1. NIGERIA PRESENTATION Nigerian team: Dr Bose Adeniran- Deputy Director, Federal Ministry of Health Dr Mohammed Kilgore - Honourable Commissioner for Health, Sokoto state Mrs Amina Abubakar Abdu- Ag. Commissioner/PS Ministry of Health Bauchi State Mr Obi Oluigbo - Director of Programs, Society for Family Health Mr Abdullahi Maiwada – Senior Program manager Reproductive health, USAID

2. Presentation outline Demographic and health indices Implementing structure. Strategic focus Supporting documents Key features of FP programme Challenges

3. Federal Republic of Nigeria: States and Zones

4. Demographic and health indices Population- 140million (census 2006) 250 Ethnic groups and 470 languages WRA- 30million Population of under 15 constitute 45% of the population Growth rate- 2.83% TFR- 5.7 average with variation,4.7 urban area,6.3 rural area. (NDHS 2008) MMR- 545/100,000livebirths (NDHS 2008) Under 5 mortality -157/1000 live births (NDHS 2008) Total CPR – 15%,CPR modern methods-10% Unmet need-20%, 15% for child spacing,5% limiting births. Sero-prevalence HIV/AIDS- 4.4% Sentinel survey.

5. Implementing structure Federal level Leadership Policy/guideline formulations Coordination Provision of technical Assistance to States Monitoring/Evaluation. State level 36 States and FCT,Abuja LGAs 774 LGAs and 6 Area councils. Development partners- WHO, UNFPA, USAID, DFID.

6. Strategic focus Integrated approach to service delivery. Health system strengthening (Refurbishment of PHCs, Provision of basic equipment and recruitment and deployment of skilled health workers to health facilities (midwives service scheme). Community mobilization and engagement

7. Supporting documents National Population Policy for Development Revised RH Policy Adolescent health and development policy Family planning service protocol in line with 2008 WHO MEC. Integrated Maternal Newborn and Child health Strategy (IMNCH) National Strategic Health development Plan (NSHDP) National Health Bill. Surveys- NDHS(2008), NARHS (2007).

8. Key features of FP programme Integrated Maternal Newborn and Child health (IMNCH) budget line 2010. Functional contraceptive logistics management system with user fee. Forecast of 5years contraceptive requirement. Training of Clinical service providers on Contraceptive technology and Commodity logistics. Partnership with notably NGOs- PPFN,SFH,ARFH Inclusion of FP service in National health Insurance scheme/CBHIS

9. Key features of FP programme Community based Depo- provera injectable contraceptive method-piloted in Gombe state 2 LGAs (Funakaye and Yalmaltu/Deba) Pilot use of standard days method using plana Cycle beads. Community level intervention on demand creation, referral and access to services in 22 States of with high unmet need in Family planning.

10. Challenges FP programme largely donor driven. Inadequate resources for procurement of quality contraceptives, capacity building of service providers Inadequate skilled health workers for provision of long term methods IUD and Implants Inadequate demand creation activities. Socio-cultural inhibitions Lack of male involvement. Weak partnership with private health facilities.

11. Solutions Increase budgetary allocation for FP Scale up of Community based distribution of FP services. Strengthen demand creation activities

12. Nigeria- Culture and Tourism