Nigeria, the most populated country in Africa, is going through the longest period of civilian rule since its independence. However, in addition to rebuilding the economic and political system of the country, the Nigerian government has to rebuild its heath infrastructure. Its under-five mortality rate is 197 deaths per 1000 live births, and HIV, malaria and diarrheal disease account for about a quarter of the deaths among adults.
PSI operates in Nigeria through its implementing partner Society for Family Health (SFH), which was founded in 1985 by several eminent Nigerians and PSI. Starting with two employees and one office in Lagos, SFH has grown to over 200 employees working out of 17 offices scattered across the country. SFH began with one product and one HIV/AIDS prevention grant and now markets nine products and manages five contracts worth $120 million.
In 2005, past successes helped SFH become the first Nigeria NGO qualified to receive funding directly from the U.S. Agency for International Development (USAID). The five-year cooperative agreement between USAID/Nigeria and SFH aims to improve the health and quality of life among Nigerians by increasing the use of reproductive health products and services among women of reproductive age.
Nigeria now accounts for nearly 10 percent of the HIV/AIDS burden in the world, with 4 million of its citizens seropositive. Over the years, SFH has supported the federal government’s efforts in responding to HIV/AIDS through its wide range of community intervention programs developed to suit specific target audiences. It has adopted various strategies to motivate its audience through the use of mass media, mid-mass media and interpersonal communication to achieve behavior change.
As part of its deliverable to the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), SFH is in partnership with private sector workforce to increase capacity towards the implementation of workplace HIV/AIDS programs in 12 states. In this vein, SFH works with major blue chip organizations spread across communities in Nigeria to carry out surveys which will provide data on HIV and AIDS knowledge amongst the workforce which will serve as guidelines towards developing intervention programs.
The Nigerian Bottling Company (NBC) (Coca Cola) project 2004 – 2005 was designed to increase knowledge and awareness about HIV; increase personal perception of risk; increase correct and consistent condom use; decrease the level of stigmatization surrounding HIV and STIs; and increase knowledge about voluntary counseling and testing. The Exxon Mobil project trained peer educators for workplace outreach. SFH provided technical support for surveys, peer education, drama, condom logistics, education material production and distribution. Shell Petroleum Development Company and Chevron HIV/AIDS Prevention programs are targeted at building the capacities of employees to effectively increase access to HIV prevention, care and treatment among their fellow colleagues. Strategies include peer education; condom distribution and training of trainers.
SFH also implements a comprehensive social marketing program that improves reproductive and sexual health with special emphasis on youth. In 2004, it developed a popular youth campaign ‘Zip Up’ in collaboration with FBOs to promote abstinence and delay in sexual debut. This ‘Zip Up’ campaign was so popular that Nigerian youths have adopted it as a life style anthem. Since 2005, SFH’s partnership with BBC World Service Trust has helped increase mass media outputs for HIV prevention, especially with the development of youth specific targeted and designed campaigns such as Flava and “Ya Take Ne”? which address issues raised from community level intervention interactions. In 2006, efforts increased to target out-of-school female youth especially in the predominantly hard to reach northern parts of Nigeria.
In 2006, SFH also launched the PEP Model, a replicable, scalable and cost effective model that uses well-developed participatory approaches to behavior change. It engages at-risk populations in the process of developing positive behaviors. It is a community level strategy that was implemented in 112 low-income, high-risk community sites in Nigeria. Following its exit strategy and handing the program over to trained community-based organizations, scale-up activities have commenced in various other communities.
Malaria remains the foremost killer disease in Nigeria. It accounts for over 25% of under-5 mortality, 30% childhood mortality and 11% maternal mortality. To address the importance of both malaria treatment and prevention, SFH malaria programming centers on Pre-Packaged Therapy (PPT) and Long Lasting Insecticide Treated Nets (LLINs).
In line with the Federal Ministry of Health’s new treatment policy on malaria, SFH promotes the new policy of using Artemisinine-based Combination Therapy (ACT) as the new first line drug for the treatment of uncomplicated malaria. A new brand of ACT for Children KidACT was developed and launched in 2008. The brand is heavily subsidized for affordability to poor and vulnerable Nigerians who bear the brunt of malaria.
Since malaria prevention is equally as important as malaria treatment, PermaNet long-lasting insecticide-treated nets are distributed by SFH as an inexpensive and easy way of preventing malaria from burdening the health and economic well-being of Nigerians.
SFH implements two complimentary projects—the Promoting Sexual and Reproductive Health and HIV/AIDS Reduction (PSRHH) project and the Improved Reproductive Health in Nigeria (IRHIN) project. PSRHH is a seven – year project (2002 – 2007) that is funded by DFID, while the IRHIN Project is a USAID Project which runs from 2005 – 2010.
SFH aims to contribute to the Millennium Development Goal (MDG Goal #5) of reducing maternal mortality rates in Nigeria and to the national awareness of population management issues and child spacing to improve the understanding of, access to and correct use of contraceptives to reduce unintended or mistimed pregnancies.
SFH is also one of the 14 countries implementing the 5-year Women’s Health Project being funded through PSI to reduce the incidences of Maternal Mortality (MMR in Nigeria is 800/100,000 live births).
Water, Sanitation and Hygiene
The Nigerian National Water Supply and Sanitation Policy was adopted in 2000 make accessibility to adequate water and sanitation the right of every Nigerian. Despite this, one in every three Nigerians still do not have access to improved water supply, thus diarrhea diseases remain a leading cause of death – second only to malaria, for children under five years of age. SFH is working to reduce the high incidence of morbidity and mortality associated with diarrhea diseases by improving household water quality through the use of WaterGuard, a point-of-use hypochlorite solution that can be easily administered to treat contaminated water and make it safe for drinking for individuals of all ages.
While long-term plans to construct piped, chlorinated water supply infrastructure are underway, WaterGuard provides an important and inexpensive alternative to accessing treated water in the short-term.
SFH also utilizes social marketing, community mobilization, motivational interviewing, communication, and education to increase awareness of the link between contaminated water and disease, the benefits of safe water and hygiene behaviors, and the purchase and proper use of the water storage vessel and disinfectant.
- The Global Fund To Fight AIDS, Tuberculosis and Malaria
- Private and corporate donors
- United States Agency for International Development (USAID)
- United Kingdom Department for International Development (UKAID)
- Procter & Gamble
- Pathfinder International
- Crown Agents
- ActionAid International
- National Agency Food and Drug Administration and Control
- Federal Ministries of Health, Water Resources and Women Affairs
- National Action Committee on AIDS
- Oil and Telecommunications outfits
- Uniformed Services
- Civil Society and Faith-Based Organizations
- International and Local Organizations
- Public Entities
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