Background
Modern contraception use, and total fertility rates are concerning in Bauchi (6.5%, and 7.2), Kebbi (3.5%, and 6.5) and Sokoto (2.3%, and 7.0) [source:NDHS 2018]. The maldistribution of skilled healthcare workers and traditional offsite training negatively affect access to quality family planning (FP) services.
The USAID-funded Integrated Health Program (IHP) implemented and evaluated the Low-Dose High-Frequency (LDHF) onsite training at primary healthcare facilities in Bauchi, Kebbi, and Sokoto to strengthen clinical competencies of frontline healthcare workers teams in FP.
Methodology
Between January and December 2021, IHP worked with state governments/stakeholders to develop modular training packages, standardize training methodology , and rapidly scale-up high-impact FP practices in 792 public facilities across the states. IHP provided grants to local organizations to conduct training in three LGA cycles. With 17 days per facility, trainers delivered modules in 3- to 4-hour increments. IHP provided equipment, job aids, and anatomical models for continued practice with peer-learning coordinators.
Results
IHP trained 4,474 primary healthcare workers on FP services at one PHC per ward. Knowledge and skills scores pre-training were 51 percent and 46 percent respectively and both reached 92 percent post-training. In 2021 following training, healthcare workers provided 346,858 doses of injectable contraceptives, 14,376 IUD insertions, and 165,530 implants. Monthly CYPs doubled from 26,777 at training onset in January 2021 to 52,617 in December 2021. This generated 301,789 CYPs, prevented 135,963 unintended pregnancies, and averted 791 maternal deaths.
Conclusion
IHP demonstrated how LDHF training delivered at scale can significantly improve the competence and confidence for improved availability, accessibility, and utilization of quality FP services at the primary healthcare level. Local organizations enabled IHP to train thousands of healthcare workers and reach all wards and LGAs in the states.
