This webinar highlighted how the Government, Clinical and non-clinical NGOs have successfully worked with the private sector to increase the provision of post-pregnancy family planning services.
Speakers:
1. Dr. Victoria Egunjobi (Reproductive Health Coordinator, Lagos State Ministry of Health);
2. Bolaji Oladejo (State Program Manager, IntegratE Project);
3. Dr. Odanye Omotunde Busayo (Technical Officer-Service Delivery, Post Pregnancy Family Planning Project);
4. Dr. Kayode Akinkunmi (Medical Director, @Life Fount Medical Centre).
Moderator:
Iyadunni Olubode (Nigeria Director, MSD for Mothers)
3. Agenda
AGENDA ITEM FACILITATOR ALLOTTED TIME
Welcome participants/Housekeeping Iyadunni Olubode (Nigeria Director,
MSD for Mothers)
3 mins
Introduce 1st Speaker 2 mins
Presentation 1: Post-Pregnancy Family Planning in the private
sector: Best practices and key learnings
Dr Victoria Omoera (Reproductive
Health Coordinator LSMOH)
5 mins
Introduce 2nd Speaker Iyadunni Olubode (Nigeria Director,
MSD for Mothers)
2 mins
Presentation 2: Post-Pregnancy Family Planning: Approaches to
working in the private sector
Dr Omotunde Odanye (Technical
Officer-service Delivery PPFP)
13 mins
Ice breaker session 1: Poll every where Mercy Ehinmidu (Program Associate-
Operations, PPFP)
2 mins
Introduce 3rd Speaker Iyadunni Olubode (Nigeria Director,
MSD for Mothers)
2 mins
Presentation 3: Partnering with the private sector to increase
the provision of post-pregnancy family planning services in
Lagos State
Bolaji Oladejo (State Program Manager
IntegratE)
13 mins
Introduce last Speaker Iyadunni Olubode (Nigeria Director,
MSD for Mothers)
2 mins
Field experience: Partnering with PPFP project- Our success
story
Dr Akinkunmi (Medical Director, Life
Fount Medical Centre)
5 mins
4. Dr Victoria Omoera
Dr. Victoria Omoera is the Reproductive Health
Coordinator, Lagos State Ministry of Health. She
holds a B.Sc. in Physiology, an MBBS and a Masters in
Public Health, all from the College of Medicine,
University of Lagos. She also holds a Post Graduate
Certificate in Health Economics from the University
of Aberdeen and is a Member of West African
College of Physicians and an Associate Member of
National Postgraduate Medical College of Nigeria.
She is a seasoned public health specialist with over
15 years of experience in the Lagos State Public
service.
Dr. Omoera has held several positions at the State
Ministry of Health including HMIS Officer, State
Malaria Control Program Officer and Coordinator,
Maternal and Perinatal Death Surveillance and
Response Program.
5. Overview of Lagos State
Smallest but most populous state in Nigeria
(23.305 million persons1), growth rate of
3.2% .
Any method of contraception (CPR) = 49.1
% of married women aged 15โ492
Modern contraceptive method (mCPR) =
29.1 %2
Unmet need for modern methods= 29.1%2
Demand satisfied for modern methods
amongst married women = 65.9%2
6. Health Service Delivery in Lagos State.
โข The private health sector is vibrant, it provides over 60% of healthcare services to the
populace
โข Presently, there are 3,519 registered private health facilities, with 337 public health
facilities (91% are PHCs)
โข The private sector is regulated at the State level by the Health Facility Monitoring and
Accreditation Agency (HEFAMAA).
โข In addition, the State recognizes non-clinical service providers who are also a part of
the private sector, their activities are regulated by the Directorate of Pharmaceutical
Services
The private sector is thus crucial in ensuring the State Government improves its
contraceptive prevalence rate.
7. Human Resources for Health in Lagos State
โข The Health system performance and its impact on health outcomes is influenced
significantly by the size, distribution, and skill mix of its health workforce.
โข FP service delivery suffers a major gap due to the unavailability of trained FP providers,
(for injectables and long-acting reversible contraceptives), which is presently the most
desired by women.
โข Despite the successes in training a larger pool of FP providers across both public and
private sectors, the proportion of FP-trained health workers to facilities providing FP
services remains inadequate.
โข Innovative high impact programming is therefore necessary to increase service delivery
points for FP and ensure high-quality services
8. Human Resources for Health in Lagos State
โข Health sector has a total of 38,340 health care workforce in the public and private
sector, the private accounts for 63% (HR assessment 2016).
โข This shows that there are 8 skilled Health workforce per 10,000 population which is
below the WHO recommended 23 skilled health workers per 10,000 population.
โข The HRH Policy (2016) and Task Shifting & Task Sharing Policy (2017) were developed to
facilitate the achievement of Universal Health Coverage (UHC) and qualitative
healthcare delivery.
โข This ensures certain categories of HWs provide family planning information,
counselling, referrals and services depending on their qualification
10. Dr Omotunde Odanye
Dr Omotunde Busayo Odanye is the Service
Delivery Technical officer for the JHU CCP led Post
Pregnancy Family Planning Project in Lagos state
Nigeria.
She holds a Bachelor degree in Medicine and
Surgery (MBBS) from College of Medicine,
University of Lagos and a MSc degree from the
University of Essex, United Kingdom. She is a Public
Health Programmer and Health Communication
Expert.
Dr Omotunde has over 8 years of clinical practice
and is passionate about promoting healthy
behavior while advocating for an enabling
environment. Her goal is to enable individuals
attain their right to health and will always do so
through every available platform.
11. Post-Pregnancy Family Planning
in the private sector:
Approaches and Key Learnings
Dr Omotunde Odanye
Technical Officer Service Delivery
CCP/PPFP
December 17, 2020
14. Unique issues
with working in
the private
sector
Staffing issues: High attrition rate, high
percentage of unskilled staff and sub-optimal
implementation of the TSTS policy
Space constraint for privacy and confidentiality,
mostly due to leased properties
Time constraint for proper counselling, record
keeping and participation in trainings due to work
overload
Perception of low profitability of FP service
provision
Stock out of FP commodities especially condoms
and pills
15. Unique issues
with working in
the private
sectorโฆ.2
Low demand for Family Planning services
High cost of FP services especially in facilities
using HMOs, which does not cover FP services.
Increased travel time for facilities in hard to reach
areas
Restrictions due to the COVID-19 pandemic
18. PPFP integration
along the MNCH
continuum of
care
Antenatal care Help women and their
partners develop a plan for
contraceptive use after
delivery
Delivery Counsel and provide
immediate post partum
family planning options
PNC/
Immunization
Provide FP information,
counselling and services
during clinic visit
20. The Project implements its activities under 3 thematic
approaches, using data from RM&E to make programmatic
decisions
Advocacy
01
Demand
Generation
02
Service
Delivery
03
Research, Monitoring and Evaluation
21. Advocacy
Medical Directors/Facility
Owners
Two prominent private sector
professional associations
(AGPMPN, AGPNP)
Religious Houses through
the Interfaith Forum
AGPMPN- Association of General and Private Medical Practitioners of Nigeria, AGPNP- Association of General and Private Nursing Practitioners
22. In-clinic
Demand
Generation
Brand private sector health facilities
FP entertainment education and digital
media materials
Support social mobilization activities such as
key life events, outreaches
Media broadcast of FP messages; on radio,
TV, and social media.
24. Service Delivery
Commences with a performance improvement
assessment to assess the gaps in service provision
for each facility
Focused on improving the quality of FP services by
holistically addressing three key areas:
Environment Training Tools
26. Capacity building of the
various cadres of health
workers
LARC training
LARC training
Long-Acting Reversible Contraceptive Training
Inter-Personal Communication and Counselling
Contraceptive Logistics Management System
Family Planning Supportive Supervision
Task-Shifting Task-Sharing policy
34. Bolaji Oladejo
Bolaji Oladejo is the State Program Manager for IntegratE
project in Lagos State. She is a registered Pharmacist and
holds master degree in public health, as well as MBA with
specialization in human resource management, all from the
prestigious Obafemi Awolowo University, Ile Ife.
She has over fourteen yearsโ experience spanning across
hospital Pharmacy, Pharmaceutical marketing and Public
health interventions. In her 10 years work with SFH, she
has led various interventions such as Global Fund Malaria
Project, Nigeria Governorship Leadership Challenge Grant
Management at the State level.
She is an expert in private sector engagement and has led
series of advocacy to policy makers and stakeholders for
health system strengthening. She currently leads the
IntegratE in Lagos.
She is a recipient of compliance award and a member of
Pharmaceutical Society of Nigeria.
35. INTEGRATE- INTEGRATING FAMILY PLANNING AND PRIMARY
HEALTHCARE SERVICES EXPANSION AMONG COMMUNITY
PHARMACISTS AND PPMVS
presented by
Pharm. Bolaji Oladejo
36. Table of Contents
โ Background
โ Approach
โ Key Achievements
โ Key learnings/Best practice
โ Challenges and way forward
37. Background
โ CPs and PPMVs are important sources of care
โ Private sector accounts for 86% of outlets stocking contraceptives or providing FP
services (2015 FP Watch)
โ About 72% of these Outlets are PPMVs and 4% are Community Pharmacists
โ Pharmacists are grossly insufficient (1/10,000 - NBS)-WHO recommends 1/2000
โ 21,892 pharmacists registered, 12,740 licensed (PCN, 2016)
โ 55,350 PPMVs registered, 10,205 licensed (PCN 2016)
โ Knowledge of modern Contraceptive very high โ 99.9% but low uptake โ 26.4% in
Lagos
โ IntegratE project co-funded by BMGF and MSD for Mothers
38. Background
๏ต Proof-of-Concept that Community Pharmacists and PPMVs have the
capacity to provide a wider range of FP and PHC services than they are
currently authorized by law to provide.
๏ต implemented by a six member consortium led by Society for Family
health.
Other partners include PharmAccess,DKT,MSI,PopCouncil and PPFN.
๏ต Key partners- PCN,FMOH, SMOH and PHCB
39. Approach
- CP and PPMV Shops
- Directory shared with LSMOH
- Waiver to Train Providers
BRANDING
- Distribution of Green Dot
- PCN, SMOH, PHCB
FACILITY ASSESSMENT
GIS MAPPING
TRAINING
- LGA Selection
GOVERNMENT COLLABORATION
- Following GIS Mapping
- Assess Eligibility of Providers
- 311 CPs
- 211 Tier 1 PPMVs
- 43 Tier 2 PPMVs
- 1 Tier 3 PPMVs
40. Approach
Competency Assessment
(Tier 2 and CPs)
Supportive
Supervision/On-Site
Mentoring
Quarterly
Review
Meetings
Demand
Creation for FP
Services
Business
Training/Access
to Finance
Distribution of
PPE during COVID
Pandemic
41. Key Achievements
280 Providers visited
(SSVs)
191 Providers Meeting
Target
(75% Benchmark)
- Health Trained PPMVS
- Non-Health Trained PPMVS
- Community Pharmacists
- 60% Reporting Rate
RESEARCH
- Knowledge Retention
- Client Exit Interview
- Self Injection Study (SC)
- Via Mobile DHIS2
REPORTINGTRAINING
SSV
- FP Training (6 days vs 3 days)
- Documentation using NHMIS
42. Key Achievements
FP Data Elements
(2018-2020)
PPMVs
(n=254)
CPs
(n=313)
Total
(N=567)
Client Counselled 50,930 32,631 84,324
New FP Acceptors 12,903 6,760 19,850
Females 10-49 Using FP 30,506 30,916 61,868
AYPs (10-24 Years) 11,691 2,459 19,111
Women given Oral Pills 21,584 21,534 43,485
Injectables Given 1,437 2,968 4,411
Implants Inserted 782 985 1,769
Implants Removed 166 236 402
Referrals Made 747 206 908
43. Lessons Learnt/Best Practice
๏ต Involvement of ACPN land PPMVs leadership at the State and zonal levels has
helped in coordination of CPs especially for trainings. This has been the same for
the PPMV groups.
๏ต Some zones have provided review meeting venues at little or no cost to show
ownership of the project
๏ต About 80 CPs have completed their competency training on LARC in Ikorodu,
Kosofe and Alimosho LGAs in Lagos.
44. Challenges
๏ต Documentation remains a challenge as about 60% reporting rate is
being recorded consistently
๏ต Training seems to be burdensome to the providers because they have
to leave their businesses for days
45. Way Forward
โข Thereโs a need for a change in attitude of providers (especially CPs) towards
documentation and reporting
โข Training should also not be seen as burdensome, as expansion of service is for
professional enrichment
46. Conclusion
โข PPMVs and CPs are better positioned to provide a wider spectrum of FP and
other PHC services as a result of their education and presence at the
community level.
โข FP uptake has continued to increase across the years on the project among
trained providers (although hampered by low reporting rates).
โข Hence, for them to be integrated into the formal health sector, there is a need
to improve in data reporting and documentation.
47. Photo Gallery
A CP inserting Jadelle during Training
A CP Counselling Client using the BCS Card and MEC Wheel
A CP INSERTING IMPLANT DURING COMPETENCY
A group OF CPs in Ikorodu During LARC
Training
51. Dr Olukayode
Akinkunmi
Dr. Olukayode Akinkunmi holds a Bachelor degree
in Medicine and Surgery (MBBS) from Ahmadu
Bello University and proceeded to have his one-
year compulsory houseman-ship at the General
Hospital Ikeja now known as Lagos State University
Teaching Hospital in the year 2000.
Dr Akinkunmi has worked in several private
hospitals before establishing his practice in 2007.
Since then, he has grown the then small practice to
a 25 bedded purpose-built hospital with
standardized facilities for primary and specialized
care.
In 2013, he returned to school for diploma in Family
Medicine graduating from the National
Postgraduate Medical College in 2015. He is
currently the Medical Director of Life Fount Medical
centre, Egan (Alimosho)
