Accelerating Progress Toward Reaching Nigeria’s Malaria Control and Family Planning Targets
With a population of 181.5 million, Nigeria makes up two percent of the world’s total population. Yet, it accounts for 10 percent of the total maternal, infant and child deaths around the world. Losing more than 300,000 lives a year, Nigeria experiences more malaria-related deaths than any other country.
In 2014, malaria accounted for a third of all hospitalized children under five.
Nigeria’s National Malaria Strategy stresses the need for social and behavior change communication (SBCC) to prevent and control malaria. In 2014, HC3 worked with Nigeria’s National Malaria Control Program to develop and produce a blueprint for SBCC malaria activities.
Low family planning planning use is also a concern in Nigeria, due, in part, to a number of social and structural barriers to accessing family planning in Nigeria. While many residents know about family planning methods, only 10 percent of currently married women of reproductive age using a modern method of family planning. In 2014, the federal Ministry of Health (MOH) announced its goal of raising contraceptive prevalence rate (CPR) from 15 percent to 36 percent by 2018. To reach this ambitious goal, HC3 worked to improve family planning norms in focal states where CPR is as low as 0.7 percent.
Malaria Control and Prevention
The HC3 Nigeria Malaria Project, funded by the U.S. President’s Malaria Initiative (PMI), worked with the National and State Malaria Elimination Programs and other partners to develop comprehensive social and behavior change communication (SBCC) programs for malaria prevention and control. Behavioral objectives included increasing uptake of long-lasting insecticidal nets (LLINs), intermittent preventive treatment in pregnancy (IPTp), rapid diagnostic tests and artemisinin-based combination therapy.
The project also strengthened the capacity of the National Malaria Elimination Program’s (NMEP’s) Advocacy, Communication and Social Mobilisation (ACSM) branch for SBCC leadership. Results from this collaboration included:
- National Malaria Theme Song: Production of the song and music video “Play Your Part” engaged popular Nigerian musicians 2Face Idibia, Sani Danja and Eve-B. To continue public discussion, a remix contest was organized with submissions from various professional and amateur song artists.
- Comprehensive Mass Media: Mass media efforts included a weekly radio magazine program in Pidgin English (Play Your Part) and Hausa (Taka Naka Rawan), the Nollywood-produced television drama series Newman Street, a set of six radio and television spots in Pidgin English and Hausa, and print materials. HC3 strengthened NMEP’s media capacity by building strategic media partnerships, developing a toolkit for media reporting and improving their online presence.
- Focused Interpersonal Communication (IPC) and Referral to Services: Intensive IPC activities were implemented in focal areas with a high malaria burden that are selected in collaboration with local authorities and community leaders. By linking home visits and community dialogues to mass media messaging, a community-media feedback loop was created. Community Volunteers also referred pregnant women and children with fever to health facilities. Preliminary analysis has shown that this has resulted in increased uptake of ANC and IPTp services, increased LLIN use and early health-seeking behavior in the focal areas.
- Good Quality Malaria Medicines Campaign: To reduce the prevalence of substandard, spurious, falsely-labelled, falsified and counterfeit (SSFFC) malaria medicines, a campaign was launched and followed by vendor and community volunteer training.
- SBCC Support to PMI LLIN Replacement Campaigns: The SBCC activities linked to the LLIN replacement campaign in Zamfara State in late 2015 reached over 80 percent of all Zamfara citizens, and resulted in higher rates of net hanging and use. HC3 will continue to provide SBCC support to PMI’s LLIN Replacement Campaigns in Benue, Oyo and Kogi States in 2016.
- Provider Initiatives: Targeting SBCC activities at health providers and forming strategic partnerships with them addressed the supply-side challenges in malaria interventions.
- National Malaria ACSM Guidelines: These guidelines and the accompanying user’s guide provided a common vision for health communication professionals across levels, enabling ACSM to lead and coordinate relevant stakeholders, and has resulted in greater harmonization of messages and materials among partners, reducing duplication of efforts and thereby leveraging funds from various donors.
“The national malaria theme song is one of the innovative and creative campaign tools to increase knowledge about the key malaria prevention and treatment methods, which also simplifies individuals and household key steps to being malaria free.”
-Dr. Ezeigwe, National NMEP Coordinator
In 2015, HC3 conducted an assessment on family planning use in Bauchi and Sokoto and found several promising approaches: careful efforts focused on child spacing rather than limiting childbearing; service delivery improvements; and a strong focus on demand-side activities to promote family planning use at the community, family and individual level. HC3 worked with the Federal and State ministries of health and other partners to increase the contraceptive prevalence rate (CPR) in Bauchi, Sokoto and Ebonyi states.
Building on work done by Nigerian Urban Reproductive Health Initiative, the program aimed at addressing the full spectrum of family planning needs in the Demand-Services-Advocacy continuum:
- Demand Generation: Promoted family planning methods for achieving desired child spacing as well as for broader benefits. Radio spots used by NURHI were translated into local languages and broadcast in focal states.
- Improving Service Delivery: Worked closely with state ministries of health and service delivery partners to examine service provider beliefs and develop interventions addressing them, and linking increases in demand for family planning methods to available services.
- Advocacy: Improved family planning norms in focal states by enhancing dialogue with religious and traditional leaders, news media and other stakeholders.
In addition to supporting Nigeria in reaching its CPR target, HC3 pretested family planning interventions in the country.
- Long-acting reversible contraception (LARC) materials: These materials increase access to LARCs for youth (ages 15-24). A video, discussion guide, brochures and posters were pretested. HC3 also partnered with youth to create videos increasing acceptance of LARCs among this age group.
- Smart client intervention: HC3 developed an mHealth tool using interactive voice response (IVR), supported by short messaging service (SMS), that can reach clients directly to emphasize the importance of being an informed and engaged family planning client.
- Federal Ministry of Health (FMOH)
State Ministries of Health (SMOH)
National and State Malaria Elimination Programs
President’s Malaria Initiative (PMI)
- Geographic Coverage