2020 is around the corner and Nigeria has not done much in the area of increasing the Contraceptive Prevalence Rate (CPR) as it is still less than 20 per cent.
The Family Planning 2020 (FP2020) which is a global movement, supports the rights of women and girls to decide freely and for themselves whether, when, and how many children they want to have.
The Nigerian government is part of that movement, where it pledged to increase the CPR from 15 per cent to 27 per cent by 2020. While the knowledge about family planning is very high, the problem is the uptake of a method.
In Lagos state for instance, the population of women of reproductive age is 5,460,712, the CPR for modern method is 26.4 per cent and any method is 48.3 per cent (according to NDHS report).
Unmet need is 11.8 per cent for married women and 8.1 per cent for all women. Meanwhile, the CPR target for the state is to achieve 74 per cent by 2020.
Looking at the number of health facilities in the state, there are about 3,245 health facilities (314 public health facilities and 2,931 private health facilities. Public health facilities by category would be primary: 286, secondary:2 and tertiary:2).
The number of health facilities providing FP services is 286 and a minimum of 286 family planning providers are also working in the state. That figure cannot adequately cater for the over 5,460,712 that would need family planning.
That is where the problem lies, because according to FP experts, the knowledge is high with good penetration of messaging, the commodities are available, yet the uptake is still low, as approximately 30 per cent of women in the state need a Contraceptive but do not have access to it.
With all the structures in place, Lagos state no doubt can exceed the national target, if women that demand contraceptives receive them. The big question now is: how are family planning commodities delivered to patients?
According to Edwin Akpotor, a pharmacist in the private sector, both community pharmacists and patent medicines vendors are responsible for over 60 per cent of primary health care needs of Nigerians.
Akpotor said there is need for the government and other relevant stakeholders to ensure essential PHC services are Task Shifted or Task Shared (TSTS) with Community Pharmacists and Patent Medicine Vendors (CPPMVs) bearing in mind their unique contribution.
He said if both non-clinical private providers were included in the TSTS Policy, contraceptive coverage would increase from 30 per cent to 90 per cent.
Corroborating his view, Reproductive Health Coordinator, Lagos State, Dr Saidat Okaga, said the goal for Nigeria was to raise the CPR from 15 per cent to 36 per cent, to contribute to the reduction of maternal mortality rate by 75 per cent and infant mortality rate by 66 per cent by 2020, adding that achieving the Blueprint’s goal would avert 1.6 million unintended pregnancies, and 400,000 infant and 700,000 child deaths.
Okaga said in 2017 an estimated 600,000 women were using a modern method of contraception in Lagos state which helped the state avert 143,000 unintended pregnancies, 46,000 unsafe abortions and 900 maternal deaths.
She disclosed that Lagos State aimed to strengthen demand for a full range of contraceptive methods and FP services by delivering targeted, accurate FP information to men and women and addressing common FP myths and misconceptions.
“Ensure youths are well informed on reproductive health issues and FP services available, increase coverage and access to high-quality integrated FP services and commodities through the private sector, faith-based organizations, private hospitals/clinics, pharmacies and CPPMVs as appropriate for some methods.
“Strengthen the capacity of healthcare workers to provide safe, high-quality FP services, including counselling, provision, and removal of long-acting reversible contraception. Develop a comprehensive monitoring and evaluation plan for family planning logistics and service provision,” she added.