The Expanded Social Marketing Project (ESMPIN), funded by USAID, improved the health of women and children in Nigeria by increasing use of modern family planning methods and child health. To achieve this, a team, including Society for Family Health (SFH) along with the Association for Reproductive and Family Health (ARFH), BBC Media Action (BBCMA) and Population Services International (PSI) worked to: increase access to family planning (FP), reproductive health and child health products; increase use of health products and practice of health behaviors; generate support from all sectors for social marketing as an important part of a total market approach; and improve the viability of local manufacture of key health products. The story below comes from the ESMPIN project.
From a Beneficiary to an Advocate of Modern FP Methods
“Oh, is this all there is to it? I thought family planning was a difficult process,” Eze said as she exited the theater. “I didn’t even feel anything after the insertion. At first, I was scared because of what other women say about family planning. But I summoned my courage because of my trust and relationship with your agents after they came to my house.”
Eze Nwaneka, popularly called Mama Ejima, is 34 years old and lives in Ugwuoye in the Owerri Autonomous Community – one of the communities selected for ESMPIN project intervention – within Nsukka Local Government Area in Nigeria’s Enugu State. She is a small vendor and married to a farmer in his late forties. Eze is a mother of eight children, all under the age of six, including two sets of twins born less than one year apart.
“My major worry was that my husband is a peasant farmer and he is already old and frail. We only manage to survive from the proceeds from my scanty kiosk. Now we have six children, the first child is six years old. He is the only one in school while others are not enrolled into school yet.”
“My mother’s younger sister gave birth to 12 children but died at her thirteenth pregnancy. It is quite unfortunate we didn’t know about family planning then. I am so happy I found the solution through you and I know family planning is good for every woman. I plan to encourage and maybe invite all the women of reproductive age in my village to Nsukka for family planning.”
Eze is one of the numerous beneficiaries of the ESMPIN community-based intervention who have adopted a modern method of FP after meeting with the interpersonal communication agents in the community. It turns out the entire village where Eze lives had held several meetings with the couple to urge them to refrain from giving birth almost every year, which had on several occasions resulted in stillbirths. With the timely, and according to the couple, “divine intervention” of SFH via the ESMPIN Project, both the couple and the community can now breath a sigh of relief.
Eze is now a reference point to other women of reproductive age (WRA) within her community. Soon after she adopted a FP method, a good number of WRAs became convinced that modern contraception is safe from the positive experience shared by Eze, who says she never feels there is anything inserted into her body.
Did it work?
As the five-year project comes to a close, the program has been exposed to rigorous measurement and evaluation. A one-off analysis of the impact of demand creation on malaria objectives was randomly done for Bauchi State, which charted the Intermittent Preventive Treatment uptake trend and Akwa Ibom State, researching Rapid Diagnostic Test use. The comparison was for six months before a select intervention period and six months into the intervention period. Health facility intermittent preventive treatment uptake results from Bauchi showed an average of 34% increase in Intermittent Preventive Treatment 1 uptake and 61% increase for Intermittent Preventive Treatment 2 uptake. Similarly, Rapid Diagnostic Test use in Akwa Ibom recorded an average increase of 391% within the intervention period.
As for demand creation using interpersonal communications agents, a total of 15,123,844 interpersonal communication contacts were recorded through the entire Cycles 1-10 of ESMPIN (at 102% of planned target) along with 598,037 redeemed family planning referrals (similarly at 80% of target).
For more information about the methods, standards, materials and outcomes of ESMPIN, please find the following online resources: