What I’ve Learned Championing Self-Care in Nigeria

By Tunde Segun, Interim Senior Program Officer Family Planning, Nigeria Country Office, Bill & Melinda Gates Foundation

Photo credit: ©Bill & Melinda Gates Foundation/Andrew Esiebo

At the Bill & Melinda Gates Foundation, we believe one of the most important ways countries can support individuals, families, communities, and societies is by investing in women’s health. That’s why family planning has long been a priority for the foundation. Our aspiration is to ensure that women everywhere can access contraceptives and quality care that enable them to make informed decisions about their health and future—including whether, when, and how many children to have.

We believe promoting self-care is critical to achieving this vision. That’s why self-care is an important part of the foundation’s family planning strategy and why we are a proud member of the Self-Care Trailblazers Group.

Based on what we’ve learned about women’s and girls’ preferences, the foundation is investing in a range of innovative contraceptive products that put care directly in their hands and empower them to take charge of their own health on their own time with no or minimal reliance on often overworked health care providers or overcrowded health facilities.

But our commitment to self-care is not just about tools – it’s also about optimizing how care is provided to meet women’s and girls’ evolving needs. We’re testing new approaches to bring people the information and services they need to manage their own health when, where and how they want, such as through digital counseling and direct-to-consumer platforms like online pharmacies. Ultimately, our self-care investments are anchored in the belief that when people can better manage their own health, we can better meet their needs, advance gender equality, and improve global health outcomes.

Self-care is also personal for me. It’s an issue I’ve championed through my early days as a practitioner, and later as an advocate and as the focal point on adolescent reproductive health within Nigeria’s Federal Ministry of Health.

I’ve seen first-hand through my work in Nigeria how self-care programs that provide the right tools and the right guidance can help women be the agents of their own health. For example, I worked in one of the northern States in Nigeria on a program that empowers women in simple self-care activities, like taking each other’s blood pressure, using a traffic light-enabled blood pressure machine. I also witnessed the impact of improved counselling for pregnant women on birth preparedness and complication readiness during pregnancy, so they can look out for signs of danger for themselves and their babies.

Since then, Nigeria has made other important steps to integrate self-care interventions within its health system, including through new national self-care guidelines for sexual and reproductive and maternal health. As part of the guidelines, Nigeria is increasingly committed to expanding access to DMPA-SC self-injection. At the Gates Foundation, we’re supporting DMPA-SC rollout through investments that cover research, service delivery, demand generation, and systems strengthening.

As more countries embrace self-care, there are a few lessons from Nigeria that are worth sharing:

1. First is the importance of adapting to local contexts and to evolving needs. Nigeria adopted a Task-Shifting and Task-Sharing policy for essential health care services around the same time the self-care guidelines were rolled out. This helped show where different kinds of providers could help carry out sexual and reproductive and maternal health program functions.
2. Second, guidelines must be accompanied by plans to ensure they’re executed. Costed plans were critical to helping partners see all the steps needed to support the guidelines.
3. Third, our success in Nigeria would not have been possible without coordinated advocacy. The Federal Ministry of Health worked across our States to orient government, media, service providers, regulators, and other key stakeholders in Nigeria on the self-care guidelines. This has reduced costs for standalone trainings and allowed for a quicker start to implementation.

Together, these efforts have led to an astronomical increase in the number of women in Nigeria relying on self-injectables.

Nigeria’s success illustrates the importance of collaboration in expanding self-care in countries around the world. To help empower people – especially women and girls – to play a larger and more active role in their care and ultimately live healthier lives, we must continue building partnerships, strengthening investments, and deepening advocacy efforts.