Parallel 3 - Abstract presentations (Oral-028 - Oral-030)

Innovative approaches to improve FP service delivery: Exploring a business case for PPMVs participation in achieving increased uptake of modern contraceptives
Authors: Uchenna Igbokwe, Uchenna Okafor, Amina Baba-Ari, Boniface Igomu
Address: Solina Center for International Development and Research, 8 Libreville crescent, Wuse 2, Abuja
Corresponding author:
Uchenna Igbokwe, MBChB, MSc
Phone: +234 803 400 8291
Email: uchenna.igbokwe@solinagroup.com
Category: Impactful strategies to strengthen the FP2030 agenda
Background
Nigeria's modern contraceptive uptake remains low at 12%, with high unmet needs for family planning amongst about 19% of married women. PPMVs represent a vital opportunity to improve the uptake of modern contraceptives due to their numbers, presence in rural communities, and market share. IntegratE, in collaboration with the government, implemented a 3-tiered accreditation program for PPMVs across Lagos and Kaduna states. The program built the capacities of PPMVs to provide quality family planning services and commodities. This study explores the Return on Investment (ROI) that PPMVs derived from the program and its value to their businesses.
Materials and Methods
A mixed method approach was used for data collection from a purposive sample of 224 enrolled PPMVs. Quantitative data on ROI were collected using semi-structured questionnaires, while focus group discussions were used to collect qualitative information.
Results
Over half of PPMVs reported increased revenue of 50-100% due to the program, with the majority attributing the revenue growth to malaria and family planning services. 90% of PPMVs affirmed the usefulness of the accreditation program to their businesses. The PPMVs identified increased capacity in FP service delivery, business management, and improved access to quality commodities as the most useful components of the program, which sustained their participation. 
Conclusion
Ensuring that PPMVs derive significant benefits from capacity improvement programs towards improved service delivery is imperative for sustainability and greater impacts.

Background
Comprehensive sex education is essential to prepare adolescents for life in a changing world. It improves sexual and reproductive health (SRH) outcomes and promotes safe and gender-equitable environments. With increasing number of out-of-school adolescents, the task becomes evident via formal education. This abstract assesses best practices among near-peers to increase access to SRH services among out-of-school adolescents.

Methods
The USAID/YPE4AH's strategy centers around Youth Hubs-safe space to seek reproductive health (RH) information/services. The TEENSMATA Hub is a product of user-centered design approach providing a safe-space to learn and play, manned with a near-peer nurse. The project combines sports, fun-based activities led by near-peer mentors (aged 20-28) to spur healthy behavior change among adolescent boys and girls (15-19). Adolescents visit the healthcare provider to discuss their SRH needs and other concerns. Aside the SKILLZ sessions, other adolescents' access ASRH information/services through walk-ins.

Result
Between March-August 2022, across the six hubs in Lagos and Kano, 6,729 adolescents were mobilized by youth coaches for group sessions and counseled on FP, while 3,323 took up contraceptives methods (61% females). Another 159 adolescents were referred by their peers who had completed the SKILLZ sessions, 100 of these taking FP methods. Adolescents reported feeling free to speak to each other about their SRH needs without bias and making extra efforts to refer peers to access information/services in a safe space irrespective of distance.

Conclusion
The findings show that despite the barriers in reaching out-of-school adolescents with comprehensive SRH information and services, mobilizing adolescents through near-peers and consequently peers, create opportunity to bring together a network of adolescents who can access comprehensive AYFS information/services within safe spaces. By harnessing positive peer-influence, Nigeria can make strides towards improving the health/well-being of young people

Background/Objective:
Flexi Track Survey conducted by The Challenge Initiative (TCI) Nigeria Hub reveals that the prevailing myths and misconceptions about contraceptives in Abia State is; contraceptives use encourages promiscuity (male 21.5%, female 15.8%), reduces sexual urge (male 16.6%, female 13.2%), leads to infertility (male 24.5%, female 21.4%), causes deformities in infants (male 23.0%, female 19.5%) and causes harm to the womb (male 23.9%, female 22.5%). The objective is to demonstrate the use of SBCC strategies in correcting FP misconceptions for improved access to FP counselling and services.
Materials and Methods: 
TCI supported SBCC committee is charged with the responsibility of coordinating all SBCC interventions and leveraging on existing events to spread correct FP messages. Social mobilization is another SBCC strategy used for FP demand generation to improve social norms in favor of FP. Interventions engage young men and women aged 18 to 35 years as Community Mobilizers who carry out Neighborhood Campaigns aimed at generating demand for FP. TCI also worked with Government to adapt and air TV and radio spots on FP.
Results: 
SBCC Committee strengthened Government ownership, better coordination of activities, diffusion of FP messages and entrenched sustainability. After these interventions, New FP Acceptors increased from 24,141 during a one year period without TCI support (July 2017 – June 2018) to 66,555 during a one year period of TCI support (July 2018 – June 2019) accounting for 46% increase in New FP Acceptors in Abia State (DHIS2).
Conclusion: 
Myths and misconceptions about contraceptives has continued to be a barrier to contraceptive use. There is need to intensify SBCC to motivate women and men of reproductive age to adopt healthy reproductive behaviors. Emphasis should be on using SBCC to dispel myths and misconceptions that contraceptives is dangerous to health, leads to infertility, causes harm to the womb and causes deformities in infants.