In recent times, the advocacy for family planning has become crucial as demand for reproductive and population reduction, economic and health care continue to grow.
There is no doubt the benefits of family planning are numerous and if properly executed will go a long way in enabling countries to achieve the Sustainable Development Goals (SDGs).
At the July 11, 2017 Family Planning Summit in London, U.K and Nigeria demonstrated its commitment to achieve a modern contraceptive prevalence rate (MCPR) of 27 per cent among all women by 2020.
The summit was a forum of network of partners to bring local actions and solutions to scale, particularly for populations that have traditionally been left behind in family planning, such as youths, women and girls.
FP2020 is the outcome of the July 2012 London Summit where over 20 countries committed to enabling 120 million women and girls have access to life-saving contraceptives, irrespective of where they are by 2020.
However, at the dawn of 2019, which is barely 12 months to reaching the target FP2020 objectives on contraceptives usage, indicators show that Nigeria currently has 13. 9 per cent Modern Contraceptive Prevalence Rate (MCPR) for all women.
MCPR refers to a proportion of women, ages 15-49 that use modern method of contraception, including hormonal and barrier methods, sterilisation, emergency contraception, Lactational Amenorrhea Method (LAM) and standard days/cycle beads method.
Mr Adebiyi Adesina, the senior economist on the Track20 Project, said that Nigeria is currently at a 13.9 per cent MCPR for all women which are a national average as situations in each state vary.
According to him, “This is for all women of reproductive age which refers to women between the ages of 15 and 49; however, there is a wide variety of context across states as each state has its own realities, so you will, of course, see that difference.
“What it looks like in the different states vary from as low as two per cent to as high as over 20 per cent prevalence rate by states”.
For a target which initially started in 2012, it is only realistic to evaluate the feasibility of achieving this commitment, pinpoint the challenges, proffer some solutions as well as emphasise the benefits of achieving this target.
Adesina said that two key populations will trigger Nigeria’s growth in FP use.
“They are the youth, women between the ages of 15 and 24 and post-partum women who have just delivered within the first six months of delivery.
“This population is going to be key but because we are talking about Nigeria nationally, there is going to be differences in states.
“In some states, because they have a large youth population, the youth might be their focus.
“Other places, because they have a large married population and delivering population that might be their key demographic key to focus for FP services.
“What is important to understand is that in all these programmes, the growth in FP can only be achieved if we identify what the context is and each state has to take the lead in doing that”.
Adesina said that in terms of programme implementation, data is key and state data is going to be even more crucial in achieving the contraceptive usage and FP2020 targets.
“It is up to the states to make that decision to drive this by also designing programmes, policies on how to improve FP programmes and service delivery.
“These will include commitment to budgeting and financing, improved distribution, increased sensitisation and other interventions”, Adesina said.
The Family Planning 2020 in its ‘FP2020: Catalyzing Collaboration’, says that modern methods of contraception has prevented over 2 million unintended pregnancies and 735,000 unsafe abortions between July 2017 and 2018.
In spite of this progress, only 13.3 per cent of women aged 15-49 are using modern contraception in Nigeria and one-in-four married women aged 15-49 have unmet need for modern contraception.
This status quo goes further to raise apprehension on Nigeria’s possibility of meeting its FP2020 commitments.
Dr Olumide Okunola, a senior health specialist in IFC and World Bank says it is not likely that Nigeria will meet its target for FP by 2020. According to him, “One of the problems always associated with the limited coverage of family planning services is socio-cultural.
“However, while it is okay to rebrand and be strategic about these issues, there is need to situate expansion of coverage within economic growth.
“To situate this discussion within the context of human capital development and not focus on family planning and its methods.
Okunola, therefore advised that family planning advocacy and activities should expand to focus on particular states because family planning advocates and activists have been absent completely in most states.
“To achieve key indicators, NGOs, governments, organisations and individuals should go to states to help them develop work plans to expand NCPR”.
He also said that one of the biggest challenges in public Primary Heathcare Centres (PHCs) is not necessarily the commodities but the consumables such as menthylated spirit and cotton wool, even in delivering some products as well as lack of prompt operational expenses for PHCs.
“We won’t reach the goal but we can accelerate; we can do better than what we are doing if we focus on the key enablers and changing the policies when they need to be changed.
“We can do better by accelerating the pace of those policy changes and also focusing on implementing what works as well as what is evidence-based and we have it already”, he said.
Dr Oladapo Ladipo, president, Association for Reproductive and Family Health (ARFH), also said that meeting the 27 per cent MCPR by 2020 is unrealistic, given the current data that we have.
“However, we need to, at least, appreciate the effort that has gone into increasing the CPR by at least two per cent point per annum”, he said.
According to him, what can be done to get to the target is to improve the knowledge aspect about the product themselves.
According to Ladipo, there is need to also ensure a good logistics system that will ensure that commodities are available in rural areas because if people now voluntarily want to have a family planning product that is not available, it will discourage them.
“I think the country should not despair; we should not lose the momentum; we should keep doing and look for ways of improving the service we are offering toward achieving that goal.
“We have to look at areas that have the need for that intervention and also ways for partners and stakeholders to work closely with the government in service delivery, advocacy, data and others”.
The Bill and Melinda Gates Foundation advised that Nigerian government should urgently increases domestic funding for FP.
According to the foundation, this has become necessary as donor funding is dwindling and healthy people still remain the greatest assets of any nation.
Dr Paulin Basinga, Nigeria country director, through Ms Diallo says, “For Nigeria to reach its full potential, it needs to prioritise its greatest assets, its people.
“This is by investing in their health, education and equal opportunity which ensures prosperity that is sustained from generation to generation”.
The foundation affirms that Nigeria has the resources and knows how to get this right.
“Donor money is shrinking and it is urgent to increase domestic funding for health and more specifically for family planning.’’
The chairman, Senate Committee on Health, Sen Olarenwa Tejuosho, calls on the executive to release the additional one million dollars to the three million already committed for FP services.
Sourced from NAN
