STRENGTHENING PHCS IS HELPING EXPAND FAMILY PLANNING ACCESS IN KWARA
BY
SA’AD HAMDALAT TEMITOPE
PRESS SECTRETARY KWARA STATE MINISTRY OF HEALTH
Through training, commodity provision, community mobilisation and supportive supervision, MSI Nigeria Reproductive Choices is helping to improve access to family planning services in Kwara State. The experience of women and health workers in Ilorin South shows how strengthening frontline facilities can turn awareness into actual uptake, while also revealing the challenges of sustaining the gains.
For Fatima Taiye, family planning began with a worry. After the birth of her child, Fatima recalled her aunt becoming pregnant again very soon after giving birth. Fatima did not want to find herself in the same situation, with another pregnancy coming before her child was old enough. So she went to a health facility.
What happened there was important to her decision. Rather than simply being offered one contraceptive method, she said health workers explained the different options available to her, including implants, injections and methods of varying durations. She was examined and supported to make an informed choice. She chose the three-month injectable. For Fatima, the method brought peace of mind and helped her achieve the spacing she wanted between her children. Her experience has also shaped the advice she gives other women: seek family planning information and services from qualified health workers rather than unqualified providers.
Fatima's experience is part of a wider change that MSI Nigeria Reproductive Choices is seeking to support in Kwara State: making family planning services more accessible and reliable by strengthening the health facilities where women receive them. MSI currently supports 42 facilities in the state. Its intervention combines health-worker training, provision of commodities and consumables, supportive supervision, community mobilisation, outreach and data-quality monitoring. The experience of Tanke, Kulende and Olufadi Primary Health Care Centres in Ilorin South Local Government offers a glimpse of how that approach is working.
A different experience at the PHC
At Tanke PHC, the starting point was a familiar combination of problems. Nurse Gabi Precious, a registered nurse and family planning provider at the facility, recalled that uptake was relatively low before the intervention. Awareness was limited, misconceptions about contraception were common, community mobilisation was inadequate and commodities and trained providers were insufficient.
Availability can turn demand into service
A trained provider, however, cannot provide a method that is not available. At Tanke PHC, Nurse Gabi identified the timely supply of family planning commodities and consumables as the intervention component that had made the greatest impact. When the necessary supplies are available, she explained, providers can perform the procedures and deliver services. Government procures family planning commodities, while MSI Nigeria procures consumables and medical instruments and supports their distribution, including last-mile distribution to supported facilities.
The State Family Planning Coordinator also acknowledged the role of the Kwara State Government, particularly its funding for last-mile distribution. She stressed that maintaining commodity availability is essential because without commodities, there can be no service. This combination of partner and government support is important. MSI's intervention operates within the public health system rather than separately from it, helping facilities respond when women decide to seek family planning.
Reaching women before they reach the clinic
But availability at the PHC is only part of the challenge. Women must first know that the service exists and be able to reach it. MSI's demand-generation activities include community sensitisation, house-to-house mobilisation and referrals. The programme also conducts health talks, engages community stakeholders and promotes male and adolescent involvement in reproductive-health discussions.
For communities that are far from health facilities, MSI takes free family planning services closer to them through outreach. At Kulende PHC, providers conduct outreach to communities that are distant from the facility, with community health educators helping to mobilise residents. Some activities are conducted monthly, depending partly on the availability of commodities and consumables.
This matters because distance can influence both access and choice. The Kulende provider said some women prefer longer-acting methods partly because they do not need to return to the facility as frequently. The approach therefore links two things that are often treated separately: creating demand and ensuring that the health system is ready to meet it.
The evidence is beginning to show
There are signs that the combined intervention is translating into increased use of family planning services. The State Family Planning Coordinator reported that Kwara's modern contraceptive prevalence rate (mCPR) had risen to 38.8 percent, compared with 9.9 percent in 2023–2024, citing recently released mid-year NDHS figures during the interview. She also reported an increase in new family planning acceptors when first-quarter 2024 was compared with the corresponding period in 2026.
In Ilorin South, the Family Planning Supervisor identified Tanke, Kulende and Olufadi as the local government's high-volume PHCs, with performance better than other facilities in the area. She monitors indicators including new clients, contraceptive uptake and counselling. She ranked Olufadi as the most improved, followed by Kulende and Tanke. MSI's Programme Officer, Muhammed Danbaba, also reported increased knowledge, awareness and service uptake among women of reproductive age since MSI began its intervention in Kwara. He said routine data triangulation and data-quality assessment are used to verify reported results. The figures, however, should not be interpreted as proving that MSI alone caused the increase. The interviews indicate a strong association between the intervention and improved services and uptake, but government support and other factors may also have contributed.
Behind the statistics are individual decisions
For Fatima, the statistics are represented by a very personal outcome. She wanted to avoid an unintended pregnancy while her child was still young. The health facility gave her information, assessed her and supported her to make an informed choice. Other clients interviewed reported similar experiences. Shakirat Tiamiyu said she heard about family planning at a hospital, chose the three-month method and was satisfied with the way she was treated.
Matthew Oluwatosin initially chose an arm implant before switching to the three-month injectable. She recalled being screened before receiving the method and advised women to keep track of the expiry of their contraceptive method and return for renewal. At Kulende, the provider described family planning as an informed choice, with clinical assessment and medical history helping to determine which method is appropriate for each client.
This is perhaps where the intervention becomes most tangible. Increased uptake is not simply about putting more contraceptives into the hands of women. It is also about creating a service in which women can ask questions, understand their options and make decisions without being forced into a particular method. For Fatima, that experience was sufficiently positive for her to encourage other women to seek professional family planning services.
The gains have not eliminated the challenges
The progress comes with important limitations. The most immediate concern is the sustainability of commodity supplies. The State Family Planning Coordinator said Kwara needs to increase its financial commitment to the National Basket Fund for family planning commodities, arguing that federal resources alone are insufficient to guarantee continuous availability.
Human resources are another concern. Tanke PHC still needs more MSI-trained providers, while MSI's Programme Officer identified staff attrition as a challenge. Insecurity, kidnapping and poor road networks also make service delivery and outreach more difficult. There are also gaps in the available facility-level data. Some respondents could not provide exact figures during the interviews because the relevant registers were not immediately available. The Kulende provider, for example, said new-acceptor figures would need to be obtained from the facility register. These limitations do not erase the reported improvements, but they point to the importance of stronger routine data systems and greater domestic investment if the gains are to be sustained.
From intervention to sustainability
The experience in Ilorin South suggests that no single component of MSI's intervention is responsible for the change on its own. Training gives providers the skills to offer services. Commodities allow them to respond when clients arrive. Community mobilisation creates awareness and referrals, while outreach reduces distance. Supportive supervision and data-quality assessments help maintain standards. The strength of the approach lies in how these elements reinforce one another.
For women like Fatima, the result is experienced simply: she can walk into a health facility, receive reliable information, discuss her options with a trained provider and obtain a method that fits her needs. The longer-term question is whether this improved experience can be maintained. MSI's Programme Officer identified government ownership as central to sustainability, while the State Family Planning Coordinator pointed to the need for stronger state financing of commodities.
For now, Fatima's story provides a simple measure of what the intervention is trying to achieve. She needed a service she could trust when she decided she wanted to space her children. By strengthening the facilities closest to communities—and connecting those facilities to trained providers, commodities and community mobilisation—MSI Nigeria Reproductive Choices is helping expand access to family planning in Kwara State. The lasting test, however, will be whether Kwara can finance commodities, retain trained providers and maintain service quality as partner support declines.
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