Delivering contraceptive vaginal rings: Review of postpartum and postnatal care programs in Nigeria

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial in determining how best this relatively new contraceptive innovation would be placed within the existing framework. This report reviews the status of various postpartum and postnatal programs in Nigeria, the feasibility of leveraging the ongoing policy, and program opportunities to integrate the PCVR within Nigeria’s post-delivery care environment for the well-being of mothers and their infants

Delivering contraceptive vaginal rings—Task sharing policies and practices in the delivery of family planning services: Experiences from Nigeria

Despite tremendous progress over the past decades in family planning and fertility reduction, more than 220 million women have unmet need for contraception globally. The government of Nigeria pledged over $11 million to procure contraceptive commodities for distribution in the public sector from 2011–2015, to increase the contraceptive prevalence rate (CPR) that had stalled at 10 percent for almost two decades. The Population Council is facilitating the registration, introduction, and scale-up of the Progesterone Contraceptive Vaginal Ring (PCVR), designed particularly for breastfeeding women, in the sub-Saharan African countries of Kenya, Nigeria, and Senegal. In Nigeria, restrictive policies regarding matching health care cadres with maternal and child health interventions have previously hindered widespread availability of essential commodities to rural areas where providers’ skills were deemed marginal. With the adoption of the national task-sharing policy, which enables lower cadre and community-level providers to deliver essential reproductive health services in hard-to-reach terrains, this report weighs the feasibility of the PCVR to leverage the existing task-sharing platform to achieve large-scale rural uptake, expand the methods mix for postpartum contraception, and contribute to increasing the CPR in this country

Strengthening in-service training and continuing education (IST/CE) for frontline health workers for Bauchi and Cross River states

This brief details Council efforts to develop effective, and costed, in-service training and continuing education modules for frontline health workers in Bauchi and Cross River states in Nigeria. This project was funded by WHO to aid the training and development of Nigeria\u27s public health worker sector

Contraceptive Use and Its Socio-economic Determinants among Women in North-East and North-West Regions of Nigeria: A Comparative Analysis

This study investigated the socio-economic factors associated with reported contraceptive use by women of reproductive age in northern Nigeria. Bivariate and logistic regression analysis was applied to successive Nigeria Demographic and Health Survey (NDHS: 1999-2013) data to examine the relationship between reported use of modern contraceptives (the dependent variable) and the socioeconomic status (age, rural-urban residence, education, religion, current work status, marital status, and number of living children) of these women in the north-east (NE) and north-west (NW) geo-political zones (GPZs). The results indicated that women’s socio-economic status were positively associated with use of modern contraceptives in the NW in 1999 (AOR=2.15; 95%CI=1.47, 3.14), 2003 (AOR=1.64; 95%CI=1.30, 2.08) and 2013 (AOR=1.30; 95%CI=1.12, 1.50) and also in the north-east in 2008 (AOR=0.74; 95%CI=0.64, 0.86). Contraceptive use could increase as FP programmes better respond to the socio-economic and cultural circumstances of women in northern Nigeria

Collaboration with the University of Calabar for human resources for health management training for Bauchi and Cross River states

A pool of knowledgeable staff is required within middle and senior management for long-term human resources for health (HRH) planning and effective management at all levels of the health system—federal, state, and local. This brief reports on the training by the Population Council, in partnership with the World Health Organization in Nigeria, of 105 key personnel on HRH planning, management, policy dialogue, advocacy, and resourcing for the HRH project “Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria.” Critical HRH-related capacities were built among key Nigerian health system personnel and managers, most significantly in the states of Bauchi and Cross River and within their local government areas. These efforts should facilitate better long-term HRH planning and management in these areas, hopefully leading to improved health outcomes in these states. In addition, the institutional strengthening of a national center for HRH Training and Education, through the sustainability efforts of the HRH project, will continue to build the capacities of healthcare managers and workers throughout Nigeria

Population Council\u27s support for Nigeria\u27s third national Human Resources for Health conference and efforts to institutionalize HRH conferences in Nigeria

This project brief describes the Population Council\u27s partnership efforts with public health stakeholders in Nigeria to plan and host a third national conference for provision of necessary and relevant information on critical health issues to health staff and stakeholders throughout Nigeria

Willingness to pay for contraceptive vaginal rings in Nigeria

During the last two decades, Nigeria’s contraceptive prevalence rate (CPR) for modern methods remained at 10 percent, one of the lowest rates in sub-Saharan Africa. Following the renewed global commitments culminating in the 2012 London Summit on Family Planning with promises to reach an additional 120 million new users of modern contraceptives worldwide, Nigeria’s Federal Ministry of Health set a new target of raising Nigeria’s CPR to 36 percent by 2018. One way to accomplish this is by meeting the contraceptive needs of women in the immediate postpartum period and beyond. Attention is being focused on making proven contraceptive methods more available and affordable for postpartum use by including newer technologies that are breastfeeding-friendly. The progesterone vaginal ring is an effective method specifically geared for breastfeeding women. For use beyond the postpartum period, an investigational long-acting contraceptive vaginal ring (CVR) is being developed. As a prelude to introducing the rings in sub-Saharan Africa, the Population Council conducted a “Willingness to Pay” study in Kenya, Nigeria, and Senegal. This study provides key findings on the maximum consumers are willing to spend for the PVR and CVR in Nigeria

Strengthening Cross River state schools of nursing and midwifery by updating their training curricula, procedure manuals and student handbooks

Many of Nigeria’s Nursing and Midwifery schools and colleges encounter challenges that include outdated training curricula, which can lead, in some cases, to loss of accreditation. In Cross River state, in 2014 only one health training institution was accredited—provisionally. Five other institutions had lost their accreditations from the Nursing and Midwifery Council of Nigeria (NMCN) which stipulates minimum standards of compliance for accreditation. An assessment team led by the Director of Nursing of Calabar’s Ministry of Health visited the Cross River schools to determine the best ways of addressing the gaps in the accreditation team’s report. Through the HRH project efforts led by the Population Council, all of Cross River’s schools of Nursing and Midwifery are now accredited by NMCN

Assessment of in-service training and continuing education (IST/CE) for frontline health workers in Bauchi and Cross River states, Nigeria

Training contributes tremendously to the development and sustenance of health workers’ competencies for quality healthcare services. Although Nigeria has a higher stock of human resources for health compared to other African countries, the World Health Organization argues that its distribution is highly skewed toward urban areas. Building and maintaining staff capacities requires continuing professional development through in-service training (IST) and continuing education (CE). This study assesses current IST and CE for health workers in Bauchi and Cross River states to provide evidence to inform policy and planning and improve implementation of capacity-building for health workers in Nigeria

An assessment of human resources for health hiring, deployment and retention, procedures and practices in Cross river and Bauchi states, Nigeria

Primary health care (PHC) is the first contact in a healthcare system and, at its core, includes access to basic interventions that address health needs at the community level. These basic interventions are provided by key frontline health workers—nurses, midwives, and community health extension workers—critical for facilitating immediate access to maternal, newborn, and child health services at PHC facilities. Despite the critical roles of these healthworker cadres, their distribution is uneven and skewed—geographic and within levels of care and governments, in addition to poor distribution of skills—compounded by high attrition due to poor human resources for health (HRH) management and development. The aim of this study is to examine the HRH hiring, deployment, and retention procedures and practices in Cross River and Bauchi states in Nigeria, to generate evidence to support the development of improved and gender-sensitive hiring and deployment guidelines. The study also provides recommendations for improved HRH planning and management for better service delivery