1 Management Sciences for Health

Stronger health systems. Greater health impact.

Dr. Zipporah Kpamor, Chief of Party – Nigeria (MSH)

Partnership with faith based organizations:

FP acceptance in Nigeria

2 Management Sciences for Health

Background

Goal: improve poor health delivery system

Challenges:

-religious and cultural resistance

-high illiteracy rates

-poor knowledge of reproductive health issues

-distrust of foreign influence

MSH supports the implementation of voluntary FP

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Situation

FP indicators

• High TFR = 5.7 1/13 women dying in childbirth

• Low CPR = 9.7% High maternal mortality rates: 545/100,000 live births

infant mortality rates:

75/1,000 live births

Slow FP uptake due to

• Short birth spacing

• Perceived religious prohibition

against FP use

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• Christianity and Islam major religions practiced in the

country

• Religious leaders influence traditional practices at

family households

• Husbands- the decision makers of the family, value large

families and cultural beliefs reject the use of high impact and

lifesaving contraceptives

• Both Christians and Muslims support use of FP but

misconceptions, including the interpretation of FP as

abortion and birth control

Religious Community

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MSH Intervention in Nigeria

(2007-2011)

Collaboration with Christian

Health Association of Nigeria

(CHAN) – objective of “Reaching

the Unreached”

- comprised of 4,400 hospitals,

clinics, health programs and

leprosaria centers, mostly located in

rural areas

HIV/AIDS Treatment Care and

Support project

– MSH facilitated acceptance to FP

commodities for women in six

states

Nigeria Indigenous Capacity Building (NICaB) project

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MSH & CHAN partnership

3 methods of intervention:

–community level

– through religious leaders and community/village

health workers for prevention including PMTCT

and FP

–care and support services

–primary health center level

– for the provision of HIV treatment and basic

health services

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MSH & CHAN partnership

• Multi-prong strategy: – evidence-based local

advocacy

– behavior change

communication

– capacity building

– referral for commodity

supply

• Use of language such as

healthy timing and spacing

pregnancy instead of FP

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Community Level Intervention

• Engage religious leaders to break barriers to FP

• Trainers of Trainers (Imams, priests, nuns, and catechists)

who trained service providers and volunteers from among

women fellowship groups and the market women

associations.

• To incorporate advocacy for FP with the religious messages

and mainstream FP discussion into other sectors of the

project: HIV/AIDS, education, agriculture, water and

sanitation

• Use of religious leaders in community mobilization

• through organized community meetings, in mosques and

churches.

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• Integrated FP discussions

into other clinic activities

counseling for HIV Testing

and Counseling,

antenatal and post natal

clinics

• Trained clinic service

providers to provide quality

FP services depending on

their faith

Health Facility Level

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• Religious leaders helped remove barriers to FP

• Sermons addressed: girl-child education,

immunization, family planning, and antenatal care

• Community members where religious leaders were

engaged showed better understanding and an

increasing acceptance of RH/FP

Results

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• Empowers religious leaders and the faith communities

to effectively tackle resistance to uptake of services

to improve communication with the use of appropriate

language to sensitize potential FP users

• Increases FP acceptance

with Intersectoral collaboration and the integration of FP

messages into other development initiatives such as

PMTCT

through multiple levels of influence: including individual,

community and institutional factors are likely to improve

acceptance of FP in faith communities.

Conclusion: Partnership with Faith based

Organizations …