End-of-Project Evaluation of the Nigeria Family Health (FH+) Project

The USAID/Nigeria-funded Family Health Plus (FH+) project implemented a three-pronged approach to increase the long-acting reversible contraceptives (LARCs) contraceptive prevalence rate (CPR). Managed by Marie Stopes International of Nigeria with partners Palladium Group (formerly Futures Group International) and Marie Stopes International, the three-year project ended in March 2017. It focused on training public health providers on LARC service delivery, advocacy to create an enabling environment, and demand and public awareness of LARC, and worked in 20 states in all geopolitical regions of Nigeria, training 2,124 providers in LARC and certifying more than 1,549 providers in LARC. The evaluation team visited public health facilities in three to four Local Government Areas in five states to observe LARC service delivery and to interview clients and providers. Stakeholders at the federal and state levels were also interviewed.
Overall increase of LARC CPR during the project’s period of performance was 1.5 percent. FH+ conducted the LARC training, but the quality of performance in facilities was found to be sub-par. The assessment focused on sustainability, cost effectiveness, quality of the training activities, and the value of the mobile District Health Information Software (DHIS) data collection system. Although the project’s Advocacy component organized Advocacy Working Groups, it did not focus on creating an enabling environment to support LARC acceptance. Furthermore, demand creation was seldom conducted, nor did it occur regularly. Most of the budget was spent on training advocates in the working groups and LARC providers. Training activities had exceedingly high budgets and, compounded with the low quality of the LARC providers and Advocacy Working Groups, their effectiveness and the return on investment was low and not sustainable.

Resource type: 
Operating Unit: 
Foluke Adeniji
Joshua Awoleye
Dee Bennett
Tahirah Ikharo
Omatayo Olugbemi
Omobola Odutolu
Sa'adatu Sule
Publication date: 
September, 2017
Contract mechanism: 
GH Pro