A couple in Abuja Federal Capital Territory (FCT) is discussing what to have for dinner. The discussion about eating last week’s soup quickly turns into an argument about finances. The couple worries about being able to make ends meet – how will they pay their rent and afford the “luxuries” they want for their family, like fresh meat and vegetables, on their current income? The conversation becomes a discussion about the need to limit their family size to maintain their marriage and have the family they want while providing a better life for their family. This scenario comes from the Nigerian Urban Reproductive Health Initiative’s (NURHI’s) Second Chance radio drama and is common in real life among poor families in urban Nigeria.
In past years, most reproductive health and family planning projects in Nigeria focused on the health benefits of family planning to mothers and babies. When NURHI started working in six urban areas of Nigeria, the project decided to also focus on complex and pragmatic family planning benefits based on qualitative data findings.
Many women from Ibadan and Kaduna participating in focus groups expressed quality-of-life motivations to space or limit births, such as time and money. Specifically, the women felt they were better able to educate and provide for a smaller family.
The NURHI project responded with messaging that encourages Nigerians not to have a specific number of children but to plan their futures to ensure happy and healthy lives for the children they do have.
“Before family planning in Offa was not as good as it is now…But now, with the interventions of NURHI and the federal and state government…people are coming out for family planning–-the male, the female, the old and the young are all coming for family planning.” – Mrs. Ruth Dare, registered family planning provider, Ilorin
While many health and development initiatives must rely on secondary data sources to understand the context in which they work, NURHI has been able to build a robust research strategy to support its program design using quantitative data collected by the Measurement, Learning & Evaluation (MLE) project, along with qualitative research conducted by the NURHI team. The results from these research efforts are the basis of effective health programs. NURHI also uses these data to refine its strategy to integrate increased family planning knowledge with understanding of the role family planning can play in improving quality of life. This strategy includes promoting spousal communication through various media channels including print, radio and television.
Since NURHI began its efforts, knowledge about family planning, spousal communication and contraceptive use have increased in at least one NURHI project city. The change in contraceptive use between baseline and mid-term varies across cities, however. For example, among women in union, in Abuja FCT, modern contraceptive use only increased by 2.3 percentage points, from 31.9 percent to 34.2 percent, while in Kaduna, use increased by 15.5 percentage points, from 19.6 percent to 35.1 percent. Statistically significant change in contraceptive prevalence rates (CPR) between baseline and mid-term was found in Ibadan, Ilorin and Kaduna but not in Abuja FCT.
Given that Nigeria is a vast country with a large, diverse population, rather than a single countrywide strategy, NURHI has decided to use more regionally specific approaches moving forward. For example, in Abuja FCT, using television for messaging has worked well, while in the other cities, radio has been more successful. NURHI will continue to refine its messaging in all of its sites using findings from the MLE mid-term and program monitoring data.
This story was originally written by the Measurement, Learning & Evaluation Project, which evaluated the Urban Reproductive Health Initiatives (UHRIs) in Kenya, Senegal, Nigeria and India. The Challenge Initiative is charged with expanding access to the proven solutions and successes developed under the UHRIs.
