By Ibrahim Sha’ban
Having noticed a wide advocacy and gender-role gaps in the 2014 policy document on the implementation of Family Planning program, the development, Research and Project Center, dPRC under the partnership for advocacy in child and family health, PACFAH@SCALE, recently convoked a strategic meeting with the state-level PF focal persons and Civil Society Organisations, CSOs, to appraise the new policy direction of the programme.
The meeting, which took place in Abuja recently, drew participants from government, CSOs, media partners and the PACFAH@SCALE implementing states of Niger, Kano, Kaduna, Lagos and Taraba.
The participants were taken through the findings of a review and meta-analysis of existing national policy documents, aimed at checking the effectiveness of accountability mechanism for Family Planning blueprint which is due for a review this year.
Similarly, a pre-event press statement signed by the Senior Technical Advisor to the dRPC-PAS project, Dr Emmanuel Abanida, said the general idea behind the meeting’s concept of accountability is to monitor the FP program’s effectiveness, know what policies are working and link resources to results.
According to Mr Abanida, there is a need for serious strengthening and institutionalisation of accountability mechanisms and standards in the renewed FP Blueprint (2019/2023).
Also, while declaring the meeting open, the Director and Head Reproductive Health Division, Federal Ministry of Health, Kayode Afolabi, emphasised that investing in a robust accountability system that tracks and reports annually real-time, domestic resources on FP expenditures at national and state levels is the most important mechanism for the renewed Blueprint.
Family Planning statistics and government interventions
Available statistics by the Nigeria Demographic and Household Survey (NDHS) 2013 shows that modern Contraceptive Prevalence Rate in the country is 10% and the Unmet Need for Family Planning is at 16.1%.
That is, Nigeria’s modern Contraceptive Prevalence Rate (mCPR) need is 12% (for married women) and 14% (for all women) meaning that the mCPR is currently growing at the rate of 0.5% annually.
However, unmet need for the service was estimated to be 24.2% which shows that while more women of reproductive age in Nigeria desire to access family planning, the programme’s capacity to meet their needs is highly inadequate.
It is also expected that over 13 million additional women of reproductive age would be using modern family planning methods to enable the achievement of the said mCPR target.
Speaking during a panel of discussion, the deputy director, Reproductive Division in the Health Ministry, Greg Izuwa, pointed out that the government wants to achieve 27% modern contraceptive prevalence rate, CPR by 2020.
To this end, according to him, Nigeria will require a growth rate in the mCPR of about 6.6% annually to achieve the set target.
On what the government is doing to promote affordability and access to the FP services, Mr Izuwa emphasized that the government through the Federal Ministry of Health is offering free FP information, services and commodities to clients at public health facilities across the country.
He, however, added that select private health facilities are equally being supported with government’s free commodities to enable them to provide FP services at very subsidized fees to their clients.
Mr Izuwa further stated that the Health Ministry initiated 6 interventions which include renewed collaboration with key stakeholders, establishment of Basket Fund, scale-up of counterpart funding contribution to $5 million, introduction of Task-Shifting and Task-Sharing policy, introduction and scale-up plan for Depomedroxyprogesterone Acetate Subcutaneous Injection project and the introduction of National Supply Chain Integration project to address the current FP logistic challenges.
Addressing the seeming absence of advocacy in Family Planning policies
So precious as the government policy interventions could be towards meeting the 2020 target of 27%mCPR, experts have observed that advocacy is virtually absent in all the national policy documents of the government, hence a stumbling block towards meeting the set target.
The experts asserted that given the current state of things in the country, there is a need for advocacy by the civil society organisations and the media to address the country’s socio-cultural norms such as preference for large families, religious tenets, and women’s lack of decision-making power in matters related to sexual and reproductive health.
Associate Professor of Public Health, University of Ilorin, Aderibigbe Sunday Adedeji, who delivered a paper during the meeting, disclosed that in the course of reviewing over 10 national policy documents on Family Planning, only a few documents addressed issues related to policy advocacy.
He, however, regretted that in all these documents reviewed, there was no evidence of domestication of advocacy at the lower levels, i.e. states.
Mr Adedeji, therefore, recommended that policymakers should ensure that all family planning policy documents to be developed should be carefully crafted to ensure that policy advocacy issues are not left out.
“Policymakers should also ensure that they regularly update the policy documents to make them more appropriate for the times.
“Government and policymakers should ensure that policy documents on service guidelines have clear statements on the role of advocacy in improving service delivery,” he stated.
Addressing gender imbalance in new Family Planning blueprint
In as much as cultural norms and gender barriers needed to be recognised in order to have a seamless administration of family planning services across the board, existing policy documents have proven themselves to be gender blind.
Consequent upon this, gender experts faulted these documents for not been able to address the long-held cultural norms and barriers against the Family Planning program in the country’s heterogeneous population.
Gender Consultant Joyce Ahmadu, who delivered a paper on gender assessment of family and child health policies, noted that while reviewing nine policy documents on Family Planning, she had discovered that three of the documents are gender-specific, another 3 are gender sensitive and 3 others are gender blind.
She said that the epileptic nature of gender role assignment has resulted in ignoring roles and relations affecting women’s FP needs such as lack of women’s participation in decision making for FP.
She, however, noted that although the FP blueprint acknowledges that family planning can help promote gender equality, it only recognises promoting male involvement through costed BCC targeted key messages, but does not make provision for men’s FP needs.
She said gender equality must not only be assessed and analysed in the national policy but also be integrated and mainstreamed in the new FP blueprint.