Family Planning: Nigeria is making progress – Ejike Oji
From a zero budget, not too long ago, to U$ 4 million in 2017, Nigeria seems to be making some progress, albeit slowly, in the provision of access to family planning in the country, the Chairman, Association for Advancement of Family Planning (AAFP) Dr. Ejike Oji, tells NHO Bureau Chief, MARCUS FATUNMOLE in this interview during the just-concluded FP 2020 Reference Group meeting in Abuja. Oji, who is the Civil Society Organizations’ Focal Person for FP 2020 in Nigeria, and led the CSOs to the meeting, among others, commended efforts of the Federal Government and other partners in driving family planning programmes in the country. Excerpts:
In what ways do you think Nigeria can help in achieving FP 2020 which targets additional 120 million users of contraceptives across the world?
FP 2020 is a global push. At the end of the day, we will drive it down to what will be Nigeria’s contribution to that success that we are expecting by year 2020. But, if you look at what has happened so far when the mid-point evaluation was done last year, it showed that additional 30 million women have already started using family planning service since the FP 2020 Summit in London. Even though, unfortunately, in 69 poorest countries in the world, there hasn’t been much really happening, including Nigeria.
When you look at what is really happening on the national scene, first of all, you need to ask yourself, is the will there? And, how can you gauge whether the will is there? First, you come to the policy statement. Second, it comes with putting your money where your mouth is. The Federal Government, during the last administration, made family planning services free. The minister at that time, Prof Onyebuchi Chukwu, was able to get government, with support from AAFP, to make family planning free.
And, the next thing was not just making it free; you have to also cashback it. The Federal Government agreed to put $3 million. Before, it was zero budgeting. So, they put $3 million, which was a quantum jump from zero to three million. So, development partners, UNFPA, USAID majorly including other organizations have been taking the remaining part of our family planning commodities.
Some years ago, the Federal Government also went ahead to do costed implementation plan to find out really how much this would cost the country to enable it meet its goals. Our internal target is that by 2018, Nigeria should attain a CPR of 36 percent. So, they have done that. This year, during our family planning conference, the Minister of Health made a proclamation that they are going to increase the budget from $3 million to $4 million. And, that has happened. That was the commitment they made again at the FP 2020 in July – that Federal Government would increase its budgetary allocation to family planning.
The other thing is that there are three levels of governance in the country, federal, state and local government. At the sub-national levels, we are now saying there should be push at those levels. The Federal Government has done its part, they purchased the commodities, shipped it to the states, but the last mile concept, which is taking the commodities from the warehouses to the service centres and make sure the women get the services is what the state and local government can do. That is where the most of the advocacies, including from the Federal Government, should go to.
Are we making any progress?
The answer is yes. A journey of a thousand miles starts with a step. We started first of all from zero allocation, three million dollars to four million dollars. We know that our contraceptive prevalence rate has stagnated at 10 percent for almost 10 year. In fact, the last one they did was 9.8 million. But, it’s not so as bad as we think. Track 2020 did a survey, and they brought out a mid-survey result which is not final yet. They are saying don’t quote us yet. But, they are saying that there is an increase of about 14 to 20 percent in some places. That means that our contraceptive prevalence rate will increase. In the next six months or so, they will come up with the final result. And, that will tell us whether we are doing well or not. But, I would say, religion and culture are major barriers, apart from myths and misconceptions.
Given the fact that the bulk of monies for family planning go to procurement of contraceptives which are purchased outside Nigeria, don’t you think we can begin to produce these commodities locally?
I am somebody that thinks of small government at all times. The only thing government can do is to put an enabling environment. But, if you look at the cost of family planning, for you to be able to make a profit, you have to produce in scale so that you have a volume that will have effect on the pricing. So, I don’t know whether Nigeria is consuming enough to be able to produce in the volume that will satisfy our demand.
And, remember, that this is something that the private sector has to be involved in. if there is any body you will be talking to, it is the private sector. And, one of the key things in terms of supporting what you are saying is that if the private sector can make dialogue with the government and government says ‘whatever you produce, we are going to buy,’ they know that they have a ready market in Nigeria they (will) put their money there; knowing that they can get customers when they produce. So, it is a very good and important step that we’ll also be taking. There are a lot of dynamics, it is not just pushing it, but, also making sure that it is something that will be economically viable for sustainability.
How would you react to religious belief that the use of contraceptives is a sin?
What else do you expect a cleric to say? No cleric, especially a Catholic cleric, will come in the open and tell you that the Catholic Church is embracing modern methods of family planning. But, go to the women, Catholic women, whether they are using contraceptives or not. That is where the truth is. We’ve done a lot of survey which showed that regardless of what the priests are saying, women know what is good for them. That is, for me, the most important thing is to give women information to enable them make decisions for themselves. That is where education comes in. Education is such a vaccine to people taking information and making use of that information. If you do a survey, I don’t want to keep repeating it, SOGON did a survey years ago, 49 percent of unwanted pregnancies are among the Catholic. It is there to see.
We are not fighting anybody. We are not condemning anybody. The Catholic are also part of the Family Planning inter-faith forum (we are attending here) What they are saying is that we should use natural method. But, we are saying that natural method: Yes. It is good to use it. But, how many people even know how to teach it? Research also has shown that its failure rate is very high. And, when its failure rate is high, it means that you have unintended pregnancy. And, when you have unintended pregnancy, it either becomes wanted or unwanted. And, you know what normally happens when it becomes unwanted.
So, everybody has his brain, his cognitive power to make decision for himself or herself. That is why we continue to talk and talk. They say a word is enough for the wise. I don’t want to be joined in the politics of the Catholic or Muslims. The politics I’m interested in is what I tell the women. I work with nine women groups, and I have found out that once you give women the information, they take decision that is best for themselves.