November 13, 2015
Written by Jhpiego Kenya, Nigeria & Zambia
The Apkans, like many couples in Nigeria, were wary of contraception. Myths about methods of family planning (FP) had reached them—from the purported negative effects on women’s sexuality to the potential for reduced fertility. None of these myths are true, but the Apkans didn’t know that. Luckily, nurse-midwife Uduak Okum was prepared for their skepticism. Thanks to a six-day Jhpiego-supported training on long-acting and reversible contraceptives (LARCs), she had the knowledge and skills to counsel the unsure couple, who ended up accepting an implant. Her success with the Apkans motivated her to do more to promote FP—particularly among men. Okum believed engaging men in FP could rapidly expand access to modern contraceptive methods. And she’s right: according to the United Nations Population Fund, husbands and male partners greatly influence women’s reproductive choices. Involving men often means overcoming cultural, social and gender barriers prevalent in Nigerian society. So Okum set out to confront FP myths with culturally appropriate, fact-based information about contraception. She reached out to men and women in salons, church meetings and other social gatherings. “I also organized [educational] sessions in the outpatient clinic, child welfare clinic, antenatal clinic and postnatal ward,” Okum said. Together, these efforts resulted in greater awareness of FP services at the hospital, and even led to the relocation of the existing FP unit to a larger facility within the hospital. “We now have new male, female and youth acceptors of family planning,” the nurse-midwife said proudly.
After learning of the benefits of LARCs through Jhpiego’s work, nurse Nomsa Zinti was eager to share her new knowledge and skills with the women in her community. To expand access to FP services and make them more convenient, Zinti dedicated certain days to LARCs and they were a hit. Prior to Zinti’s innovative idea, women needed to walk as many as 12 kilometers to reach a health post that offered LARC services, only to sometimes find that the health care provider on duty was unskilled at providing an intrauterine device or implant. When Zinti’s health center began offering the new service, the response was overwhelming. Zinti struggled to keep up with demand. She didn’t want women leaving without being seen or without receiving a contraceptive method of their choice. Undeterred, Zinti decided to integrate LARC counseling with child health care, antenatal visits and other health services. As a result, 100 women in three months received implants, thanks to Nurse Zinti. That’s innovation with impact!
Charge Nurse Margaret Amutala returned from an implants training and noticed that her facility lacked enough job aids and other informational and educational resources for both health care providers and clients. She was so energized by how much women could benefit from contraceptives that she even developed her own job aids based on the reference materials provided to her at the training and all that she had personally learned. The materials have helped service providers at her facility remember the key counseling messages on the benefits of FP, including implants. Thanks to Amutala, more women and families will receive the information they need to make wise choices about their health and their future. The challenges that health care providers face to bring high-quality FP and contraceptive choice to women and families across the world are broad and varied, but we know that health workers have the passion and skills to innovate, strategize and fight for their clients’ futures.