TCI Advocacy Leads to Removal of Family Planning Fees in Anambra State, Nigeria
Family planning service provision costs are one of the major barriers to family planning uptake throughout Nigeria, including in Anambra State. Through a net-mapping exercise, The Challenge Initiative (TCI) worked with state counterparts and community members to identify those with influence in Anambra State who could be candidates for an Advocacy Core Group (ACG). TCI helped the state establish this watchdog group independent from the government following established guidelines based on national policy. TCI establishes and/or strengthens ACGs to ensure sustainability of resource mobilization and an enabling environment for family planning services.
With TCI support, the Anambra State ACG played a key role in eliminating fees for family planning services. The advocacy group made several visits to the Chairman of the Anambra State House of Assembly Committee on Health, the Special Advisor on Health to the Governor and the Anambra State Commissioner of Health to advocate for the removal of user fees, explaining that service delivery fees are a significant deterrent to family planning uptake.
After TCI shared advocacy briefs with the Commissioner for Health in November 2018, the commissioner promised to present the issue to the state governor. The governor then issued an official policy statement in January 2019 directing that user fees for family planning and immunization services be removed.
Women in Anambra state can now access family planning services without paying any service fee. The State Primary Health Care Development Agency and Local Government Area heads of health departments are currently monitoring the situation to ensure full compliance with the directive.
“Since the removal of user fees, there has been remarkable increase in the turnout of clients for family planning and other integrated services rendered in the facility,” said the officer in-charge of a maternal and child health center in the Anambra town of Ogibi. “Monthly data show an increase from 40 clients to about 70 or more.”