Report from the 4th National Family Planning Conference in Abuja, Nigeria, November 7–9

After years of slow and intermittent progress, signs that a family planning movement is taking hold in Nigeria were on display at the 4th National Family Planning Conference in Abuja in early November. This movement was evident in the array of supporters represented at the meetings, spanning federal and state government, non-government organizations and donors/foundations. This burgeoning movement is bolstered by evidence of progress in advancing family planning access and use—evidence generated by the Nigerian Urban Reproductive Health Initiative (NURHI) and the recent round of Performance Monitoring and Accountability 2020 (PMA2020) data. 

The Gates Institute has a long history of partnership in Nigeria, dating back to 2004 when the Institute sponsored a parliamentarian leadership seminar. 

Now, Advance Family Planning (AFP) is partnering with Pathfinder International/Nigeria advocating for state budgetary commitments to family planning, currently focusing on 13 states. These efforts, in collaboration with Palladium, have paid off, as the Governor of Plateau State, Hon. Simon Lalong, recently included family planning as a line item and an allocation for US $25,125 in the state’s 2016 budget—a first.

PMA2020’s first round of surveys to generate national-level estimates sampled 7 states (Anambra, Nasarawa, Kano, Kaduna, Lagos, Rivers and Taraba), finding the national mCPR among married women was 16%, 6 percentage points higher than the 2013 Nigeria Demographic and Health Survey (NDHS), with increased use of injectables and implants and growing overall demand for family planning. 

The Challenge Initiative (TCI), a new project funded by the Gates Foundation and led by the Gates Institute globally, is being implemented in Nigeria by Johns Hopkins Center for Communication Programs’ Nigerian Reproductive Health Initiative (NURHI). TCI aims to scale up urban reproductive health solutions using a demand-driven incentivized approach, partnering with municipal and state governments and leveraging their and other resources to accelerate the achievement of results. 

Going forward, the Gates Institute’s initiatives will continue to work collaboratively, to build on these successes. AFP has used PMA2020 data in Lagos, Kaduna and Nasarawa to inform advocacy objectives and messaging, and will use it in the future to track policy and budget actions made by decision makers especially at the state level. With regard to TCI, in states that overlap with AFP and have active advocacy working groups, those groups will advocate with key decision makers to fully implement the TCI family planning package in their states. 

The 4th National Family Planning Conference, 2016 
From November 7 to 9, 2016, the 4th National Family Planning Conference was held in Abuja, Nigeria. Approximately 550 participants registered for the conference, and over 900 are estimated to have attended—a number far greater than prior conferences. The atmosphere was upbeat and positive. 

A high-level meeting on “Investing in a Rising Nigeria: Family Planning, Youth and New Normals” was co-hosted by the Bill & Melinda Gates Foundation, Senator Daisy Danjuma and the Gates Institute. Attended by 80 key stakeholders, the program highlighted a new generation of family planning leadership, the accomplishments of NURHI, the rising trend in family planning practice captured in the PMA2020 surveys, the growing base of local philanthropy, Plateau State Governor’s first-ever budgeting for family planning and the ways in which Nigeria is on the move. Closing comments were delivered by the Nigerian Minister of Health. 

The Gates Institute’s projects (PMA2020, AFP and TCI) also each sponsored panels. 

  • A panel on task-shifting, on November 8, sought to explore the role of the professional associations and regulatory agencies to garner support for sound implementation of the policy, and brought panelists from the FMOH (Dr. Afolabi, Head of RH Unit), the Nursing and Midwifery Council of Nigeria, the National Association of Nigeria Nurses and Midwives, the Nigeria Medical and Dental council, the Nigeria Medical Association and the Community Health Workers Registration Council of Nigeria. Panelists reaffirmed support for the policy and pledged to continuously raise awareness among their professional ranks. 
  • A panel on TCI, on November 9, was moderated by Dr. Edugie Abebe. Panelists were Moji Odeku (NURHI), Oying Rimon (TCI), Lester Coutinho (Gates Foundation), State Health Commissioners from Taraba, Rivers, Anambra, Kaduna, Kano, and Nasarawa, and Dr. Afolabi (Director of the Reproductive Health Unit in the Federal Ministry of Health). After hearing how TCI would work and what NURHI could offer, each commissioner came forward independently to express his interest in working with TCI. Two did condition their willingness on needing to learn more, but they also cited support for family planning based on PMA2020 survey results. However, their unilateral interest in TCI means at least 7 states are likely to sign on to cost-share in moving family planning forward. Ogun State Commission of Health contacted Moji Odeku separately about their willingness to be part of TCI, bringing the total number to 8 states.

There were other developments during the visit, including a UNFPA youth pre-conference (120 youth participants representing all 36 states and FCT) with an interactive AFP advocacy session that will follow up with some small grant awards to select youth organizations, a PMA2020 data utilization workshop, and meetings with high net-worth individuals. 

A notable highlight was the commitment of additional US $4 million (up from US $3 million) for commodities made by the Federal Minister of Health, Prof. Isaac Adewole, at the opening ceremony, and reaffirmed by the Chair of the Committee of Health Services, National House Assembly member Hon. John Okafor, on the last day prior to the closing ceremony. 

This conference may well represent a strategic inflection point for Nigeria, in terms of making family planning a priority in both policy and action. The NURHI data and the positive trends showed by PMA2020 nationally and in all 7 states covered by the survey provided the evidence and the backdrop for family planning champions and stakeholders to feel that their hard work is making a difference. 

Headwinds against progress may be posed by the deteriorating economic conditions, but these could also be seen as opportunities. For example, the requirement for school fees, which used to be free, may have implications for desired number of children. 

Positive progress is indicated by a number of commitments made by the Government of Nigeria, such as Nigeria’s FP2020 commitment and the accompanying National Family Planning Blueprint as well as key policy documents, such as the task-shifting policy allowing community health extension workers to provide long-acting contraceptives – injectables and implants. Considering all of this, and Nigeria’s hosting of this family planning conference, there is increased optimism that by 2020 more women, girls and couples in Nigeria will have voluntary access to a full range of contraceptive choices to meet their fertility needs and desires.

Positive changes in Nigeria in family planning will have diffusion effects in other parts of Africa.

Tuesday, December 13, 2016 - 11:30