"This technical brief presents key learnings, best practices and experiences from implementing the Expanded Social Marketing Project in Nigeria (ESMPIN) between April 2011 to August 2016."
ESMPIN, implemented by Society for Family Health (SFH) Nigeria/United States Agency for International Development (USAID). Nationwide social marketing focuses the development objective of improving the health of women and children in Nigeria by increasing the use of modern family planning methods and child health products. Partners include the Association for Reproductive and Family Health (ARFH), BBC Media Action (BBC MA), and Population Services international (PSI).
"The case studies in this brief are used to highlight best practices, lessons learned, results, challenges, and achievements in the child health and family planning related aspects of the project. The four volumes in the series focus on" the following:
- Technical brief 1:
- Case study one - Community Participation in Program Implementation describes the community-based distribution approach for strengthening family planning (FP) practices and diarrhea prevention and management. EsMPIN identified and mobilised local resources within a community by choosing community leaders and influencers to find frontline workers called interpersonal communication agents (IPCAs), who led the programme’s field level social and behavioural change communication (SBCC) activities, resulting in accountability in implementation. "Community leaders, when engaged early, tended to be involved in monitoring and supervising frontline workers, including IPCs and health care facility workers." Review and monitoring sessions were set up as community forums with the ward development committees (WDC), which are community structures responsible for health and development within wards. Community monitoring guaranteed health personnel availability at public health clinics (PHCs), gave providers feedback on health results in the community, and helped ensure free commodity provision. Community leaders mobilised community members to monitor PHCs for improved programme sustainability.
- In case study two, ESMPIN used the community-based distribution (CBD) approach of family planning products in hard to reach areas of northern Nigeria, employing the community organisation, structure, and institutions to promote the use of and provide non-clinical family planning services and help ensure affordability and availability. In case study three, community-based distribution (CBD) assistants provided " information on effective and routine hand washing techniques with soap, the point of use water treatment for diarrhea prevention, and treatment of diarrhea with ORS [oral rehydration salts]/Zinc," working closely with WDC members.
- Technical brief 2:
- Case study four - Collaboration: Because FP services were lacking in some communities, ESMPIN worked with John Snow International (JSI) to training Long Acting Reversible Contraceptives (LARCS) providers after Advocacy at the state level sought support to build capacity of providers.
- Case study five demonstrates how integrating programmes helped increase malaria commodity uptake. Working with IPCAs, FP messages and malaria-related topic were disseminated for three months, and then the cycle switched to FP and diarrhea information dissemination.
- Technical brief 3: Case study six describes 10 cycles within the IPC intervention of ESMPIN including: community mobilisation sessions; meeting with the health department to identify high needs communities; holding male involvement sessions; using mass media to reinforce messages of IPCAs; collaborating with the private sector facilities to enhance coverage; continuously training proprietary medicine vendors, and using evidence-based social marketing. Sustainability was addressed with wall murals, community involvement, trained IPCAs, community health and community health extension workers, and trained service providers.
- Technical brief 4: Case study nine addresses the role of community leaders in fostering male involvement in maternal and child health through male involvement sessions with IPCAs and community leaders who are influential among men in their communities.
- Case study ten describes influencing government’s commitments by involving local governments in projects and seeking guidance from state governments, as swell as updating them on progress, in part through collecting service statistics and analysing bottlenecks and solving them through capacity building, and garnering political support and government staff support.
- Case study eleven addresses the ESMPIN experience and engagement of religious/traditional leaders in the role of advocacy for maternal and infant health by encouraging messaging in sermons on reproductive health and birth spacing, for example."Most religious leaders relied on the citations from religious books to support their reproductive health and birth spacing messages." On-day conferences helped to highlight areas where support was needed and to gain signatories to a communique of commitment by traditional and religious institutions and stakeholders to educate and mobilise their communities. When security is in question: "Modern FP methods are often misconceived and distributed with cultural and religious connotation, creating barriers for their uptake. Instability in a community as a result of security challenge is a threat to any program implementation. ...[F]ield managers liaise with security operatives or agents in the community in order to ensure the security of lives (for its agents and staff) and properties."
Population Services international (PSI) website, January 10 2018. Image credit: ESMPIN