In Nigeria there are 22 million married women who want to space birth or stop pregnancies altogether but are not currently using any modern birth control method. Without these methods, they get pregnant and carry children they do not want as their body breaks down over time. Of those who are lucky enough to live and deliver their babies, many develop chronic conditions that they must live with and spend money on for the rest of their lives. In Oyo State, there are thousands of women who want to plan their families, but the Nigerian health system fails them every day. My goal is to tell their stories.
Long gone are the days that African women needed convincing. What women need now is a renewed commitment by the world to help them meet their need to smartly plan their family.
Serifat Akande is a 30-year-old hairdresser. She lives and works in Ibadan city - the largest city in West Africa. She has been planning her family for a long time - opting in an out, as her family needs. When her previous children were old enough and her husband was ready for another child, she removed the product she had used and shortly got pregnant. She is a family planning spokeswoman within her community mainly because the practice has and continues to work for her. She talks to hairdressers and other members of her professional unions about family planning because she believes it has saved her life - and saved her family’s finances.
Alhaja Opoowu does not look like a family planning evangelist, but she is. She first decided on family planning 28 years ago and has been a believer in a woman’s right to choose the composition of her family ever since. Like most women, she thinks of family planning as simply an economic tool. Morality and technical human-rights arguments are not her framework. Many women like her believe family planning is like a simple savings account: it protects their families from financial catastrophe.
Like most women, she thinks of family planning as simply an economic tool. Morality and technical human-rights arguments are not her framework.
Historically, health workers have had to inform women of the health consequences of many births. With child mortality so high, it was imperative for women to have as many children as possible. However, with the remarkable reduction in child mortality in Nigeria - especially in the southwest region - many women are now convinced that planning their family is the best option for their health and for their purses. Long gone are the days that African women needed convincing. What women need now is a renewed commitment by the world to help them meet their need to smartly plan their family. Women like Alhaja Opoowu and Serifat Akande are waiting on the Nigerian health system to deliver essential services that help them plan a smarter life.
The Gates Foundation funded project, Nigerian Urban Reproductive Health Initiative (NURHI), shows how much agency Oyo State women have in deciding their sexual reproductive health care. Between October and November of last year, 16,113 units of contraceptive commodities were used by women in the 5 local government areas of Ibadan. Women who were ready to control their reproductive future requested and received 3,931 condoms, 2,355 IUCDs, 6,140 doses of depo-provera, 1,415 contraceptive pills, and 2,272 doses of noristerat. Nigerian women are ready to plan their families. All they need from us is a commitment to help them meet their needs. The Oyo State Abiyamo Program that will be launched by the state ministry of health hopes to build on the lessons of NURHI and other projects to expand services to the women living in the other LGAs in Oyo state.
I was so glad to attend the Women Deliver conference a couple weeks ago. Apart from the energizing time I spent with people who speak my language and understand my passion for women’s health, I got to attend country caucuses where the Nigerian government was held accountable for its past promises to invest in the sexual and reproductive health of Nigerian women. Last May, at the London Summit for Family Planning, the Nigerian government pledged to increase investment for family planning products to $33.4 million. During the country caucus, many members of the civil society stakeholder group finally got the chance to hold the Ministry of Health accountable for its promises. This is a major step in the right direction. Participants asked questions and made the government re-commit to reporting its activities as they relate to access to family planning commodities and maternal health in general.
Additional investment is needed; 22 million Nigerian women are looking to their health providers to deliver these essential services. Now is the time to increase investment for the women of Nigeria.