Background and Objective

Latest evidence shows that 23 million girls aged 15 to 19 years in developing countries have an unmet need for modern contraception. As a result, half of pregnancies among this group are estimated to be unintended. Nigeria is the most populated country in Africa with an estimated 200 million people.  2.3% of this population are adolescents. They are characterized by series of physiological, psychological, and social changes which present fatal and life-threatening health risks due to risky sexual behaviors. 

Materials and Methods

Reaching adolescents with SRH information and referral for FP services is increasingly difficult. In response to this dire situation, Options developed an intervention in Nigeria and Kenya, that improved girls' access to quality ASRH information and services in the private sector. This involved addressing community barriers through stigma reduction and community referrals by 'Big Sisters', who adopted existing technology such as social media and hotlines.  The model was piloted in 28 LGAs in Oyo and Ogun States of Nigeria. 

Results

The 'Big Sisters' approach significantly increased the number of adolescent girls accessing various RH information including FP services in the communities through a peer-to-peer approach. 94,233 girls were reached with ASRH information and 18, 370 were referred for reproductive health services from August 2018 to July 2022.  85% of these girls who took up referrals had consultations with providers and were given the FP method of their choice. 

Conclusions

The Big Sister approach to expanding access to FP is an innovation that achieved project outcomes, ensures sustainability, and empowers girls in their communities with lifesaving skills, and knowledge to make informed SRH choices. It achieved improvements in reaching adolescents with SRH information leading to an increase in FP uptake and a reduction in preventable reproductive health challenges among girls between the age of 10-20 years.