An Assessment of Integration of Family Planning and Maternal, Newborn and Child Health in Kano, Nigeria

In an effort to more systematically understand mechanisms of effective maternal newborn and child health and family planning (MNCH / FP) integration ACCESS-FP carried out an assessment of an integrated program in Northern Nigeria. The ACCESS-FP Program supports basic maternal and newborn health care services including FP in three states Kano Katsina and Zamfara. Although FP services are made available to all women a specific aspect of the program was to integrate messages and services tailored for the needs of women in their first year postpartum. This assessment examined perceptions of policymakers providers and community members with regard to integrated MNCH / FP services as well as factors facilitating and negating the use of these services. The team conducted one-on-one interviews with six policymakers and eight service providers using semi-structured interview guides. The team held eight group discussions which included a participatory methodology with four women’s groups and four other community groups. Key findings included: From the point of view of providers and clients all services were not considered equal. It was clear that perceptions of the value of different services varied. In terms of priority MNCH services labor and delivery was not ranked high in importance among services by either service providers or women’s groups. Providers and policymakers agreed with the approach of incorporating FP with routine MNCH. Women did not appear to be daunted by the relatively complex service schedules. Barriers for integrated services included the issue of staff time identified by policymakers and providers. Although this study had limitations it did demonstrate the utility of reviewing MNCH / FP integration. The tools used here will be further modified and adapted for application in other settings to improve our understanding of effective MNCH / FP integration. The findings from this assessment indicate that an approach that systematically increases MNCH / FP integration is feasible and can have a positive effect on service use particularly FP even in a very conservative environment. (Excerpts)