*Y.C.* Improving Contraceptive Services in rural communities in Nigeria
4. The project is titled: Improving contraceptives services in rural communities with special focus on the Alimosho Local Government area of Lagos State. I have chosen this project because the Alimosho LG Area is made up of many rural communities which lack basic health facilities and family planning services for maternal health programs.
Investigations have shown that Young women are at risk of unintended pregnancies. Some even deliver at homes thereby compounding the problem in rural areas. There are over 15 methods of contraceptive methods available worldwide for preventing unwanted pregnancies and STIs transmission including HIV but most of these methods (90%) are not available in most developing countries. The situation is even worse in rural areas where health facilities are either non-existent or lacking leaving the rural dwellers with little or no option to access good reproductive health services. Most facilities here are inadequate and this is further compounded by lack of medical personnel leaving labor cases with traditional birth attendants. Trained nurses, midwives, doctors or specialists are either non-existent or in very critical low supply leading to increase in maternal mortality in rural areas. These problems are further compounded by inaccessible roads or poor road networks or distance between the clinics and homes, poverty, poor power supply, local myths / misconceptions, malnourishment, etc.
In addition, most people in these rural communities both young and old women and men have no access to quality information services on HIV/AIDS, STIs, Sexual/reproductive health and rights,etc. Thus the actualizations of the MDG in these communities seem to be in trouble or like a tall dream.
Thus this project is expected to result in effective and improved maternal health services translating into reduced abortion related mortality, improved family planning and fertility services.
Some of the previous work I have done include determining the prevalence of macrocytic anaemia among pregnant women in the calabar environment (undergraduate research project) and the result showed or confirmed earlier works indicating the prevalence of macrocytic red cells in pregnancy. I have also been involved in screening pregnant women attending ANC at the Igbinedion teaching hospital and found out that one out of every eight women test positive to HIV but other STIs are near Zero.
This project is aimed at improving contraceptive / family planning services in target rural communities by introducing newer contraceptives methods, creating necessary awareness about their uses bearing in mind the socio cultural environments. There will be practical demonstration of newer female contraceptives and an explanation of its advantage to the women attending clinics in these rural clinics/health centers. Opportunity will also be created to invite men and husbands to similar enlightenment program so that they can give support to their wives and partners and help as agents of change.
At the end of these programs, it is expected that the adoption and usage of new contraceptive methods will greatly help to reduce ignorance among the people.
About You
Section 1: About You
First Name
JOSHUA
Last Name
ANUNIBE
Website
Organization
Neighbourhood Health Foundation
Country
Nigeria
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
Yes
Section 2: About Your Organization
Organization Name
Neighbourhood Health Foundation
Organization Website
Organization Phone
234-0703-334-2104
Organization Address
suite 35/36,tawa plaza,10 momodu alli st.,ijegun, ikotun,lagos,Nigeria.
Organization Country
Nigeria
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Your idea
Name Your Project
*Y.C.* Improving Contraceptive Services in rural communities in Nigeria
Country your work focuses on
Nigeria
Describe Your Idea
4. The project is titled: Improving contraceptives services in rural communities with special focus on the Alimosho Local Government area of Lagos State. I have chosen this project because the Alimosho LG Area is made up of many rural communities which lack basic health facilities and family planning services for maternal health programs.
Investigations have shown that Young women are at risk of unintended pregnancies. Some even deliver at homes thereby compounding the problem in rural areas. There are over 15 methods of contraceptive methods available worldwide for preventing unwanted pregnancies and STIs transmission including HIV but most of these methods (90%) are not available in most developing countries. The situation is even worse in rural areas where health facilities are either non-existent or lacking leaving the rural dwellers with little or no option to access good reproductive health services. Most facilities here are inadequate and this is further compounded by lack of medical personnel leaving labor cases with traditional birth attendants. Trained nurses, midwives, doctors or specialists are either non-existent or in very critical low supply leading to increase in maternal mortality in rural areas. These problems are further compounded by inaccessible roads or poor road networks or distance between the clinics and homes, poverty, poor power supply, local myths / misconceptions, malnourishment, etc.
In addition, most people in these rural communities both young and old women and men have no access to quality information services on HIV/AIDS, STIs, Sexual/reproductive health and rights,etc. Thus the actualizations of the MDG in these communities seem to be in trouble or like a tall dream.
Thus this project is expected to result in effective and improved maternal health services translating into reduced abortion related mortality, improved family planning and fertility services.
Some of the previous work I have done include determining the prevalence of macrocytic anaemia among pregnant women in the calabar environment (undergraduate research project) and the result showed or confirmed earlier works indicating the prevalence of macrocytic red cells in pregnancy. I have also been involved in screening pregnant women attending ANC at the Igbinedion teaching hospital and found out that one out of every eight women test positive to HIV but other STIs are near Zero.
This project is aimed at improving contraceptive / family planning services in target rural communities by introducing newer contraceptives methods, creating necessary awareness about their uses bearing in mind the socio cultural environments. There will be practical demonstration of newer female contraceptives and an explanation of its advantage to the women attending clinics in these rural clinics/health centers. Opportunity will also be created to invite men and husbands to similar enlightenment program so that they can give support to their wives and partners and help as agents of change.
At the end of these programs, it is expected that the adoption and usage of new contraceptive methods will greatly help to reduce ignorance among the people.
Website URL
Innovation
What makes your idea unique?
5. The project is unique because it is the first of its kind in the target communities. It will allow the rural people have a feeling of new technologies and facts and offer them opportunities to be part of the program. Also it will help to equip the participants and the health care workers with adequate skills and knowledge about the other types of contraceptives which have eluded them for years.
It will also help to bring family planning services closer to the people and make for choices rather than being narrowed to available choice.
Overall, it will help to reduce the rate of abortions and help increase fertility among couples through proper counseling programs.
As a widely travelled individual in Nigeria, I have discovered that 5-6 people (both Adolescents and Adults) are pregnant in every street in Nigeria. According to the zones of the country, the trend is higher in the North & South West compared to South East & South South and this is due to the lifestyles and cultures of the different zones of the country. This pattern or distribution also reflects in maternal reproductive health problems. The situation is even higher in rural streets and this places more burden on the Nations fragile health services/system and puts or exposes more women at risk of child birth. The rate of pregnancy if not checked also places a burden on the socio economic development of the country. Nigeria’s population is placed at above 140 million people but this is likely to triple in 2-3yrs time if effective birth control policy is not put in place to restrict child bearing per couple to maximum of 3 instead of the present 4 which is still being abused due to a weak policy system and religious beliefs. So one of the best ways to check this ugly trend and reduce associated maternal mortality in Nigeria is to allow the introduction newer contraceptive methods.
Do you have a patent for this idea?
Yes
Impact
This Entry is about (Issues)
What impact have you had?
As stated earlier, I have coordinated many events in our locality which include the annual WORLDS AIDS Day, Candle light Memorials, School to School HIV awareness programs, VCT services and the Y-CARE program. Through these programs, I have been able to create adequate sensitization and enlightenments in target rural communities of Ijegun, Ijagemo and Ije-ododo and the people have seen the reason to adopt behavioral changes that will help to prevent/reduce HIV, STIs infections and Drug abuse.
Similarly, I was instrumental to the setting up of the Igbinedion University HIV/AIDS program which later got sponsorship from PEPFAR/USAID and my activities have contributed to the proper enlightenment of the University community and environs. Also I have offered care and support services through our organization which resulted in empowering people living with HIV/AIDS (PLWCA) with means of livelihoods as well as ensuring the rights of PLWHA .
Problem
7. The project is trying to address the short supply of contraceptive methods/devices and stopping the practice of giving births at home very common in rural areas and some cultural problems associated with these in Nigeria and Africa as a whole by increasing awareness and making many more contraceptive options available to allow for choices rather the present limitations to condom, birth control pills, rhythm method and withdrawal methods (coitus interruptus). Even the female condoms still seem alien in these rural communities while the other ones are not properly utilized due to poor knowledge. So this project aims at creating adequate sensitization using local languages about these issues, promoting available options as well as introducing new options through practical demonstrations at clinics and health centers. In this case, attempt will be made also to scale up this initiative by establishing contacts in close by west African countries especially clinics and health centers in disadvantaged rural communities where the people can access better information about the different contraceptives available so that they can make their choice.
Actions
- Questionnaire development directed at health care workers responsible for family planning / antenatal clinics to ascertain current use and problems.
- Meetings with health care workers based on the analysis of the Questionnaires.
- Meetings with local authorities, community and opinion leaders, health officials, ngos and other stakeholders to enlist their support and commitments.
- Working with international agencies / NGOs that will provide contraceptives and other support materials.
- Training of health care workers and volunteers to help in spreading the message and feed backs.
- Holding sessions with pregnant women, young women and others e.g men at clinics and demonstrating the use of new contraceptives.
- Advocacy campaigns and Rallies to promote the use of other contraceptives.
Results
The participants will be adequately sensitized resulting in improved contraceptive/family planning services, thus leading to decrease in Abortion rates and mortality associated with it. This will be partly achieved by reviewing some cultural norms that expose female subordination and discourage girls and women from influencing decisions about contraceptives and being equal participants in their relationships by informing and educating them about their sexual and reproductive health in an effective, easily accessible, yet culturally appropriate way.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
2011: In the 2011, for this project to be successful there is the need for policies to be put in place making access to reproductive and sexual health services free and affordable especially in rural communities where many are facing the challenges of poverty, inaccessible roads and transport system, inadequate medical personnel. Once this policy is in place, it will prepare ground for solid foundation in 2012.
2012: In the year 2012 and with policies in place from 2011, it will be easier to access contraceptives especially newer ones and make them available in greater quantities in health centers. Similarly, increase in funding is very necessary for this project to succeed. Thus there is the need to attract fund from donors and these donors should remove unnecessary bottlenecks and make funds available so that it will be easier to bring newer contraceptives, create awareness and move to all parts of the country over time.
2013: The year 2013 must see increased funding by partners and stakeholders backed by increased commitment by key officials of government all levels, increased training of health care workers and improved partnership with other ngos. It will also need increased sensitization on the need to adopt the new contraceptives using the media and local channel. Emergency contraception is expected to be very operational.
Monitoring and evaluation will also be part of the activities in 2013, to help in identifying success, failures, areas of improvement and feed backs.
What would prevent your project from being a success?
The project may not be successful if certain areas are not considered such as: the socio cultural belief of the people about contraceptives (myths), misconceptions, inadequate training of health care workers, inadequate demonstration of how to use the contraceptives, non involvement of male partners (husbands), inadequate or lack of funding, poor advocacy, non-availability of new contraceptives, non-challant attitude or lack of interest by participants, illiteracy, refusal to attend clinics, VCT or family planning centers.
How many people will your project serve annually?
1001‐10,000
What is the average monthly household income in your target community, in US Dollars?
$50 - 100
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Idea phase
Is your organization a
Non‐profit/NGO/citizen sector organization
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
Neighbourhood Health Foundation
How long has this organization been operating?
1‐5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have a non-monetary partnerships with NGOs?
Yes
Does your organization have a non-monetary partnerships with businesses?
Yes
Does your organization have a non-monetary partnerships with government?
Yes
Please tell us more about how these partnerships are critical to the success of your innovation.
11. The partnership with other ngos and stakeholders is very critical to the success of this project as no one can be an Island on its own. Networking is the best way to achieve effective results as other ngos may be working or may have worked on similar work so there is the need to share and cross fertilize ideas and to learn from each other experiences.
Moreover, the partnership will enable technical and logistic assistance to be made available for this project. This partnership will help to prevent parallel programs with no result at the end, so we believe by joining hands with others, we will be able to access more assistance and have more strength in pursuing this idea and be able to present stronger position with desired results.
What are the three most important actions needed to grow your initiative or organization?
i. Advocacy: We need to embark on adequate advocacy campaigns to create awareness about this program, enlist the support and commitment of key players and stakeholders on why things need to change and why people should support and embrace this change.
ii. Funding: Funding is critical to grow this initiative because it is the main support to achieve set goals and objectives. Thus funding will be needed from donors, government and agencies to carry out the programs especially the purchase of contraceptives, transportation, trainings, etc.
iii. Manpower: This is also needed to achieve this initiative as adequately trained manpower will result in effective programming. Medical, health professionals, social professionals and volunteers are needed in this project. Also external consultants will also be consulted from time to time for expertise and trainings.
The Story
What was the defining moment that you led to this innovation?
I have worked in the hospital environment for over 10years both in the urban and rural areas. However I have spent more years in the rural hospitals. All through this period, I have witnessed several maternal health problems ranging from under aged pregnancies leading to Vesico Vagina Fistulas, complicated pregnancies leading to abortions, maternal and child mortality and other reproductive health problems. I get touched in situations where adolescents became pregnant with no man being held responsible because in most of these cases when complications set in such as severe anaemia no one will be willing to donate blood, such may lead to death. I have discovered that most women or girls are restricted to the very few available contraceptive options and so cannot make choices best suited for them while others don’t even bother to embrace any option. Emergency contraception is most times not even available. I was touched by an experience at the Igbinedion University Teaching Hospital when a young woman delivered a marasmic child and died. Shortly after, there was no one who came forward as the husband. The baby as sick as he is became an abandoned baby in the hospital and was taken care of by the nurses until the baby died a week later. This is an isolated case out of thousands. So, I believe adequate maternal care services / family planning service needs to be put in place as well as new contraceptive services in order to reduce such incidence.
Tell us about the social innovator behind this idea.
I, Joshua Ahamdi Anunibe was born on the 2nd of December 1976 in lagos, Nigeria. I am the only male in a family of five. I had my primary education at ola-olu primary school, mushin from 1980 to 1985 and my secondary school education from 1986 to 1992. I completed my university education in 1998 with a B.Sc degree in medical laboratory science. I am presently awaiting an MPH degree from the university of Benin here in Nigeria. I am also awaiting a second postgraduate degree in Hematology from the Igbinedion University, okada, Nigeria.
Working Profile:
I started on HIV/AIDS program since 2002 at the Neighbourhood Health Foundation and was appointed a field/testing officer in the PEPFAR/Igbinedion university HIV/AIDS awareness project between 2005-2007. I returned back to Neighbourhood Health Foundation (NHF) as the Program Manager and later became the Project Coordinator of the USAID/YWCA/NHF partnership program titled Y-CARE Project in 2009. I have initiated several projects and with several partners in our rural communities.
My Vision:
I am looking forward to greater challenges and opportunities especially in the area of maternal, reproductive and sexual health and rights of both young women and adults. This is because of the health challenges being faced by these people in a constrained and poor environment such as ours occasioned by poor health facilities and systems, poor policy instruments and implementation ,poor funding of maternal health programs, illiteracy and socio cultural/religious problems and beliefs especially in African countries. The present statistics on maternal mortality and morbidity is really alarming and demands concerted actions and I want to be part of those that will bring changes and improvement to the system.
How did you first hear about Changemakers?
Through another organization or company
If through another, please provide the name of the organization or company
Youth Coalition
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Comments
Hi Joshua,
You have a lot of enthusiasm and some great ideas to try and provide access to contraceptives to rural communities in Nigeria. I would like to hear more about your thoughts on how you plan on implementing your idea. Who will you work with in the communities to conduct awareness raising? How will you form your awareness raising content and materials? How will you bear in mind the local cultural and traditional context in delivering messages about contraceptives and contraceptive use? How will you evaluate the impact of awareness raising on contraceptive use?
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