Background/Significance:
With efforts geared toward improving the reproductive health status of adolescents in Nigeria, the modern contraceptive prevalence rate (mCPR) among girls 15-19 years is still very low at 2.3% (NDHS2018). The Society for Family Health with support from the Federal Ministry of Health implemented CIFF-DMPA-SC Scale Up Project, leveraging on the Big Sister Models to drive uptake of DMPA-SC/SI and improve the modern contraceptive methods among adolescent girls 15-19 years. This model was implemented in Osun and Edo States.
Program intervention/activity tested: The Big Sisters are peers, younger healthcare providers, and satisfied users of contraceptive methods including DMPA-SC. They were trained on peer-to-peer strategies, administration of DMPA-SC/SI, and empathy-based counseling skills to increase their confidence and capacity to effectively coach women to overcome fears of pain and lack of self-efficacy. In addition to driving uptake in communities, the Big Sista's received wider sales training and were provided a basket of goods, including antimalarial, condoms, ORS, and other fast-moving commodities (FMCG) which they could sell and resupply as a means of earning extra income.
Results/key findings: Through this Big Sister model, a total of 2,476 WRA, including adolescents were reached with sexual and reproductive health messages and have taken up the DMPA-SC/SI. About 1,315(53%) women were provider administered while 1,161(47%) were to self-injected. The program has been able to avert 217 unintended pregnancies, 519 disability-adjusted life years, and provided 619 couple-year protections.
Lessons Learnt: The Big Sister model is an innovation that has the tendency to increase the reach of sexual and reproductive health and the uptake of modern contraceptive methods. This will in turn result in increasing the modern contraceptive prevalence rate among adolescent girls in the country.
