Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study

Abstract

ObjectiveIn Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers.MethodsA qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria.ResultsProviders support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services.ConclusionsThe family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

A Systematic Review of the Role of Proprietary and Patent Medicine Vendors in Healthcare Provision in Nigeria

“…Mystery client visits indicated that less than 15% of customers purchasing birth control pills were informed about side effects [ 40 , 78 ]. Some PPMVs expressed the need to maintain good communications, discretion, and confidentiality when dispensing family planning products to young customers [ 63 ], however others indicated that they may exclude youth and unmarried customers from receiving family planning services [ 79 ].…”

Contraceptive service provider imposed restrictions to contraceptive access in Urban Nigeria

“…Client use of FP services in Pakistan has been associated with FP training experience of providers [21]. Prior research from Nigeria has indicated that family planning (FP) training among providers offering FP is actually rare [11]. …”

“ Doctors are in the best position to know …”: The perceived medicalization of contraceptive method choice in Ibadan and Kaduna, Nigeria

“…Evidence also exists of health facility barriers in method choice, including staff levels, expired stock, provider bias, and lack of training in Nigeria and other developing countries [3] , [17] , [18] , [19] . The general medicalization of family planning and the clinic-based nature of distribution has been criticized as a barrier to increasing levels of contraceptive use [20] , [21] , [22] .…”