Addressing Family Planning Challenges in Kano State
Kano State, located in northern Nigeria, has one of the highest fertility rates in the country, with approximately 5.8 births per woman. This figure is nearly three times the global average of 2.2 births per woman. The state records around 1,000 births daily, contributing to rapid population growth and placing significant pressure on health facilities and Nigeria’s already fragile economy.
Family planning needs in Kano remain largely unmet due to limited access and low awareness. The modern contraceptive prevalence rate (mCPR) among women aged 15 to 49 is only 10.6%, a notable improvement from the 5% recorded in 2018. However, there is still a long way to go to ensure that all individuals who need family planning services have access to them.
Child Spacing: A Critical Issue
Child spacing, the practice of timing pregnancies to allow adequate intervals between births, remains poorly understood in Kano. Several challenges persist, including cultural misconceptions, inadequate access to contraceptives, stockouts of family planning commodities, and a shortage of trained healthcare personnel. Most discussions about child spacing focus primarily on women, excluding men from the conversation. This exclusion makes awareness efforts and messaging incomplete, as reproductive decisions often require support and agreement from both partners.
To address this gap, MSI Nigeria Reproductive Choices, a leading provider of sexual and reproductive health care services, actively involves men in discussions about child spacing and contraceptive use across communities in Kano State. Operating in Nigeria since 2009, the organization recognizes that sustainable behavior change in family planning requires engaging both women and men, as reproductive decisions are often made jointly within households.
Engaging Men and Women at Once
One of the strategies MSI Nigeria introduced to reach and include men in family planning discussions is through Majalisa, a traditional Hausa social space where men usually gather to discuss politics, business, and family. Through these gatherings, MSI engages men in Kano communities to provide information on child spacing. During these sessions, MSI staff speak to men in Hausa about the benefits and methods of child spacing and distribute leaflets that explain the available options.
Aminu Umar, a 28-year-old resident in Rano Local Government Area (LGA), has attended these male gatherings for nearly six years. He shared, “Today’s world with many social ills, child spacing offers the chance to train children properly without being overburdened.” He emphasized the importance of creating awareness about the significance of child spacing.
Ibrahim Turaki Aliyu, a tailor whose shop is situated near one of the Majalisa in Rano LGA, explained, “When we discuss child spacing, some people say it will help them economically because life is hard now. Everything is expensive. It [family planning] brings succour to [families], and that is when they [Majalisa members] would ask questions about the child spacing methods and how to access these services.”
For women, MSI Nigeria engages them through MS Ladies, community-based healthcare providers who deliver door-to-door family planning services from their own homes to women in their communities, including hard-to-reach areas. The initiative started with 25 MS Ladies in Kano and has now expanded to 100. Currently, there are 312 trained and certified MS Ladies spread across Nigeria.
Hajiya Ado Rano, who has volunteered as an MS Lady for at least four years, conducts in-reach engagements twice every month. These involve visiting communities that are far from the city. She stated that each month she reaches about 120 to 130 women within communities. She explained, “Since many of the communities we serve are hard-to-reach areas, if we say some of the women should come to town and collect these contraceptives, they cannot because the cost of transportation is too expensive. So, when it is time for the in-reach, I charter a tricycle and go to these communities.”
She also mentioned that all MS Ladies work with client record forms, which are completed by every woman who has accessed any of the child spacing commodities from them. The form has a physical and digital version to ensure data is saved.
However, she noted that some people spread false information about child spacing in their communities and cited the stockout of commodities as another challenge they face. In a month, she gets a request of about 40 Intrauterine Devices (IUDs), which exceeds the 10 or 15 she receives.
Community Mobilisers and Their Impact
Shamsiyya Malam, a resident of Wudil LGA, recalled that she heard about child spacing after giving birth to her third child. She has used an implant for five years and switched to the injectable method after its removal. She now encourages other women in her community to adopt suitable child spacing methods, stating, “When one gives birth to many children, it is often difficult to [take care of] them.”
According to Abdullahi Isa, MSI Nigeria’s Social Norms Advisor, the organization works collaboratively with the government to strengthen the health system through training of contraceptive providers on long-acting methods of family planning. Under their Public Sector Strengthening (PSS), they have supported 2,780 public health facilities. Through MSI Social Marketing, Isa said they ensure the availability of “affordable and high quality” sexual and reproductive health commodities such as condoms and back-up emergency contraceptives.
Voices from the Community
Halima Abdullahi Dankaza, who owns a local restaurant in Rano and volunteers for MSI Nigeria as a community mobiliser, creates awareness about child spacing in her community. She noted, “The women welcome it. Some would tell me that their husbands have mentioned it to them [already].”
Another MSI community mobiliser, Hauwa’u Umar Bello, in Kanyan Utai village of Wudil LGA, pointed out that people have many misconceptions about child spacing in her community. However, when they seek clarification in the right place, these misconceptions are often cleared. She urged all women to ask questions about child spacing in the right place to avoid being misled.
Umar, one of the men who learned about child spacing in his Majalisa, cited misinformation as a major problem they face in Rano. He noted that some people who are against contraception spread lies to discourage uptake of contraceptives. He also mentioned that there are a few cases of women who have experienced bleeding and weight loss after adopting it. When these side effects are shared with a health worker, they are immediately addressed.
