Nigeria 2015 FPwatch Survey: Findings from a contraceptive commodity and service assessment among public and private sector outlets

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Nigeria aims to achieve a contraceptive prevalence rate (CPR) of 36% by 2018 to fulfill their FP2020 commitment. To meet this objective, Nigeria is taking actions to improve equity and access to family planning through a range of policy and programmatic initiatives.

Nigeria presents a challenge for health programmers due to its large population of more than 170 million people and wide ranging cultural, religious and political contexts. Progress in improving access to and use of modern contraceptive methods has been similarly challenging. The total fertility rate has recently begun to decline and currently stands at 5.5 children. According to the most recent 2013 Demographic and Health Survey (DHS), 11.1% of Nigerian women are currently using a modern contraceptive method, a slight increase from 10.5% in 2008.1,2 Short-acting contraceptive methods are most commonly used with only 1.4% of women using a long-acting reversible contraceptive (LARC) or permanent method (LARC/PM). There are significant regional and socioeconomic disparities in use of a modern method. The unmet need for family planning, consequently, remains high at 16.1%.1

The public sector’s role as the immediate source of commodities and supplies for contraceptive users in Nigeria has fallen substantially in the past 20 years as private sector provision has rapidly expanded.3 Nearly 60% of Nigerian women reported receiving contraceptives through the private sector, while 30% reported a public sector source. However, the majority of LARC/PMs were received through the public sector. The most common source of modern contraceptives reported (38.2%) was privately-owned, patent and proprietary medicine vendors (PPMVs). In Nigeria, the private sector plays a large role in distribution of contraceptive commodities and services, in contrast with most sub-Saharan Africa countries.4 However, high quality evidence on the growing private sector provision of contraceptive methods in Nigeria remains limited.3