CMAM in Sokoto State (2014-2015)
Nigeria has an average prevalence of global acute malnutrition of 14%, which is higher than the Sub-Saharan average of 9%. As a response to this, ACF, UNICEF and other partners, in close collaboration with FMoH introduced the Community-based Management of Acute Malnutrition (CMAM), a 15-years old system of service provision that has been incorporated by many health ministries across the world. In 2009, CMAM was initially piloted in two states, Katsina and Yobe, in 30 treatment sites. ACF started its activities in Nigeria in 2009 with full support for CMAM programme. After some years of its introduction, CMAM is facing a new set of challenges. Whereas its geographic presence has impressively improved, it still has to deliver better outcomes, both in terms of its total admissions and in terms of the rate of cure that it can provide as well as awareness about the programme in the states where it is currently being offered.

CCSI was engaged to provide a communication strategy that could help improve the visibility and awareness of CMAM services in two LGAs in Sokoto state. The goal was to increase total coverage of CMAM by improving the way communities participate in the programme through a better identification of acute malnutrition cases, a better referral to existing facilities with CMAM services and, overall, an improved knowledge about malnutrition and its treatment. The campaign involved the development of communication strategy and SBCC materials for both print and electronic channels. While a forty-man community volunteer were recruited and trained for community mobilisation activities, the radio spots and radio magazine programmes served to complement the community mobilisation activities. The campaign was a short one and has come to a close while end of project evaluation result showed there was an increase in awareness of malnutrition and traffic to facilities where CMAM services were offered.

The Nigeria Urban Reproductive Health Initiative (NURHI) was designed to increase contraceptive use in selected urban sites (FCT, Kaduna, Ilorin, Ibadan, Zaria and Benin City) in Nigeria, with a focus on the urban poor. Through a strategic combination of service delivery, communication, social mobilization and advocacy inputs the NURHI project increased demand for and supply of family planning, ultimately leading to long-term market driven sustainability.

The second phase of the NURHI project (NURHI 2) is designed to increase contraceptive use in Lagos, Kaduna and Oyo States. It is an extension of the successful NURHI project, and runs from 2015 to 2020. This new phase of NURHI builds on successful strategies implemented over a six year period by the first NURHI project in six Nigerian cities. NURHI 2 aims to be a proven strategy that increases contraceptive prevalence rate (CPR) where it is directly implemented; and it provides the evidence, strategies, technical assistance, and incentives necessary for replication in non-intervention states.

NURHI 2 envisions A Nigeria where supply and demand barriers to contraceptive use are eliminated and family planning becomes a social norm.

Core partners on NURHI 2 are the Johns Hopkins Center for Communication Programs (JHCCP), Centre for Communication and Social Impact (CCSI) and Association for Reproductive and Family Health (ARFH).

CCSI supports intermediary outcome 1.4 ‘Increased demand for family planning by women and men’ and 1.5 1.5 ‘Increased demand for reproductive health knowledge and services for youth’.

PPFP

The aim of the Bill and Melinda Gates Foundation and Merck for Mothers-funded Post-Pregnancy Family Planning Project (2017-2021) is to increase contraceptive use among post-pregnancy women. The project will be implemented by extending and adapting the existing approaches and tools of the Nigerian Urban Reproductive Health Initiative (NURHI 2), to reach post-pregnancy women in Lagos with the information and services they need to begin using family planning. The post-pregnancy period includes the period of pregnancy through one-year post-pregnancy; this includes miscarriage and any pregnancy that does not

result in a live birth. The Nigerian Urban Reproductive Health Initiative (NURHI 2) is designed to increase contraceptive use in Lagos, Kaduna and Oyo States using the NURHI Model, a strategic combination of advocacy, demand generation and service delivery mostly through the public sector.

The PPFP project will tailor the interventions to address the unique needs and potential of private providers to better provide post-pregnancy women family planning services and create demand for those services. The PPFP team is made up of partners from NURHI 2 of Johns Hopkins Center for Communication Programs (CCP), Center for Communication and Social Impact (CCSI), Association for Reproductive and Family Health (ARFH) and key government and professional associations with the addition of new partners, Health Strategy and Delivery Foundation (HSDF) and DKT International who bring critical new experience and skills for working with the private sector quality and logistics management. The projects expands into 200 facilities in Year 2.

The Challenge Initiative

The Challenge Initiative is an Urban Reproductive Health program designed to help states, communities and institutions adapt innovative Family Planning models for improved maternal health in Nigeria. The Initiative supports states to accelerate the sustainable and impactful scale-up of proven-to-work FP interventions based on the evidence of its predecessor program – the Nigerian Urban Reproductive Health Initiative (NURHI) since 2009.

Currently operating in 11 States in Nigeria (Niger, Bauchi, Delta, Kano, Ogun, Anambra, Plateau, Cross River, Taraba and Edo), TCI adapts a demand-driven business unusual model where states, cities, and partners ask for technical and financial support and assistance to implement successful FP programming to match their own investments.

CCSI supports Social Mobilization, Mass Media roll out, dissemination of SBCC materials and Adolescent and Youth Sexual Reproductive Health (AYSRH) Demand Generation Activities