OYO STATE FAMILY PLANNING/ CHILDBIRTH SPACING SERVICES OYO STATE Advocacy Kit
Nigerian Urban Reproductive Nigerian Urban Reproductive Health Initiative Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
POLICY BRIEF
Oyo State Health Indices Contraceptive Prevalence Rate: 37.4% Unmet Needs: 13.2% Infant Mortality: 69/1000 HIV/AIDS Prevalence: 3% Maternal Mortality Rate: 262/100,000 live Births
Total Fertility Rate: 4.5 2013 NDHS
OYO STATE POLICY BRIEF Oyo state prides herself as a pace setter in social, cultural and economic development. However the health indicators need a lot of improvement to keep the pace setter status.
Oyo state has 262 maternal deaths per 100,000 live birth annually These maternal deaths are preventable with the use of reliable and appropriate interventions including family planning/ childbirth spacing (FP/CBS) services. Infant mortality stands at 69 deaths per 1,000 live births The unmet need for contraceptive use is 13.2% While the contraceptive prevalence Rate (CPR) is 37 .4%
How to Improve Contraceptive Use in Oyo State.
The Need for Specific Budget Line for Family Planning/ Child Spacing The NHIS and under 5/MDG fund initiative introduced by Oyo State as well as the new Health Insurance Agency provide a window of opportunity to mainstream FP/CBS in order to reach the undeserved and less privileged.
There is the need to incorporate a specific budget line by creating a sub-code in the newly introduced IPSAS policy for FP/CBS programs. The continuous release of funds will create a huge opportunity to sustain FP services.
Nigerian Urban Reproductive Health Initiative Adequate funding for FP/CBS is needed for logistics, capacity building, supervision, monitoring and demand creation to achieve improved uptake of FP/CBS Services.
The State Government to pass into law the state Reproductive Health Bill. The delay in passing the bill compromises the recognition of FP/CBS as a critical component of maternal health interventions. This further compounds the problem posed by the lack of a specific budget line and sustained release of Funds for FP consumables and services.
CONTRACEPTIVE USE
No Method 24.4% 62.6% Modern Method 13.0% Traditional/ folkloric Methods Unmet need to space/Limit is 13.2%
ACTIONS REQUIRED Create Budget Line
Increase and release budgetary allocation for family planning/ childbirth spacing services to support capacity building, equipment , supportive supervision, monitoring, demand creation, procurement of consumables and other logistics.
Approve and pass RH Bill and other enabling laws to help the effective delivery of family planning services.
Promote and strengthen public private partnership for family planning/ childbirth spacing programs and services.
Nigerian Urban Reproductive Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
FACT SHEET
The Current Situation At State and L.G.A levels Family Planning funding is almost non existent necessitating illegal charges by providers The total population of women of reproductive age group (15 to 49 years) in Oyo State is 1,633,333 (2015 projection) and out of this, about 262 maternal deaths per 100,000 live births are recorded annually. Although Oyo State Health Indices this is lower than the national average, it is still Contraceptive Prevalence Rate: 37.4% unacceptably high considering the level of literacy and social economic development of the State. Unmet Needs: 13.2% Infant Mortality: 69/1000 FP/CBS programs are underfunded at all levels in the HIV/AIDS Prevalence: 3% State and so cannot provide products and services to Maternal Mortality Rate: 262/100,000 those who need them. This is further worsened by the live Births dearth of skilled health providers at service delivery Total Fertility Rate: 4.5 points. Although Family Planning commodities are free, 2013 NDHS family Planning services are still being charged for, because of non availability of consumables which are necessary for the provision of Family Planning services. CURRENT GOVERNMENT INTERVENTIONS WORTHY OF NOTE: FP/CBS services are provided at all the three levels CONTRACEPTIVE USE of health care delivery.
No Method Free supply of FP commodities by Government and 24.4% partners. 62.6% Modern Method 13.0% Establishment of the State Health Insurance Agency Traditional/ folkloric (SHIA). Methods The free health care policy for pregnant women, Unmet need to space/Limit is 13.2% children under 5, widows and the aged in all the L.G.As
Nigerian Urban Reproductive Health Initiative CHALLENGES Implementation of the adopted National Health Policies is still being hampered due to delay in passing the Reproductive Health (RH) Bill into law. Family Planning is not seen as critical component of Maternal Health Interventions. Lack of a specific budget line and non release of funds for FP/CBS programs and services at State and LGAs. The State FP/CBS blueprint is yet to be launched. When the document is launched, it will provide the roadmap to the implementation of FP/CBS in the State with appropriate funding. ACTIONS REQUIRED
Incorporate Family Planning/ Childbirth Spacing Services into existing National / State Health Insurance Scheme.
Increase budgetary allocation and ensure prompt release of funds for FP/CBS at all levels of government.
Adopt, pass and implement the Reproductive Health (RH) Bill.
Update FP/CBS equipment and infrastructure to improve the provision of high- quality services.
Promote the integration of FB/CBS into all health and development programs.
DEFINITION OF TERMS
Family Planning/ Childbirth Spacing- An informed decision by an individual or a couple on how many children to have and when to have them and using modern contraceptive methods to adequately space pregnancies. Maternal Mortality- Death of a woman while pregnant, within 42 days of childbirth or termination of pregnancy. Contraceptive Prevalence Rate- Percentage of women between 15-49 years who are practicing or whose sexual partners are practicing any form of contraception. Urban Poor- Women of reproductive age in the poorest, poorer and middle wealth groups (as defined by NDHS) living in urban areas. Reproductive Age: Generally defined as women aged 15-49 years and men 15- 59 years. Contraceptive- A device or drug which can be used to delay/ space pregnancy by preventing conception. Safe Motherhood – A set of interventions that work to ensure the survival, health and well being of a mother and her newborn from conception through childbirth and infancy. Also includes the transference of meaningful information and skill to achieve adequate spacing and number of pregnancies according to the desires of the mother. Unmet Needs- the percentage of persons of reproductive age who want to use contraceptives but do not have access to them either due to unavailabity or lack of information. High Risk Pregnancy- A pregnancy where the mother is younger than 18 years or above age 35 years or where the time from the last birth to the next is less than 24 months apart or where the parity ( Number of pregnancies resulting in delivery) is 5 or higher.
Nigerian Urban Reproductive Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
ROLE OF THE LEGISLATURE
Oyo State Health Indices Contraceptive Prevalence Rate: 37.4% Unmet Needs: 13.2% Infant Mortality: 69/1000 HIV/AIDS Prevalence: 3% Maternal Mortality Rate: 262/100,000 live Births
Total Fertility Rate: 4.5 2013 NDHS
The weak implementation of family planning/ childbirth spacing (FP/CBS) programs at the state CONTRACEPTIVE USE and local government levels is largely due to inadequate funds as there is no specific budget line No Method for FP/CBS programs. 24.4% 62.6% Modern Method 13.0% The State Government has developed its own RH bill Traditional/ folkloric which reflects the national policies but awaiting Methods passage into law. The delay in passing the bill Unmet need to space/Limit is 13.2% compromises the recognition of FP/CBS as critical component of maternal health intervention. This further strengthens the problem posed by the lack of specific budget line and the sustained release of ACTION REQUIRED funds for capacity building, supportive supervision, nEnsure the passage of the RH Bill and enact all other monitoring, demand creation, procurement of relevant laws that would ensure availability of high consumables and other logistics. quality Family Planning/Childbirth Spacing programs and services.
Appropriating more funds in the State health budget nAppropriate more funds in the State Health Budget for for FP/CBS intervention will scale up the quality of Family Planning/Childbirth Spacing interventions to FP/CBS programs and activities. cover supplies, equipment, infrastructure, commodity logistics and management system, supervision, training of healthcare providers and demand creation. Enacting and supporting enabling laws to back effective FP/CBS programs is required for the State to nEnsure that the approved budget is efficiently used for attain the Sustainable Development Goals (SDGs) Family Planning through oversight functions. particularly of FP/CBS particularly goals 1-5.
Nigerian Urban Reproductive Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
ROLE OF COMMUNITY & RELIGIOUS LEADERS
Oyo State Health Indices Contraceptive Prevalence Rate: 37.4% Unmet Needs: 13.2% Infant Mortality: 69/1000 HIV/AIDS Prevalence: 3% Maternal Mortality Rate: 262/100,000 live Births
Total Fertility Rate: 4.5 2013 NDHS
Community and religious leaders have significant “Islamic teaching is ever in support of family planning in influence on their community members. They are that, it is meant to help create a conducive family set up recognized as custodians of community values as such that will make you live well in this world and as well be they tend to influence the attitudes and behaviours of able to perform good.... Islamic scholar in Ibadan. members of their communities. Community members in Further readings: Qur’an, 2:233; Qur’an 2:286 turn expect their leaders to take actions that will improve “God's concept in creation is to bring about a system that their health and quality of life. Therefore, community and is to be managed under a secured control with the religious leaders have a special stake in ensuring the instinct of the people. Hence, he commanded; …. “be health and well- being of the people they lead. fruitful and multiply and replenish the earth, and subdue it: and have dominion (control)…” Genesis 1:28 Social and cultural beliefs in some communities inhibit Further reading 1 Timothy 5:8,- Pastor P.O. Oloyede. the use of modern family planning / childbirth spacing services (FP/CBS). This is further compounded by ACTION REQUIRED disagreements and unclear religious teachings on issues nMake public statements in support of Family Planning/ concerning FP/CBS. Childbirth spacing services. nMainstream FP in Social and Religious talks Studies have shown that FP/CBS can avert high risk nSupport Community Health campaigns to ensure community members have access to information and education, health pregnancies and consequently reduce maternal death by and development issues. 40 %(Cleveland J. et al. July 2012 Lancet: Contraception nEngage legislators in their domain to enact laws for the and health, Vol.360 No 9637 pg. 149-156) provision of free comprehensive maternal and child health services including Family Planning/Childbirth spacing services at all Community and Primary Health Care facilities FP/CBS is critical to improving maternal health; therefore, nAdvocate for the staffing, equipping, and funding family it is pivotal to all maternal and child health interventions. planning childbirth spacing clinics at all Community and Primary Healthcare facilities. The health and well being of the women is closely linked nEncourage Community members to utilise family to the health and well-being of the family and the planning/childbirth spacing services to reduce maternal community. mortality and improving the health of mothers and babies.
Nigerian Urban Reproductive Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
ROLE OF HEALTH SECTOR POLICY MAKERS
Oyo State Health Indices Contraceptive Prevalence Rate: 37.4% Unmet Needs: 13.2% Infant Mortality: 69/1000 HIV/AIDS Prevalence: 3% Maternal Mortality Rate: 262/100,000 live Births
Total Fertility Rate: 4.5 2013 NDHS
In Oyo State about 262 maternal deaths per 100,000 The current implementations of the National Health live births occur annually. These maternal deaths Insurance Scheme Under 5/MDG Fund initiative in are preventable with the use of reliable and six LGAs (Ibadan South East, Ibadan North East, appropriate interventions including modern Family Ogbomoso North, Atiba, Iseyin and Saki) provide a Planning/Childbirths Spacing (FP/CBS). Family window of opportunity to mainstream FP/CBS at all Planning (FP) can avert high risk pregnancies and levels of Maternal Health Care especially to reach consequently reduce maternal deaths by 40% the rural and urban vulnerable groups. (Cleveland J. et al. 2012. Family Planning: Contraception and Health. Lancet volume 380, No Enacting and supporting laws to back effective FP/CBS programs will contribute significantly to the 9837, Page 149-156). FP/CBS is critical to improving achievement of other health and Sustainable maternal health. It should therefore be pivotal to all Development Goals (SDGs). maternal and child health interventions. Oyo State Government has adopted many of the ACTION REQUIRED existing national health policies including the nApprove the integration of FP services into the State Reproductive Health Policy but implementation had Health Insurance Scheme and the existing free Maternal, been a major challenge. This is due to the absence of Neonatal and Child Health care programs. a law to give backing to the full implementation of nFacilitate increase and ensure prompt release of budgeted these policies, which RH Bill is meant to achieve. funds for FP services for the purpose of capacity building, supportive supervision, monitoring, demand creation, Another challenge is the non-recognition of family procurement of consumables and other logistics. planning as a critical component of maternal health nEngage the legislature as a matter of urgency to approve interventions. This is evident in the lack of specific and pass the Reproductive Health Bill and other enabling laws that would help in the effective delivery of FP budget line and non - release of funds for FP/CBS services. programs and service at all levels of intervention in nMake recommendation for the recruitment of skilled FP the State and further compounded by illegal charge providers. of fee for FP due to non-availability of consumables.
Nigerian Urban Reproductive Health Initiative HEALTH SECTOR POLICY MAKERS, OYO STATE Oyo State records about 262 maternal deaths per 100,000 live births annually. These deaths are preventable with the use of reliable and appropriate interventions including modern family planning which is critical to improving maternal health.
The Oyo State Government has adopted the National Reproductive Health (RH) Policy, however the implementation of this policy has been a challenge. The absence of a law to give backing to the full implementation of the RH Policy has hindered its progress. OYO STATE HEALTH INDICES Contraceptive Prevalence Rate - 37.4% Unmet Needs - 13.2% Infant Mortality - 69/1000 Maternal Mortality(MMR) - 262/100,000 live births Total Fertility Rate - 4.5
CONTRACEPTIVE USE
No Method 24.4% 62.6% Modern Method 13.0% Traditional/ folkloric Methods
Unmet need to space/Limit is 13.2%
CHALLENGES Non recognition of family Planning as a critical c omponent of maternal intervention as evident in the non- creation of specific budget line and non release of funds for family planning and child spacing
Nigerian Urban Reproductive Health Initiative HEALTHY FAMILY, HEALTHY STATE. FAMILY PLANNING/ CHILDBIRTH SPACING
ROLE OF THE EXECUTIVE
OFFICE OF THE GOVERNOR
Oyo State Health Indices Contraceptive Prevalence Rate: 37.4% Unmet Needs: 13.2% Infant Mortality: 69/1000 HIV/AIDS Prevalence: 3% Maternal Mortality Rate: 262/100,000 live Births
Total Fertility Rate: 4.5 2013 NDHS
Developing effective and sustainable policies as well as CONTRACEPTIVE USE laws on Family Planning programs and activities are critical in achieving the Sustainable Development Goals (SDGs) that seek to improve maternal health and No Method standard of living, particularly SDGs 1 to 5. 24.4% In Oyo State about 262 maternal deaths per 100,000 live 62.6% Modern Method births occur annually. These maternal deaths are 13.0% unnecessary and preventable with the use of reliable and Traditional/ folkloric appropriate interventions including modern family Methods planning/childbirth spacing (FB/CBS) services. Access to standard FP/CBS can avert high risk Unmet need to space/Limit is 13.2% pregnancies, reduce morbidity and consequently reduce maternal deaths by about 40%. FP/CBS is critical to improving maternal health, therefore it is pivotal to all maternal and child health interventions. (Cleveland J. et ACTION REQUIRED al. 2012. Family Planning: Contraception and Health. nApprove the integration of FP Services into the State Lancet volume 380, No 9837, Page 149-156). Health Insurance Scheme and the existing free Maternal, The current implementation of the National Health Neonatal and Child Health care programs. nIncrease and ensure prompt release of budgeted fund for Insurance Scheme Under 5/MDG Fund initiation in six Family Planning Services for the purpose of capacity LGAs (Ibadan South East, Ibadan North East, Ogbomoso building, supportive supervision, monitoring, demand North, Atiba, Iseyin and Saki East) should be expanded to creation, procurement of consumables and other logistics. cover the other LGAs of Oyo State through the State nEnsure that quality family planning services are provided Insurance Agency. through adequate staffing at all FP sites. nEngaging legislature as a matter of urgency to approve and This will provide a window of opportunity to mainstream pass the reproductive health (RH) bill and other enabling laws that would help in the effective delivery of family FP/CBS at all levels of maternal care particularly reaching planning services. the vulnerable groups in both rural and urban areas. nEnsure the implementation of the FP Blueprint.
Nigerian Urban Reproductive Health Initiative