KADUNA, NIGERIA – The FP2020 report was released at the recently concluded International Conference on Family Planning (ICFP) in Rwanda and Nigeria did fairly well in the report. One of the few successes recorded for the country came from Kaduna, a state in the northern region of Nigeria.

Kaduna state Commissioner of Health, Dr Paul Manya Dogo, was one of the very few high-ranking Nigerian government health Nigeria present at the conference. He spoke with Rural Reporters on the state of family planning in his state and his plan to ensure access and advancement of family planning service state-wide.

Excerpt

The biennial International Conference on Family Planning has ended, what’s your take-home from this conference?
It has been a huge privilege for me to attend the 5th international conference on family planning. It has provided an impetus for us to continue the work we have been doing in Kaduna where we are taking advocacy to the highest level of government to emphasise the fact that family planning is more than just a health issue. It is an issue of development and we need to invest. I am happy that Kaduna is responding favorably to promoting family planning. In the last conference which took place at Indonesia, I represented Kaduna – a sub-national entity during programmes that were done by other nations, just to show you how Kaduna has promote itself in the provision of family planning. So for me, the take home message for me is to take up the advocacy at the highest level to show that indeed there is a lifetime of returns in investing in family planning. It has a direct benefit to the woman, to her family, to the society, and to the government in general.

What is the contraceptive prevalence rate in Kaduna and what are the present gaps?
Just as you will have learnt in this conference, there is usually a difference between what happens in the rural areas and what happens in the urban area. That is where we talk about the position of equity when we talk about family planning. For us in Kaduna, the Nigeria Demographic Health Survey (NDHS) 2013 shows that for all method, we have a Contraceptive Prevalence Rate of 20.2 percent on all methods. But for modern methods, we have just 18 percent. Now, we have moved from that point based on the FP2020 2018 report, our Modern Contraceptive Prevalence Rate (MCPR) has moved to 24 percent. Now, this is a very important movement. For us to ensure equity, we are deploring family planning services in all our primary healthcare centers and in Kaduna state, what we have been doing in the past three years is to actually focus on the revitalisation of the Primary Healthcare. That is why we have put up a modern Primary Healthcare Centers in each political ward in the state. Kaduna has 255 political wards. So if we are able to provide family planning services in all of these wards, we will have provided equity for all people – whether they are rural or urban.
We have also ensured to build a robust supply chain system that will ensure that our commodity gets to the last mile so that even in the rural areas they are not denied family planning services. We have deployed logisticians who are training our health product to all our health facilities and that has helped. And that is why about a month ago, members of the civil society went to our hospitals on a fact finding mission and they discovered that virtually everywhere, essential medicines were available. So this is what we have done to bridge the gap between the urban woman and rural woman – taking services to the level of Primary healthcare so that it is very close to them and they can access care. We have also involved and trained community extension worker.
You know as a national program, we do the task shifting, task sharing policy. We have this task sharing policy. Kaduna has adopted it and so we have trained community extension workers in the provision of family planning services, particularly the long-acting reversible contraceptive. Studies that were done have shown that there is no difference in the quality of services that most senior health care give them. By training them, we have expanded access to people in the rural areas, to people that are disadvantaged because people accept them. The health workers also do outreach services by taking these family planning services to rural areas. So these are things that we have done to ensure equity in the provision of family planning in Kaduna state and we are hoping that our MCPR will continue to improve as we work hard.

Majority of the progress in the MCPR – are they in rural or urban?
I can’t really say because we did not disaggregate the figures but I won’t be surprised if it is more from the urban. Like I said, we have worked very hard, through radio and TV drama. People in the rural area are discussing family planning and they are taking these services. We have been able to work with our religious leaders and the traditional leaders so that we can break religious and traditional barriers. As a matter of fact, they are our strong partner in advocating for the use of family planning in the state.

Going forward, how do you intend to improve the health sector?
We are training more community extension workers and community health officers. We are also involving those in the private sectors. For example, we have now engaged 18 private health services that we have trained to be able to provide effective family planning health services. You know that many people patronize patent and proprietary medicine vendors, we have also engaged them. So far, we have trained 79 of them and not only will they provide these services; they will also serve as agent of referral should this patient or woman need additional care. So as we plan more into opening access to family planning, more of these caregivers will be trained.

And just to remind you that for our patent and propriety vendors, we have 3 tiers of them – there are those that are trained and have health background, there are those without health background who are educated – some even with university education and there are those who are not well educated. So for each tier, there is a particular training that we give them. We are happy because people go to them and instead of providing this illegally and crudely, we taught that they should talk to them and engage. And as a matter of fact, it’s a national programme that is integrated into the health system.
At the moment, we are piloting in Kaduna and Oyo states so that by the time we provide evidence, we are hoping that the whole country will key into this.
I think the way forward is to train more people, invest in women and then make clarion call for people to see the benefit of family planning. It has benefit across the strata of the society – the woman as a person, the man as a person and the family, the community, the state and the nation. So I think this is the way forward, not just for Kaduna state but for our country as a whole.