring intervention for staff of selected non-governmental organisations in Nigeria.

BACKGROUND: Non-governmental organisations (NGOs) are expected to be in the vanguard, repositioning reproductive health as a central issue in population and development in Nigeria. However, most of them have insufficient knowledge or access to policy and planning processes necessary at engaging effectively with the government. This article highlights the processes and outcome of an intervention aimed at strengthening the capacity of 12 non-governmental organisations on advocacy and policy related activities with emphasis on reproductive health issues. METHODS: The study employed a one group, pre and post test study design. Thirty six (36) staff from 12 NGOs was purposively selected and interviewed using a semi-structured questionnaire at baseline to assess their knowledge and level of involvement in reproductive health, advocacy and policy issues. In-depth interviews were conducted with 6 officials of the ministries of health and women affairs to document previous reproductive health and policy related collaborative efforts with the NGOs. Baseline findings were used in developing and implementing a capacity building intervention. A post intervention evaluation was conducted to assess the outcomes. RESULTS: All respondents (100%) had tertiary level education and were from a multidisciplinary background such as nursing (41.7%) medicine (25%) and administration (13.9%). The mean knowledge score on advocacy and policy issues at pre-test and post test was 39.1 ± 17.6 and 76.2 ± 14.2 respectively (p = 0.00). Participants reported making use of advocacy methods and the three most utilized were Phone calls (28.1%), Face to Face meetings (26%) and networking with other organisations for stronger impact (17.1%). The outcome of their advocacy efforts include the provision of free air time by a television station to educate the populace on maternal health issues, donation of landed property to build a youth friendly centre, donation of a blog site for disseminating information on Reproductive health issues and training of other staff of their organisations on advocacy activities. The major challenges experienced by staff of the NGOs were financial (89%) and time constraints (11%). CONCLUSION: Empowered non-governmental organisations can effectively advocate for the implementation of reproductive health policies and programmes.

The effectiveness of community based distribution of injectable contraceptives using community health extension workers in Gombe State, Northern Nigeria.

This study reports on findings of a pilot of community-based distribution (CBD) of injectable contraceptives in two local government areas (LGAs) of Gombe State, Nigeria. From August 2009 to January 2010, the project enrolled, trained and equipped community health extension workers (CHEWs) to distribute condoms, oral and injectable contraceptives in communities. The project mobilized communities and stakeholders to promote Family Planning (FP) services in the selected communities. Using anonymised unlinked routine service data, the mean couple years of protection (CYP) achieved through CBD was compared to that achieved in FP clinics. The CBD mean CYP for injectables- depo medroxy-progesterone acetate (DMPA) and norethisterone enantate was higher (27.72 & 18.16 respectively) than the facility CYP (7.21 & 5.08 respectively) (p < 0.05) with no injection related complications. The CBD's mean CYP for all methods was also found to be four times higher (11.65) than that generated in health facilities (2.86) (p < 0.05). This suggests that the CBD of injectable contraceptives is feasible and effective, even in a setting like northern Nigeria that has sensitivities about FP.

Assessing the level of preparedness of private health providers for clinical management of HIV/AIDS epidemic in Nassarawa State, Nigeria.

Very little information is available on the extent to which the private health sector is involved in clinical management of HIV/AIDS in Nigeria. This study assessed the potentials and existing capacity of 15 private health facilities in Nassarawa state for clinical management of HIV/AIDS. Information was obtained from 25 staff (15 proprietors and 10 professionals) of the randomly selected health facilities in the state using structured questionnaire. Of the 15 health facilities, three provided voluntary counselling and testing (VCT), seven had never admitted persons living with HIV/AIDS (PLWHA), two provided laboratory services, none provided home-based care for PLWHAs, two had anti-retro-viral drugs in stock, two had rooms for counselling, three had full-time doctors, and six had registered nurses. Of the 25 health workers, 5 had skills/training in conducting VCT, 15 had skills in the treatment of opportunistic infections, 14 were aware of anti-retro-viral drugs and 13 did not feel comfortable attending to PLWHAs. The study recommended capacity building on HIV/AIDS related services for the private health-workers.

Bridging the knowledge-behaviour gap through HIV/AIDS surveillance in four markets in Ogbomoso and Ibadan, Nigeria

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