Improving Access to Contraception in Akwa Ibom State, Nigeria

Task-Sharing Provision of Injectable Contraceptives and Implants with Community Health Extension Workers

Pathfinder’s Evidence to Action (E2A) Project and Pathfinder/Nigeria worked with the Akwa Ibom State Ministry of Health, from November 2015-December 2016, to train Community Health Extension Workers (CHEWs) in two Local Government Areas (LGAs) to provide implants and injectable contraceptives (DMPA) in facilities, and increase demand for both contraceptive methods through community-based outreaches.

E2A documented the interventions in Akwa Ibom through the collection and analysis of quantitative data from the Heath Management Information System, and qualitative data from key informant interviews and focus group discussions with CHEWs and facility heads where the interventions took place. This technical brief is a product of that documentation process and demonstrates the impact of those added capacities on contraceptive availability and uptake in the two LGAs of Akwa Ibom.

The evidence in this brief is meant to support efforts to operationalize the national task-sharing policy in Nigeria by showing how the policy can be applied at the state level to meet unmet demand for contraception. This brief accompanies an operations research study conducted by E2A in Cross River and Kaduna states of Nigeria, which shows that implant provision can be task-shifted to this cadre while achieving the same levels of client satisfaction and volumes of contraceptive uptake as previously provided by nurses or midwives. The operations research study is being finalized.