World Population Day: Nigeria introduces new contraceptive
• Also launches two major FP documents
Nigeria formally introduced a new contraceptive, Depot Medroxyprogesterone Acetate (DMPA-SC) as she joined other countries to mark the global World Population Day recently.
The government also launched two documents, the Accelerated Introduction and Scale-Up Plan 2018-2022, and “Global Family Planning Visibility and Analytical Network/National Logistics Management Information System (NAVISION) in collaboration with the United Nations Population Fund (UNFPA) and other partners.
DMPA-SC is a modern family planning method that combines the contraceptive drug and needle into a single unit. It is a highly effective and convenient injectable contraceptive that is administered under the skin (subcutaneous)
It is a single dose which lasts three months and can be administered in low-resource, non-clinic settings by lower-level trained cadre of frontline health care workers such as Junior community Health Extension Workers (JCHEWS), Proprietary and Patent Medicine Vendors (PPMVs) and Community-Based Distribution (CBD) agents, or even by women themselves.
Globally, contraceptive use has been shown to prevent unwanted pregnancies, reduce abortion rates, and lower the incidence of death related to maternal causes. Contraception has promoted prosperity among households and has helped them planned their lives better.
Speaking at the launch in Abuja, Minister of Health, Prof. Isaac Adewole, said the Nigerian government “is committed to harnessing the potentials of DMPA-SC to expand access to family planning services by improving access to injectable contraceptive in an effort to accelerate achievement of a national contraceptive prevalence rate (CPR) goal of 27 percent by 2020.” Nigeria’s current CPR is 15 percent.
Adewole, who was represented by Director of Family Planning in the ministry, Dr Adebimpe Adebiyi, said the plan to introduce the DMPA-SC is driven by the need to ensure contraceptive information and services reach women and adolescent girls that want to avoid pregnancy, space or limit child births, especially those who have been unable to access them.
In addition, there is the urgent need to ensure that the current unmet need is drastically reduced so Nigeria’s commitment to reach a CPR of 36 percent by end of 2018 is realized.
The aspiration of the national scale-up is to have adequate number of trained FP providers both at the facility and community levels to support provider injections as well as self-injectable services in all sections of the country by the end of the year 2020.
“Efforts will continue until the entire country is covered and DMPA-SC is made available everywhere. This plan has been projected to cost about $111.3 million,” a document made available to newsmen at the launch said.
The government also launched the Nigerian Health Logistics Management Information System (NAVISION) at the event.
Minister of Health, Prof. Isaac Adewole said NAVISION would serve as a platform to capture and use supply chain data from multiple sources and organizations to pursue the nation’s reproductive health agenda.
The overall objective, he said, was to have a platform that would promote more timely and cost-effective delivery of FP commodities and other health commodities in such a way that more women were reached with the right products where they lived and worked.
He added that NAVISION would support better coordination and improvement in limited healthcare resources allocation.
“Integrating all donor health commodities into the NAV platform clearly aligns with NSCIP’s long term goal of achieving one nationally integrated health commodity supply chain system and the GON’s commitment to track stock status, predict and prevent stock-outs and wastages as well as mange the warehousing and transporting processes more efficiently and with greater cost effectiveness.
“The system, when fully deployed, will help to improve service delivery by eliminating stock-outs and wastage; provide and-to-end by leveraging technology over manual systems; reduce overall fully landed cost of commodities by optimizing flow of commodities through the national system and improve donor confidence by providing continuous insight into stock status and key performance indicators,” the minister stated.
Closely linked with NAVISION is the Global Family Planning VAN. Nigeria has the ambition to create sustainable end-to-end visibility into the health commodities supply chain as part of its broader strategy, says the document provided by the government on the launch.
“Nigeria has been working to integrate its supply chain through the Nigeria Supply Chain Integration Project (NSCIP) Data visibility/integration has been identified as the core quick win over inventory management solutions in the medium to long term…
“The Global FP VAN will bring together, people, processes, policy and technology to transform the way our community makes supply chain decisions. From the people side, it will link procurers, manufacturers, shippers and countries in an active network focused on product flow into countries.
“In terms of technology, the platform will capture data from many sources, facilitate data harmonization and consolidate tools for network members to use.
“New processes will transform how these members interact, analyze data, and make decision.
“There will be harmonized policies that govern data-sharing ad use. The Global FP VAN will offer a platform to collectively estimate and prioritize supply needs, take actions when supply imbalances loom, and advocate for funding when necessary.
“Eventually, a well-functioning Global FP VAN will lead to more timely and cost-effective delivery of commodities; more women reached with the right product at the right time, and a better allocation of limited health resources. …..
“Access to essential medicines is critical to achieving universal health coverage, and is also recognized as a key building block for a strong health system.
“Medicines and health products are important for addressing human health problems and for improving quality of lives. They form an indispensable component of health systems in the prevention, diagnosis and treatment of disease and in alleviating disability and functional efficiency.
“Critical stakeholders, not limited only to supply chain, have over the years recognized the need to improve the pharmaceutical and health product management practices in the country, noting that a number of challenges still hinder proper access to healthcare.
“The current supply chain system in Nigeria is faced with some major challenges including stock-outs of contraceptives that continued to be experienced in a number of health facilities; expiries are also recorded in some state stores and facilities; warehouses and distribution systems not meeting minimum standards; and decreased visibility in reporting across disease areas.
“Others are multiple supply chains that are often not very well coordinated have been used to address the immediate needs for access to health care products, which have also created some challenges on the other hand; and inefficiencies due to poor coordination/integration/harmonization are evident including duplication of some supply chain activities.
“In the face of shrinking development resources, reaching 120 million new contraceptive users by 2020 will require more effective and efficient family planning supply chains. Getting there hinges on strengthening supply chain visibility. Good visibility means ‘seeing’ where commodities are through data such as planned orders, shipment progress from manufacturer to country, and country-level inventory and demand data.
“The RH community has over 10 years of experience in putting in place the people, processes, policies and tools to promote supply chain visibility a collaborative decision-making between governments, donors and manufacturers,” he added.
In a remark on behalf of the UNFPA, Reproductive Health Analyst for the organization, Dr. Titi Duro-Aino, commended the government over its effort to harnessing the potentials DMPA-SC in order to improve access to Family Planning.
The plan to introduce DMPA-SC, she explained, is driven by the need to ensure contraceptive information and services reach women and girls that want to avoid pregnancy, space or limit child births; especially those who have been unable to access them.
According to her, UNFPA supported the government to pilot the use of DMPA SC with funding from Bill & Melinda Gates Foundation and Children Investment Fund Foundation in 2017 in selected Local Governments Areas across 10 states in Nigeria. The pilot implementation, she furthered, led to almost 90,000 new family planning acceptors.
“I wish to therefore reiterate UNFPA’s unflinching commitment to support the Government of Nigeria in delivering equitable and universal access to sexual and reproductive health particularly family planning and maternal health services and to congratulate the Government on the launch of these documents aimed at reducing preventable deaths among women and children,” she said.
Speaking at the launch, President and Chief Executive Officer, Association for Reproductive and Family Health (ARFH), Prof. Oladapo Ladipo, said: “I think we should celebrate ourselves today on the launch of these important documents that bother on universal access, campaign tools for monitoring and ensuring that there is contraceptive available for everybody, both in the rural and urban areas.”
He added: “I think they should package these documents for every department of O&G, every nursing department, every school of health technology, every Ministry of Health, every Ministry of Women Affairs.”
Similarly, a senior official with Marie Stopes, Mr Bola Kusemiju, said at the launch: “for health workers and for all of us who are working in the area of health, we need policy documents, documents developed, produced with the stamp of authority of Federal Ministry of Health for us to be able to do our job very well.
“Three of such were launched today. But, especially, these document, or you call them tools, the primary aim is for health workers to use them as reference to the extent of reducing maternal deaths in the country. That is the bottom line of the documents that we have seen, being launched today.”
“Number one, you have more recent data in the documents. Number two, you have one in particular that is the first of its kind to be found in Africans. Number three, we want consistency in the work of health workers. The way the problem is treated in the north should be the same way it is treated in the south. Such references, you find them in these documents.”