Parallel 6 - Oral Session (037 – 039)

Background 
Many healthcare providers do not have sufficient experience and skills to provide adequate and inclusive quality of care to young people because of lack of training to prepare them for caring for the sexual and reproductive healthcare needs of young people. The advent of the COVID-19 pandemic has further complicated how the initiatives to ameliorate the challenges of health service delivery, for example, for the training of healthcare providers are being implemented. As such innovative approaches such as digital training are becoming among the initiatives to train healthcare providers for an inclusive adolescent and youth friendly SRH services. Therefore, this study evaluates a digital training course on gender-inclusive sexual and reproductive healthcare and rights of adolescent and youth for health providers in Nigeria. 
Method
The study adopted a quantitative data approach using a pre-post assessment of 20 providers trained on a digital platform (Medical Learning Hub).
Result
The result showed that the average knowledge assessment on counselling skills prior to the digital training was 38% and 89% after the digital training. This is showing a significant improvement in counselling skills of the healthcare providers in meeting the SRHR needs of LGBTQi+ youths with a 50% knowledge gain (p< 0.05). Also, the overall average knowledge score prior to the digital training was 44.8% but the score improved tremendously after the training with 76.7% during the post test. This shows 31.9% significant knowledge gain of the healthcare providers on the SRHR needs of LGBTQi+ Youths, which is statistically significant at 95% Confidence Interval.
Conclusions
This study concludes that using digital platform to strengthen the skill, knowledge and attitude of health workers is the most cost-effective and efficient means of capacity strengthening for health workers in Nigeria. 
Keywords: Digital Training Course, Gender Inclusiveness, Sexual and Reproductive Health Care, Adolescents and Young Persons

Introduction: In Nigeria, Contraceptive prevalence is 17% with limitations against adolescent uptake of Family Planning (FP) methods. Despite the training of multicadre providers on youth-friendly services, the number of young people receiving services at the health facilities in Lagos and Kano are still quite low. One of the strategies to address this challenge is to encourage visibility and enhance whole-site orientation for all facility staff. This study examined the effect of increased visibility of Adolescent Youth Friendly Health Services (AYFHS) on increasing FP uptake among adolescents.
Methods: Facilities were selected through purposive sampling methods from four LGAs in Lagos and Kano States, to participate in a pilot. Monthly data was tracked from the health facility register and desk review was done to observe the uptake trends across the health facilities that received FP green dot logo (FPGDL) and AYFHS banner between May-August 2022.
Results: Eighteen facilities were branded with the FPGDL and AYFHS banner. Of these, fourteen recorded increased client flow for counselling (FP, GBV and Substance abuse) and FP services; from 359 pre-branding to 416 adolescents after the branding. In addition to the branding, sampled facilities also conducted targeted mobilization, which led to over 80% increase in adolescents visiting the facilities for FP information and services in just four months, from May 2022 (67 FP users) to August 2022 (223 FP users).


Conclusion/Lessons: Creating awareness of modern FP methods availability with the aid of FP Green Dot and AYFHS banners installed within and outside the health facilities significantly increases client flow and uptake of FP methods among adolescents.
Keywords: Adolescents, youth friendly services, family planning, health facility.

Background
In Bauchi, Kebbi, Ebonyi, and Sokoto States and the Federal Capital Territory (FCT), women in remote underserved communities have limited access to family planning services. Innovative approaches to improve availability, access and utilization of family planning services are needed to prevent unintended pregnancies and avert mortalities and morbidities. 
Methodology
The U.S. Agency for International Development Integrated Health Program (IHP) implemented Primary Healthcare (PHC) Extension Services (ES) between May and August of 2022 in partnership with 462 primary health care facilities in Bauchi, Kebbi, Ebonyi and Sokoto states and FCT to increase access to an integrated package of quality services, including FP in remote and underserved communities. FP services rendered included long-acting reversible contraceptives (LARC), injectables, and DMPA-SC. DHIS2 data revealed PHC extension services contributed to increased utilization of FP in participating PHCs. 
Results
Comparing monthly LARC utilization at PHCES participating facilities before (October 2021) and after (August 2022) in the four states and FCT , modern contraceptive use rose from 22,671 to 29,436 women of reproductive age, new acceptors grew from 13,752 to 21,023, and postpartum family planning doubled from 1,000 to 2,213. Monthly uptake of injectables increased from 13,337 in October 2021 to 16,614 in August 2022, IUD insertions rose from 367 to 622, and implant insertions rose from 5,397 to 7,825.


Conclusion
Implementation of PHC extension service has led to improvements in availability, accessibility, and utilization of LARC by women in the remote and unserved communities. Strengthening and scaling PHC extension service is recommended to improve utilization of quality of FP services, particularly LARC.