This paper was presented at the media round table in preparation for the 6th Nigeria Family Planning Conference happening from December 7 -11, 2020.

1. The Future of Family Planning in
Nigeria:
Leading With Advocacy and Demand
The Nigeria Urban Reproductive Health Initiative Experience
November 2020
Dr. Mojisola Odeku
Portfolio Director, JHUCCP Nigeria

2. WHAT and HOW
people THINK about
family planning and
what they believe
OTHERS think about
family planning
predicts their
decision to use family
planning

3. The FP Situation when NURHI
Started (in 2009)
3
20%Of married women wanted to delay of stop child
bearing but were not using modern contraception
Only 9.7% Of married women were using
modern contraception
Reasons ranged from myths and misconceptions
to socio-cultural/community barriers
Data Source: NDHS 2008

4. Leading with
Advocacy: The
NURHI 2 Experience
Promoting dialogue on family
planning – from the national,
state and local government
levels all the way to
community and household
levels – is critical to
legitimizing open dialogue and
creating a supportive policy
environment for family
planning.
4NURHI 2 Advocacy Pillars

5. NURHI’s Advocacy Work
• Built transformational leaders for
advancement of family planning in the faith-
based communities
• Fostered community ownership of family
planning and the FP advocacy agenda
• Improved political commitments, governance
and accountability at state and local
government levels;
• Shifted the attitudes and mindset of key
stakeholders for effective leadership and
ownership of high impact practices
• Established mechanisms for sustainable and
impactful family planning environment for
Nigeria beyond FP2020
5

6. 6
Innovative
Faith-based
Advocacy
Created alliances with notable leaders of the
two major faiths in Nigeria, through the
establishment of Interfaith Forums, to achieve
a sustainable supportive environment for
increased use of modern FP methods.
NURHI recognized the
crucial role of religious
leaders in influencing
individual and household
decisions, including
decisions about
contraceptive use.

7. Reported reasons for non-use of contraceptives in Lagos and
Kano
7
% of women who said they cannot use
contraceptives if their religious leaders
did not think so/does not support
3.8
4.1
10
7.7
10
1.2
2.3
4.4
4.9
3.2
Religious
prohibition
Respondent
Opposes
Fear of side effects
Patner Opposes
Up to God
Lagos Kano
Why working with Religious leaders is key…
Source: NURHI2 Flexi-track Survey for Lagos, Feb 2020; TCI Flexitrack Survey for Kano, April 2019

8. NURHI 2 deployed the science of advocacy in its work
with religious leaders and generated evidence of a
relationship between increased contraceptive use and
faith-based advocacy 8

9. Exposure to Religious Leaders speaking positively about
Family Planning
51.7
36.1
41.141.5 40.5
36.3
Kaduna Lagos Oyo
Exposed Not exposed
Modern Contraceptive Use is Higher Among
Women Who are Exposed To Religious Leaders
Speaking in Support of FP Than those Not
Exposed
Source: NURHI2 Flexi-track Survey, Sept. 2018 (Round 4)
58.4
49.3 51.3
43.2
46.5 44
Kaduna Lagos Oyo
Exposed Not exposed
Modern Contraceptive Use is Higher Among
Men who are Exposed to Religious Leaders
Speaking in Support of FP than Those Not
Exposed

10. 10
Other Key Accomplishments…
FAMILY PLANNING/
CHILDBIRTH
SPACING
CHRISTIAN
SERMON NOTE
ON
May 2017
ÿ
wives and children including their sexual/reproductive health and CBSIFP issues.
(Eph. 5:25,28; Provo 25:28).
? Become educated on issues pertaining to reproductive health, safe motherhood and
Childbirth Spacing/Family Planning.
? Accompany your wives to the clinic for ante natal, childbirth and post-delivery care
and services; including adequate provision of resources and plans for any
emergency thereof; "So husbands ought to love their own wives as their own
bodies" (Ephesians 5 :28a). "He who loves his wife loves himself" (Proverbs 25 :28).
? Live out exemplary chaste lifestyle in the family (Malachi 2: 10-14; 1Cor. 6: 18-20;
1 Cor. 3:16-20).
ÿ Wives: Take care of your life and health by embracing CBS/FPas a virtuous woman.
This means that you should take personal responsibility to ensure you are healthy to
be able to take care of the family.
? Acquire basic knowledge and skills to maintain personal health and manage your
reproductive functions including knowing early warning signs and where to seek
help (Prov. 31: 10-31).
? Live out exemplary chaste lifestyle in the family (Malachi 2: 10-14; 1Cor. 6: 18-20;
1 Cor. 3: 16-20).
? Youth & Unmarried Adults: Learn about your sexuality; and adopt chaste, healthy
and holy lifestyle.
? Know that your body is the temple of the Holy Spirit (l Cor. 6: 18-20);
? Marriage is honourable and bed undefiled (Heb. 13:4; Eph. 5: 1-3).
? Children & Teenagers: Learn age-appropriate messages on reproductive health and
chaste lifestyle;
? Develop refusal skills to avoid peer pressure and risky sexual, social behaviours;
and
? Grow in spirituality. Provo 4:20-22; 2Timothy 2:22; and 1 Cor. 6: 18-20.
God is the master family planner from creation. It is thus imperative for husband and
wife to follow God's example in procreation by prayerfully planning the timing and
spacing of the children they want. (1 Tim. 3:4; 1Cor. 14:40). Every member of the family
stands to benefit from Childbirth Spacing/Family planning based on faith and factual
information. Choose life, choose health. Visit your health care provider for family
planning needs.
Husbands: Show leadership, and take charge of the health and wellbeing of your
Conclusion
Copyright 2017
ISBN: 978-978-960-466-1
By working with religious
leaders, training and re-orienting
them about family planning with
guidance from the Holy books,
they became
champions, speaking
openly and publicly about FP and
encouraging its practice among
their congregations
• Development of Faith-based advocacy handbooks,
sermon notes and Budget Tracking Tools
• Inter-faith Platforms in Kaduna, Lagos and Oyo are now
registered as independent faith-based platforms
advocating for FP/CBS
• The Federal Ministry of Health is increasingly responsive
to supporting faith-based dialogues
• Interfaith platforms exist in all NURHI 2 and TCI project
states.
• Other projects such as Breakthrough Action, CHAI, Marie
Stopes have also adopted the NURHI Interfaith model to
advance dialogues on faith issues in relation to FP/CBS.
Faith-based advocacy handbooks

11. Established functional
Budget lines and
budgetary expenditures
on FP
Strengthened capacity of
state and LGA actors on
budgeting and budget
monitoring and analysis
(The Budget Tracking
Team)
Strengthened
coordination and
accountability for FP at
state and LGA levels
through establishment of
functional RH/FP
Technical Working
Groups
Promoted Annual
Operational Planning
mechanisms to engender
ownership and
institutionalization of the
Costed Implementation
Plan by the state
Ministry of Health
11
Impactful Advocacy for Policy Change
Over 280m Naira
released for FP
across NURHI 2
States
280,994,338
Source: NURHI Program Management Information System

12. Media-based
Advocacy
• Alliances with media
representatives increased
accurate coverage and
compelling stories about family
planning
• Established Media forums
also serve as a mechanism for
holding government
accountable
12Media trained to report on FP, population, and health

13. Advocacy Core
Groups:
A Sustainable Platform for Impactful
Policy Dialogues
• Designed innovative advocacy platforms(ACG) led by of committed community
members in 2010 which is being leveraged by other partners
• Advocate for increased visibility and investment for family planning
• Received intensive capacity building to develop skills on:
• SMART Advocacy
• Resource mobilization
• Organizational and strategic plan development
• Budget tracking, monitoring and analysis
• Succession planning, etc. 13

14. Key Achievements
14
 Massive improvement in FP/CBS environment with improved investment,
public discourse and acceptance
 Budget lines were established at the State and LGA levels for FP/CBS.
 Budgetary allocations and expenditures were improved for FP at the State and
LGAs;
 Policy makers became more supportive and responsive to FP/CBS;
 Community based structures e.g. Ward Development Committee became
more empowered in voice and accountability. Improved engagement by
community leaders with LGA policy makers.
 ACGs registered with the Corporate Affairs Commission (CAC) as independent
Civil Society Organizations

15. Leading with Demand:
The NURHI 2
Experience

16. Current FP Situation in Nigeria
16
36%Total demand for family planning among currently
married women
34% Satisfied by modern methods
Unmet need is higheramong sexually active unmarried
women (48%) than among currently married women (19%)
Data Source: NDHS 2018
Low Demand…
High Unmet Need…

17. The NURHI 2 Experience
• NURHI 2 is founded on the idea that when
demand for family planning increases, supply rises
to meet the demand.
• Ideation Theory was used to design effective
messages and approaches to target key
motivational factors that influence behaviour.
• This applies similarly to service providers, whose
quality of service is influenced by their own ideas
and feelings about family planning.
17

18. Generating Demand through an Integrated, Multi-
Channeled Communication Campaign
18
Mass Media Campaign
Radio: Entertainment
Education and Spots
Television: Newman
Street, Minidrama series
Spots
Social Mobilization
Key Life Events
Community Dialogues
Neighborhood
Campaigns
Branded Materials
Below the Line Materials
Job Aids

19. Social Media
(Facebook, Twitter, LinkedIn,
Instagram, WhatsApp)
Websites
(YouTube Channel, Medium Blog,
nurhi.org, Getittogether.ng)
Mobile Apps and
others services
(My Family Planning Guide, 321 Service)
Digital Media Engagement

20. Positioning FP as a Natural Part of Life
20
Spreading the good news
of family planning at Key
Life Events (e.g. Naming
ceremonies)

21. Personalizing Family Planning –
21
Materials that
Motivate FP Use

22. Bringing FP Services
to the Communities
Neighborhood Campaigns
and referral for services
22

23. 23
How Communication
Affects Behavioural
Attributes
(Ideational Variables)
The more positive beliefs a person holds about family planning,
the more likely they are to use a method.

24. Rejection of
Myths and
Misconceptions
Between 2016 and 2018/2020,
Women who reject most myths about
FP, increased by 4.8 percentage
points in NURHI 2 States
24
Source: NURHI 2 Program Management Information System

25. Perceived Self-Efficacy
25
Between 2016 and 2018/2020,
Women with perceived self-efficacy
to use FP increased by 4.3
percentage points in NURHI 2
States
Source: NURHI 2 Program Management Information System

26. Favourable
Community
Attitudes
towards FP
Women with favorable
community attitudes
towards FP increased
by 2.3 percentage
points
26Source: NURHI 2 Program Management Information System

27. 27
Decreased provider
restriction practices for
Injectables, Implants and
IUDs
Significant Decrease in Provider Bias
82.6 75.2
36
53.2 55
65.7 62.5
13.5
25.6
49.3
Minimum Age Maximum Age Marital Status Parity Consent
Baseline (2016) Follow up (2018/2020)
80.7 69.2
33.8 43.6 47.8
65.8 55.6
12.6 24.8
43.4
Minimum Age Maximum Age Marital Status Parity Consent
Baseline (2016) Follow up (2018/2020)
Implant
IUD
Injectable
78.1 72.6
35.8 44.4
60.562.5 50.6
20.8 16.9
59.7
Minimum Age Maximum Age Marital Status Parity Consent
Baseline (2016) Follow up (2018/2020)
Source: NURHI Baseline/Endine Health Facility Survey (2016/2020)

28. 28
Source: NURHI Program Management Information System
The Big Picture…
More than
1.3 million women
received contraceptive methods at NURHI 2
supported High-volume sites and Outreaches

29. The way
Forward
29
Even in the face of public health
emergencies

30. • Develop targeted communication messages (e.g. radio
spots) to promote use of FP during the pandemic
• Promote use of self-care interventions (administration of
DMPA-SC)
• Provide Personal Protective Equipment (PPEs)
• Develop job aids on Infection Prevention Practices
• Deploy virtual platforms to strengthen skills of providers
• Integrate FP messages into other public health messages
at community levels and on social media
30
“The COVID-19 pandemic
has caused tremendous
upheaval to health
systems around the
world, disrupting access
to family planning
information and services,
as well as sexual and
reproductive health more
broadly.”
– FP 2020
Promoting FP Use during Public Health Emergencies

31. Conclusion
• Interventions that engage key
decision makers and influential leaders
as change agents for shaping norms and
creating a supportive environment are
crucial for increasing contraceptive
uptake in Nigeria.
• Investing in evidence-based advocacy
and demand generation is critical to
improving mCPR and overall quality of
life

32. Links to Related Advocacy Documents
• :
• Christian Perspectives on Reproductive Health and Family Planning in Nigeria (English) - http://www.nurhi.org/en/wp-
content/uploads/2020/11/Christian-Perspectives-In-RH-FP-in-Nigeria.pdf
• Islamic Perspective on Reproductive Health and Childbirth Spacing in Nigeria (English) - http://www.nurhi.org/en/wp-
content/uploads/2020/11/Islamic-Perspectives-for-RH-CBS-in-Nigeria.pdf
• Sermon Notes on the Christian Perspectives on Reproductive Health and Family Planning in Nigeria (English) - http://www.nurhi.org/en/wp-
content/uploads/2020/11/Christian-Sermon-Note-on-FP-CBS.pdf
• Sermon Notes on Islamic Perspective on Reproductive Health and Childbirth Spacing in Nigeria (English) - http://www.nurhi.org/en/wp-
content/uploads/2020/11/Islamic-Sermon-Note-on-CBS-in-Nigeria.pdf
• Christian Perspectives on Reproductive Health and Family Planning in Nigeria (Hausa) - http://www.nurhi.org/en/wp-
content/uploads/2020/11/Christian-Hausa-Christian-Perspectives_2019.pdf
• Islamic Perspective on Reproductive Health and Childbirth Spacing in Nigeria (Arabic) -https://nurhi-
my.sharepoint.com/:b:/g/personal/cushi_jhuccp_ng/EVdDnuDWKLJDmNjnqYfL5pIBDc42fni8jvMK6gr3OUwGZQ?e=8yUWu7
• Building Inter-Faith Alliances for Family Planning/Childbirth Spacing in Nigeria: Key Learning from Faith-based Champions, October 2017 -
http://www.nurhi.org/en/wp-content/uploads/2020/11/Building-Interfaith-Alliance-for-FP-RH-in-Nigeria-2.pdf
• Guide to Setting Up and Managing Family Planning Advocacy Working Group (2017) -
• http://www.nurhi.org/en/wp-content/uploads/brizy/26734/assets/images/iW=678&iH=888&oX=0&oY=0&cW=678&cH=506/Screen-Shot-
2020-11-22-at-10.03.07-PM.png
• FP2020 Faith and FP Brief
• https://docs.google.com/document/d/1qiHi2KzyGdS46ebX5rpFWcgEmEkxErvW/edit
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33. Links to Related Advocacy Documents
• Links to Related Advocacy Documents:
• NURHI 2 Demand Generation Strategy
• http://www.nurhi.org/en/wp-content/uploads/2020/08/NURHI-2-Demand-Generation-Strategy.pdf
• How to Guide in Adopting NURHI 2 Radio Program in Other Geographies
• http://www.nurhi.org/en/wp-content/uploads/2020/08/Adapting-A-Radio-Magazine-Programme-In-A-New-Geography_A-How-
to-Guide.pdf
• A How-to Guide for Implementing an effective Social Mobilization Strategy
• http://www.nurhi.org/en/wp-content/uploads/2020/08/How-to-guide.pdf
• Family Planning Myth Buster
• http://www.nurhi.org/en/wp-content/uploads/2020/08/Myth-Buster-English.pdf
• Frequently Asked Questions
• http://www.nurhi.org/en/wp-content/uploads/2020/08/Frequesntly-Asked-Questions-Brochure-2019.pdf
• FP Method Leaflet
• http://www.nurhi.org/en/wp-content/uploads/2020/08/Family-Planning-Method-Leaflet.pdf
• Get It Together
• http://getittogether.ng/
• NURHI 2 Social Media Strategy
• https://docs.google.com/document/d/1JMBXFzmieig-HSPIX9UhIeTZXdf2fNAgGxSYWuz6eoE/edit?usp=sharing
•
33