IntegratE: SFH, Gates, govt seek sustainable family planning gains

By Chioma Obinna

The Society for Family Health, SFH, the Gates Foundation and government agencies have called for the institutionalisation of gains recorded under the IntegratE Project, saying stronger funding, data integration and referral systems are needed to sustain expanded access to family planning services in Nigeria.
The stakeholders said the nine-year initiative had demonstrated that trained community pharmacists, CPs, and Patent and Proprietary Medicine Vendors, PPMVs, could safely provide a wider range of family planning and primary healthcare services, particularly in underserved communities.
Speaking at the IntegratE Project Dissemination Meeting in Lagos, Permanent Secretary, Lagos State Primary Health Care Board, Dr Ibrahim Mustafa, said more than 904 community-based providers had been trained under the intervention in Lagos, reaching over 400,000 people.
He said the project had expanded the range of contraceptive services available through community pharmacies and PPMV outlets, noting that many providers previously offered mainly contraceptive pills and emergency contraceptives.
According to Mustafa, training enabled providers to safely administer specialised methods, including contraceptive implants and injectables, bringing services closer to residents.
“Over 904 personnel or providers have been trained, and they have reached more than 400,000 people,” he said.
Mustafa said the intervention should not end with the formal close-out of the project, stressing that the Lagos State Primary Health Care Board was committed to sustaining and, where possible, scaling up the gains.
“If we get it right in Lagos, we can as well say that Nigeria has gotten it right,” he said.
The programme, themed “Sustaining Gains in Family Planning: Lessons from the IntegratE Project for Service Delivery, Referral Systems and Data Management,” brought together government officials, regulators, development partners and healthcare stakeholders.
Funded by the Gates Foundation and led by SFH, IntegratE began in 2017 as a pilot in Lagos and Kaduna before expanding to nine additional states — Enugu, Gombe, Kano, Niger, Nasarawa, Borno, Yobe, Bauchi and Sokoto.
Between 2017 and 2026, the project trained 863 community pharmacists and 4,961 PPMVs across the 11 states. The providers delivered family planning services to 1,756,170 women, including 399,766 new acceptors, while an estimated 117,775 unintended pregnancies were averted.
The trained providers also saw more than 1.18 million children under five, tested over 923,000 people for malaria and treated 682,601 confirmed cases, alongside treating hundreds of thousands of cases of diarrhoea and pneumonia.
Speaking for the Gates Foundation, Rodio Diallo said one of the major lessons from the project was that women, particularly those in lower-income communities, often sought healthcare from providers closest to them.
She said equipping community-level providers with the necessary knowledge and skills therefore meant that healthcare could reach women where they lived.
“The key learning is that if you give knowledge to healthcare workers and empower them, they will be better equipped to meet women’s reproductive health needs,” Diallo said.
She said assessments comparing trained PPMVs and community pharmacists with providers at primary healthcare facilities showed comparable quality of care, providing evidence for the inclusion of community-based providers in Nigeria’s task-shifting and task-sharing framework.
Diallo, however, said the size of the provider network meant that government and other development partners would have to take greater responsibility for sustaining and expanding the model.
She said an estimated 200,000 PPMVs and community pharmacists operated across the country, adding that the Gates Foundation alone could not train the entire workforce.
She called for increased government budgetary commitment and stronger investment by development partners to expand training.
Representing SFH Group Chief Executive Officer, Dr Omokhudu Idogho, Group Director, SFH Donor Funded Portfolio, Emeka Okafor, said sustainability would depend on formally integrating community-based providers into Nigeria’s health information and referral systems.
He urged government to ensure that data generated by community pharmacies and PPMVs were captured in the National Health Management Information System, particularly DHIS-II.
Okafor said studies indicated that about 60 per cent of Nigerians accessed healthcare through the private sector, making the integration of private-sector data critical to effective health planning.
“If you’re a government and you’re taking a decision based on 40 per cent of the population, I’m not sure it’s a good decision,” he said.
He also stressed the need for functional referral pathways, saying community-based providers must be able to promptly refer patients whose conditions fall outside their scope of practice.
Registrar, Pharmacy Council of Nigeria, Ibrahim Babashehu Ahmed, said the project had contributed to the Council’s strategic planning, particularly through its tiered accreditation framework.
Ahmed said the framework had helped identify and categorise community-based providers according to their capacity, providing a basis for regulation and quality assurance.
He said the project’s close-out should represent a transition from donor funding to a sustainable, institutionalised model involving government, private providers and development partners.
Special Adviser to the Lagos State Governor on Health, Dr Kemi Ogunyemi, said sustainable progress in reproductive healthcare required strong institutions, reliable data, effective partnerships, competent health workers and functional referral systems.
Represented by Senior Special Assistant on Health to the Governor, Dr Toni Adeyemi, Ogunyemi said the state would examine lessons from IntegratE for possible incorporation into its family planning programme.
The project’s national results showed that, beyond family planning, trained providers had delivered a range of primary healthcare services, while community outreach and digital platforms reached more than 2.2 million women with family planning information and generated nearly one million referrals to IntegratE-trained providers.
Stakeholders said the next phase should focus on government ownership, local training capacity, policy and regulatory institutionalisation, as well as integration of private-sector data into government health information systems.
They also called for stronger referral networks and continued quality assurance to ensure that the gains recorded during the project translate into permanent improvements in access to family planning and primary healthcare services.