NURHI Family Planning Landscaping – (Kaduna and Lagos).


Nigeria is the 7th largest country in the world, with a total estimated population of 177 million in 2013. If its population continues to grow at 2.54% per year as it has since 1969, Nigeria will become the third largest population in the world by 2050, with 450 million people, according to World Bank projections.


Evidence from Nigeria Demographic and Health Surveys conducted in 2003, 2008, and 2013 show no change in contraceptive prevalence over the last 10 years. In 2013 as in 2003, only 10% of married women were using modern contraceptives; 14.6% were using any method.


The Federal Government of Nigeria (FGoN) has set the ambitious goal of reaching an all method CPR of 36% by 2018, up from 16% in 2013 This translates to more than 11.6 million women using contraceptives, an increase of approximately 7.9 million new users over and above the 3.65 million users existing in 2008. According to projections by the Bill and Melinda Gates Foundation (BMGF), Nigeria needs to increase modern contraceptive prevalence by 2-3% per year between 2013 and 2018 to reach this target.


Nigeria is a priority country for BMGF’s family planning strategy, which supports the attainment of the global FP 2020 goals. The Foundation intends to invest resources to significantly expand contraceptive access and use in Kaduna and Lagos states. Prior to pursuing any investment, BMGF commissioned The Johns Hopkins Center for Communication Programs (CCP), Marie Stopes International Organisation Nigeria (MSION) and DKT International Nigeria to conduct a family planning landscaping exercise on behalf of the Nigerian government. The purpose of the landscaping is to better understand state-specific family planning supply and demand barriers and identify key solution levers to accelerate contraceptive use.


OBJECTIVES & METHODOLOGY


Under the leadership of CCP, the landscaping partners reviewed existing research and conducted 10 studies in Kaduna and Lagos States between December 2014 and May 2015, designed to answer specific questions in each of six content areas: consumer demand for family planning, contraceptive method mix, contraceptive method pricing, contraceptive product marketing, service channels and supply, and regulation, policy and donor coordination. Research conducted for this landscaping exercise included:


Secondary analysis of the 2013 Nigeria Demographic and Health Survey (3)

It is unclear whether the goal of 36% refers to married women or all women. The 16% CPR is for all women and all methods.


  • Questions placed on a population based omnibus survey to explore ideational factors associated with the use of contraceptives (4)
  • Geospatial mapping of public and private sector family planning services (5) (6)
  • Qualitative focus group discussions and in-depth interviews with contraceptive users and non-users, their male partners, health workers, and leaders (7)
  • Analysis of donor coordination and advocacy resources in each state (8)
  • Analysis of the contraceptive supply chain in the public and private sector in Kaduna and the private sector in Lagos (9)
  • Analysis of regulations, policies, and laws affecting family planning programs in Kaduna and Lagos states (10)
  • Analysis of private sector services and potential for expansion (11)
  • Quantitative contraceptive methods marketing, pricing and media survey (12) (13)
  • Qualitative contraceptive methods marketing research (14) (15)

On May 26 – 28, 2015, representatives from the three partners met in Lagos to review and analyze findings, discuss the meaning of the data, identify key barriers to contraceptive use in Lagos and Kaduna states and make recommendations for priority interventions that have the most likelihood of increasing contraceptive use over the next three to five years.


The analysis was organized into three domains: demand, method mix, and services and supplies. For each domain, the analysis team identified state-specific barriers and key interventions to address them, and answered specific questions from each of the six landscaping content areas.


The team used a prioritization matrix to rank interventions in each domain based on three criteria which they weighted according to relative importance: ease of implementation, potential impact on contraceptive use, and time to impact. Time to impact was given the most weight (.64), followed by potential impact (.33) and ease of implementation (.03). Prioritized interventions across all three domains were combined and prioritized to come up with state-specific recommendations.


Following state-specific analyses, the team compared findings and recommendations across both states to identify cross-cutting and federal-level recommendations.


This report presents the analysis and recommendations for Lagos state first, then Kaduna State, followed by overall programmatic recommendations that cut across both states.

Abstract Papers & Publications
Research Papers

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