Comprehensive contraceptive service delivery in a crisis setting

Location:

Introduction:

Boko Haram violence has forced some 1.82 million people from their home in Northeast Nigeria. As the uprooted continued to flee, internally displaced person (IDP) camps and host communities swelled in Borno State. Health facilities in formal and informal IDPInternally displaced person camps run by the Federal Ministry of Health had never recovered from the Boko Haram insurgency and were ill-equipped and understaffed. Health services, including sexual reproductive health (SRH), were almost non-existent in Maiduguri, placing women and girls at increased risk of life-threatening health problems.

Project Description:

In August 2016, the IRCInternational Rescue Committee initiated MISPMinimum Initial Service Package services and within 4 weeks had established the only reproductive health clinic in the Bakassi camp, which served 21,293 IDPInternally displaced persons. The IRCInternational Rescue Committee also supported 4 government primary health care facilities within the Maiduguri Metropolitan Council-Jere area, with a particular focus on contraceptive services, post-abortion care, care for sexual assault survivors, and delivery care. Additionally, the IRCInternational Rescue Committee had established comprehensive reproductive health services in Konduga (population 9,371) and Monguno (population 40,147) through SRHSexual and reproductive health clinics. During this period, the IRCInternational Rescue Committee provided support to a total of 291,767 people in Borno State.

Results:

The IRCInternational Rescue Committee successfully scaled up contraception uptake through a combination of staffing support, commodity provision, community outreach by engaging volunteers and traditional birth attendants and training of government health providers. Following a contraception training for health care providers, new acceptors increased by 50% in just one week. Between January and March 2017 across all supported sites, the IRCInternational Rescue Committee served a total of 3,474 family planning clients. Of these clients, 69% (2,398) were new acceptors of contraception and 14.4% (346) opted for a long-acting reversible contraceptive method.

Lessons Learned:

These results demonstrate a capacity to rapidly scale contraceptive services in a fragile context with low contraceptive prevalence. Emergency responders must anticipate a low number of skilled health staff available, long lead times for procurement and recruitment, and low priority for SRHSexual and reproductive health. To fill these gaps, responders must budget for more skilled staff including procurement staff and prepare data and evidence to share with local authorities and in the health cluster to prioritize SRHSexual and reproductive health.