Expanded Access

Expanding access in NURHI 2 focuses on using proven and new strategies to improve access to a wide range of modern contraceptive methods. The ultimate goal is to reach every woman in need to provide high-quality family planning services and a wide range of modern contraceptive options. This goal is achieved by preventing any missed opportunity, which involves the following:

– Scaling up to new high-volume sites, new local government areas and subsequently the rural areas of project states

– Encouraging family planning service integration at all health service delivery points- Conducting facility and community

  • based outreaches to boost uptake of family planning services- Promoting the task shifting and task sharing policy to enable community health extension workers and Community Health Officers (CHOs) to provide long-acting, reversible, family planning methods

Expanding Access to Family Planning Services

Integration

  • Training Service Providers at Integration Points Across the Continuum of Maternal, Newborn and Child Health (Antenatal Clinic, Postnatal Clinic, Post-abortion Care Unit, Immunisation)
  • Engaging Traditional Birth Attendants

Expansion of Family Planning to Reach More Men and Women

  • Establishing Facility and Community-Based Outreaches
  • Engaging Community Health Extension Workers
  • Expanding to Hard-to-Reach Communities

Ensuring a Wide Range of Contraceptive Methods

  • Domesticating the Task Shifting and Task Sharing Policy for Community Health Extension Workers and CHOs
  • Improving Method Mix
  • Using WhatsApp Groups for Commodities Tracking and Mentoring
Introduction

Phase 1 of the Nigerian Urban Reproductive Health Initiative (NURHI) contributed to an impressive 11.5% increase in modern contraceptive use among women of childbearing age over its five years of implementation (NURHI Endline Report, 2014). As a result, over 350,000 more families began using family planning methods

Selection of High-Volume Sites

In NURHI 1, a high-volume site was defined as a public or private health care facility serving the greatest number of maternal, newborn and child health clients (antenatal, delivery and immunisation clients) in the project cities. In NURHI 2, high-volume sites include only public health facilities.

Tackling Provider Bias

Empirical evidence from a NURHI 2 facility baseline study showed that providers have beliefs and perceptions that prompt them to restrict access to family planning services based on the client’s age, marital status, parity and partner’s consent.

72-Hour Clinic Makeover

The NURHI 2 72-hour clinic makeover concept is one of its novel service delivery approaches. The environment in which family planning services are provided makes a difference in improving health care delivery for both the service provider and clients.

Service Delivery Job Aids

The Community Health Extension Workers booklet is a logbook that states the essential skills to be learned by these providers, including the required number of simulation and real-life experiences. It also provides space for the instructor to add a performance score and sign off when the learning exercise has been completed.


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