Parallel 6 - Oral Session 4 (045, 046, 048)

Introduction:
Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are the first point of primary health care for most Nigerians. Given their widespread presence, IntegratE project works with the Federal Ministry of Health (FMoH) to broaden its task-sharing and task-shifting (TSTS) policy by piloting a tiered accreditation system, led by the Pharmacy Council of Nigeria (PCN) in Lagos and Kaduna States with the view to scale-up the concept. The project builds on evidence and learning generated during implementation to improve private sector provision of family planning (FP) services in Nigeria. The objective of this study was to compare health trained PPMVs' knowledge and skills gained and retained at 9 months to public health care providers offering FP counselling and injectables and implants services in the public sector.
Methodology: 
656 health trained PPMVs were trained on how to provide quality FP counseling services using the Balance Counseling Strategy toolkit. Nine months after training, their knowledge and practice of contraceptive service delivery were assessed and compared with public health providers in some selected health facilities, using structured questionnaire. Bivariate analysis using chi-square was used to determine the level of difference between health trained PPMVs and public providers.
Results
There was no significant difference in general FP counseling knowledge between health trained PPMVs and public providers in almost all indicators. Knowledge of side effects and contraindications of injectables and implants was significantly lower among health trained PPMVs compared to public facility providers. There was no significant difference in knowledge of administration of injectables between health trained PPMVs and public providers.

Conclusion 
Findings showed that health trained PPMVs can provide similar services provided in public facilities. Expanding the range of FP methods provided by health trained PPMVs will contribute to task sharing policy of FMoH and increase access to contraceptives in underserved areas. 

Background: Rivers State is one of the states in the Niger Delta region with a population of over eight (8) million people. 
Over 22% of these populations are women of reproductive age requiring family planning services. Our journey to step up the uptake of family planning services in the state began with the inauguration of the Rivers State family planning advocacy working group (RSFPAWG) in 2016.
No sooner that the group was inaugurated than it went moribund, not having capacity to carry out the work. Challenge Initiative (TCI) came to partner with the Rivers State Government, and discovered RSFPAWG and its constituents
TCI built the capacity, and challenged all the constituents of the FPAWG to become self-sustainable. TCI, graduated out of Rivers State May 6, 2022 and all the constituents of FPAWG were at various stages of their sustainability plan.
Methods: The religious leaders' subcommittee of FPAWG, which at the climax of their sustainability plan have registered with CAC as interfaith initiative for sustainable Health; have been integrating Advocacy on family planning into faith base sector programs through the following methods.
Decoration of family planning champions. Integration of Family Planning advocacy into community prayer & fasting programs Integration of Family Planning advocacy into large denominational conferences RESULTS: 
There is widespread acceptance of Family Planning advocacy messages by prominent Religious leader we decorated as Family Planning champions. Community leaders & Church members widely embrace Family Planning advocacy messages and disseminated same to their peers Improved level of awareness and uptake of Family Planning services in the state 

Conclusion & Recommendation: There is need to train more religious leaders of both the Christian and Islamic faith in all L.G.As in the State using the TCI training and capacity building modules to reduce the gap in uptake of Family planning services in the State.

Background
Quality of counseling received during family planning (FP) service provision is associated with contraceptive uptake and continuation. Although Patent and Proprietary Medicine Vendors (PPMVs) and Community Pharmacists (CPs) are the leading source of modern contraceptives in the private sector, little or no information is available on the quality of information exchange with clients. As part of IntegratE pilot study, we measured the quality of counseling received from CPs and PPMVs using the method information index plus (MII+). Specifically, what are clients' characteristics associated with high quality counseling (MII+) by state?

Methodology
Between June 2019 and February 2021, we collected data from 834 women aged 18-49 who had visited an IntegratE trained CP/PPMV for FP services in the last 2 weeks prior to the survey in Kaduna and Lagos states, Nigeria.
The quality of counseling received (MII+) was constructed using questions on whether a woman was told about other FP methods, possible side effects, what to do if side effects were experienced, and possibility of switching to another method. A binary variable, MII+ was created, with women who responded "yes" to all four questions coded as 1, and women who reported yes to less than four of these questions coded as 0. Clients' characteristics and quality of counseling were tested for association using χ2 tests.

Results
Almost two-third (61%) of women received complete information of the MII+. In Lagos, level of education, and household wealth index of women were significantly associated with receiving complete information. Religion, type of facility and fertility intentions were significantly associated with women receiving complete information in Kaduna.

Conclusion
Findings showed that quality of counseling received from trained CPs and PPMVs is very encouraging. Differences observed in factors associated with MII+ between states suggests that quality of counseling can be further improved and requires further investigation.