November 2013 ShopsProject; The time is now to build and sustain momentum for family planning to become institutionalized in the public and private health sectors in Nigeria. Every household must be positioned to make an informed choice on number of children they will have. All stakeholders must be positioned to support every woman and man in making an informed choice on family planning.
In 2007, after about 13 years active involvement in a child survival project implementation in Nigeria, I reviewed results and felt there was a gap that could have made results better. I felt unfulfilled and came to the conclusion that women need to be empowered not only in child care but they also need information on choices that can keep them and the entire family healthy. I did not go too far in my quest before I discovered that one key that can open several healthy living doors at the household level is family planning.
With biting economic challenges in Nigeria, the burden of household management, particularly child development is falling hard on women. Many women are involved in hard labor, pushed beyond limit with resultant effect being various health challenges and sometime untimely death. Myths and misconception about family planning, lack of clients’ knowledge on available choices and lack of skills of health providers on counseling and service provision especially long-acting reversible contraceptives continue to pose threats to family planning uptake in Nigeria.
Prior to the rising private sector family planning initiatives in Nigeria, clients’ access of family planning were quite limited to only the public sector and very few private facilities. Although the primary health care centers run by the government provide family planning services, they are not evenly distributed to meet the needs of the population. Private facilities owned by doctors or nurse/midwives remain the closest to the community, hence the need for their active involvement in family planning service provision. Private facilities though well located to provide health services to the people are deficient in meeting their needs because of the existing gap in family planning clinical skills which often results in missed opportunities. Most private sector family planning clients are not always inclined to patronize the public sector even when referred by their private provider due to several reasons ranging from length of time spent at public facilities, public providers’ attitude, distance to clients’ residents etc. Efforts to build the capacity of private providers in family planning services and in the integration of those services into the provision of other services have to be intensified.
There is a need to consistently educate the entire community, to achieve the change we all hope for in family planning in Nigeria. Mobilization and demand creation has to be scaled up to have positive disposition towards family planning at all levels: in the household where the words of husbands, mothers-in-laws, and other extended family members, are the rules that must be obeyed; at religious sectors where religious leaders are seen as next to God; at health facilities where the opinions of doctors and nurses are held in high esteem by their clients. Overall, there is need to give a voice to positive deviants—women and men that have adopted family planning and treasure the gains.