IntegratE: Stakeholders seek sustainability as family planning intervention reaches 1.7m women

Angela Onwuzoo

As the Society for Family Health’s IntegratE 2.0 Project provided family planning services to no fewer than 1.7 million women in Nigeria, stakeholders have called for its sustainability to expand coverage in underserved communities and reach more women with modern contraceptive methods.

SFH said the intervention provided family planning services to 1.7 million women across 11 states through community pharmacists and patent and proprietary medicine vendors trained under Nigeria’s Task-Shifting and Task-Sharing Policy.

The organisation also said the intervention provided care to more than 1.18 million under-five children, with an estimated 15,000 under-five deaths averted through malaria testing and treatment provided at the primary healthcare level.

Group Chief Executive Officer of SFH, Dr Omokhudu Idogho, represented by the Group Director of SFH, Emeka Okafor, disclosed the figures on Wednesday during the project’s close-out and dissemination programme in Lagos.

Idogho said the IntegratE Project trained 863 community pharmacists and 4,961 PPMVs to provide family planning and primary healthcare services across 11 states.

He described PPMVs as important access points for basic healthcare services, saying their training followed the three-tier accreditation structure introduced by the Pharmacy Council of Nigeria.

He said to close gaps in access to family planning, PPMVs in tiers two and three were trained to provide long-acting reversible contraceptive services.

The SFH boss also disclosed that providers treated 340,142 cases of diarrhoea and 137,703 cases of pneumonia, while identifying 10,898 presumptive tuberculosis cases, of which 1,320 were confirmed and placed on treatment.

The programme, themed ‘Sustaining Gains in Family Planning: Lessons from the IntegratE Project for Service Delivery, Referral Systems and Data Management,’ brought together stakeholders, government officials and development partners to assess the project’s impact since its launch in 2017 and discuss strategies for sustaining its gains.

The IntegratE Project, whose overall goal was to expand access to quality family planning and primary healthcare services by leveraging the private sector, was funded by the Gates Foundation in partnership with the Federal Ministry of Health and Social Welfare, the Pharmacy Council of Nigeria, the Lagos State Primary Health Care Board and primary healthcare boards in other implementing states.

Following the pilot phase in Lagos and Kaduna states, the project was expanded to Bauchi, Borno, Enugu, Gombe, Kano, Nasarawa, Niger, Sokoto and Yobe states.

Reeling out the figures, Idogho said 1,756,170 women accessed family planning services, including 399,766 new acceptors; an estimated 117,775 unintended pregnancies were averted, and 408,943 couple-years of protection were generated across the 11 implementing states between the project’s launch in 2017 and its close-out in 2026.

He said family planning commodities distributed included 4.6 million condoms, 923,558 cycles of oral contraceptive pills, 321,701 injectables and 80,679 implants.

Idogho said SFH’s focus was to reach underserved communities with quality family planning and primary healthcare services.

He said, “The key impact of the project among the several for me is that we were able to avert 15,000 under-five deaths through our implementation of PHC services. We provided malaria services to over 1.2 million under-five children; we tested over 900 of them for malaria and also provided ACT for those that tested positive.

“Of course, we can also mention so many on the side of family planning. We have 1.7 million women who accessed various family planning services through this project. And the interesting thing is that almost 400,000 of them were women who were accessing family planning services for the first time, which means that if the providers were not trained, these women wouldn’t have had access to family planning services.”

He noted that integrating community pharmacists and PPMVs into service delivery expanded access, convenience, and client choice, particularly in underserved communities.

He added, “The project trained community-based healthcare providers, including community pharmacists and PPMVs, who serve a large proportion of Nigerians, particularly those in underserved communities. This completely aligns with SFH’s vision.”

Speaking on the sustainability of the project, Idogho said that although the intervention was ending, SFH would continue to provide technical support to state governments interested in scaling it up.

“We will partner with them and provide them with technical assistance to be able to do this. This project showed how important providers are in their communities. Oftentimes they are ignored.

“The government should recognise them and integrate them into the referral system. The government should also integrate their data into the National Health Management Information System. It is only when they are integrated that the country will have full visibility of the data that is reported by all the providers,” he said.

In his presentation, Director and Head, Reproductive Health Division, Federal Ministry of Health and Social Welfare, Dr Samuel Oyeniyi, said the project had demonstrated that community pharmacists and PPMVs could provide family planning services and should be integrated into primary healthcare service delivery.

In her goodwill message, Deputy Director, Reproductive Health at the Gates Foundation, Mrs Rodio Diallo, said available data indicated that many women in rural communities accessed healthcare services through PPMVs and community pharmacies.

She stressed the importance of taking family planning services closer to women in underserved communities.

“The key learning is that if you give knowledge to healthcare workers and empower them, they will be better equipped to meet women’s reproductive health needs,” she said.

Diallo said the project compared the quality of care provided by trained PPMVs and community pharmacists with services delivered at primary healthcare facilities.

She said the project showed the expansion of family planning services in hard-to-reach communities was possible through effective implementation of the TSTS policy.

According to her, the evidence helped convince policymakers to incorporate PPMVs and community pharmacists into Task-Shifting and Task-Sharing arrangements.

She noted that the intervention was designed to ensure its gains continued beyond donor funding.

Diallo said the inclusion of PPMVs and community pharmacies in the TSTS policy marked a significant step towards institutionalising the intervention.

She also called for increased government and development-partner investment to expand provider training.

Speaking on the benefits of the IntegratE Project in Lagos State, the Permanent Secretary, Lagos State Primary Health Care Board, Dr Ibrahim Mustafa, said more than 904 personnel and providers had been trained, reaching over 400,000 people.

Mustafa lauded the implementation of the project in the state, saying it had improved healthcare delivery, particularly in underserved communities, by expanding the range of family planning services available through PPMVs and community pharmacies.

He said that previously, providers mainly offered contraceptive pills and emergency contraceptives to clients seeking family planning services, but that following the training, they could safely administer specialised methods, including contraceptive implants and injectables.

Mustafa said the intervention brought family planning services closer to residents and improved access to services in hard-to-reach communities.

The Registrar, Pharmacy Council of Nigeria, Ibrahim Ahmed, said the project should be sustained to help achieve universal health coverage.

Ahmed assured that the PCN would ensure effective regulation to harness the potential of community pharmacists and PPMVs to provide quality healthcare services to communities.

“Within the healthcare delivery system, from the data that I have, this project has increased the number of women accessing family planning services. We must sustain the gains,” the PCN Registrar said.

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