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Nigeria is the most populous country in Africa and family planning remains a heavily stigmatized – and often misunderstood – topic. Hundreds of thousands of women die in childbirth every year and, still, most couples do not use contraception or consider family planning.
Over a four-year period, the Johns Hopkins Center for Communication Programs’ Nigerian Urban Reproductive Health Initiative (NURHI) was associated with a 10 percentage-point increase in the use of modern contraceptive methods and a similar increase in the desire of women to have fewer children. This means that, because of NURHI, an additional 350,000 more families in six cities are now using modern family planning methods.
NURHI tackles both the supply of and demand for modern contraception. It works with health care workers and within community clinics to improve health care quality and access to contraception, ensuring there is adequate supply of these services. More importantly, NURHI works simultaneously with community and religious leaders, government officials, and even popular singers, using communication to explain the benefits of family planning and making it an ordinary, socially accepted part of Nigerian life – fostering demand for family planning services.
From 2009 to 2015, NURHI operated in six cities (Abuja FCT, Benin City, Ibadan, Ilorin, Kaduna and Zaria), each of which saw a pronounced increase in contraceptive use thanks to the initiative. Because of the impressive results, the Bill & Melinda Gates Foundation (along with an anonymous donor) extended the funding through 2020. This second phase operates in three Nigerian states (Lagos, Kaduna and Oyo). NURHI’s success also provides the foundation for a new Gates-funded project called The Challenge Initiative.
In its first two years, NURHI’s second phase has:
The Bill & Melinda Gates Foundation; anonymous donor
Centre for Communication and Social Impact; Association for Reproductive and Family Health