This abstract was presented by The Challenge Initiative (TCI) at the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.

1. State-led Approaches for Family Planning Demand Generation:
Lessons Learnt from the Rivers State Experience.
December 2020.
Authors: OLUCHI BASSEY*, Olukunle Omotosho, Olatunde Raimi, Chinonyerem Uhuaba
and Uduak Ananaba.

2. Presentation Outline
• Acknowledgements
• Background
• Objective
• Materials and Methods
• Results
• Lessons Learnt
• Conclusion
1

3. Acknowledgement
• To our program management at the TCI Nigeria Hub: Dr. Victor Igharo (Dir.
TCI-Nigeria) and Dr. Olukunle Omotosho (PM DG) for their innovative
leadership and support in driving DG activities on the TCI Program.
• To the entire Rivers State Health Education Team: State Health Educator, LGA
Social Mobilization Officers, and State SBCC Committee members.
• To our 120 social mobilizers, the foot-soldiers driving the demand as “the
unsung heroes’’…
• To my co-authors: Dr. Kunle, Olatunde, Chinonyerem and State Team Lead
Uduak for their support in ‘putting the work in words’.

4. 3
Background
TCI DG strategy model: build, strengthen and promote States’ capacity to implement sustainable FP
DG interventions.
…State-led approach using existing State structures at LGA/communities to implement an array
of high impact intervention (HII) activities.
Custom-made technical assistance (TA) i.e “Lead-Assist-Observe” designed to deliver results in 6
months.
Since 2019, DG social mobilization strategy have been implemented in Rivers State in 2
different Phases: (Entry-LGAs Phase and Expanded-LGAs Phase).
Mass media campaigns, Edutainment, use of SBCC, and widespread Social mobilization.

5. 4
Objective
This study aims to evaluate the 2 different Phases in a time-period of the first
four months for program impact and lessons learnt.
Mobilization in total 12 demonstration LGAs:
 Entry Phase (8 LGAs) applied the Lead-Assist-Observe model using mid-level Social
Mobilization Assistants (SMAs) for July 2019 - June 2020.
 Expanded Phase applied Observe-Assist model without SMAs (additional 4 LGAs) from
July 2020 – date.

6. 5
Materials and Methods
 TCI-Rivers State partnership commenced April 2019 for active social mobilization/DG engagements.
State-led approach framework:
 State Social Mobilization Units
 LGA Social Mobilization Units
 Community volunteers.
Both phases used trained community volunteers as
social mobilizers (SMs) communicating FP/LPAY
messages through HII activities (e.g NCs).
Evaluation focused SM activities
conducted during Entry and
Expanded LGAs Phases.
Data reviewed was from PMIS on 4 DG indicators
per LGA per Phase.
DG indicators: number SM activities
• number persons reached with FP/LPAY messages
• number persons issued referrals
• number completing referrals
Results were further assessed for completed-
referral-efficiency (CRR) trends [(number
referred/number completed referrals)x100] per Phase.

7. Results….l
6
Indicator Entry Expanded
No SM activities 200 206
Persons reached 28502 29090
Issued referrals 2550 3206
Completed referrals 712 1704
Lowest/Highest
completed refs
25
417
246
512
Sharp evident increases across all 4 DG data indicators from baseline of each Phase
Indicator Entry
(%age
increase)
Expanded
(%age
increase)
No SM activities 110 56
Persons reached 235 94
Issued referrals 1407.6 60.2
Completed referrals 1568 108.1

8. Results….l
7
 27.9% CRR Entry Phase of 8 LGAs
 53.2% CRR Expanded Phase of 12 LGAs
(devoid of the SMA-linkage approach)
Mirror’ data trends for both Phases
2991
7644 7835
10032
65 151
893 980
25 0 125 417
28
59
54
59
0
20
40
60
80
0
2000
4000
6000
8000
10000
12000
Jul-19 Aug-19 Sep-19 Oct-19
Entry-LGAs Phase DG Indicators
Reached Referred
Complted No of SM events
4001
8393 8907
7789
488 895 1041 782246 468 478 512
37
58
53
58
0
20
40
60
80
0
2000
4000
6000
8000
10000
Jul-20 Aug-20 Sep-20 Oct-20
Expanded-LGAs Phase DG Indicators.
Reached Referred
Completd No of SM events
Additional LGAs performance 19% on
all except completed referrals at 12%.

9. Results…ll
38.5
0.0
14.0
42.6
27.9
50.4 52.3
45.9
65.5
53.2
0.0
20.0
40.0
60.0
80.0
July CRR % Aug CRR % Sept CRR % Oct CRR % Total CRR %
Entry vs Expanded Phase Completed Referraal Efficiency (%)
Entry-2019 Expanded-2020
Monthly CRR trends had fluctuations but showed 4.1% and 15.1% increase from each Phase’s baseline.

10. Learnings
9
Consistency and proof-of-mandate of the
TCI BU DG model (i.e visible results in 3
months).
Evident increases recorded in both Phases
clearly demonstrates that FP ‘intenders’ are
actively being reached and accessing services
in Rivers State.
Better program efficiency when State
structures/Officials’ capacity is directly
strengthened.
Expanded Phase approach: a model for
effective FP/CBS DG resource mobilization
(e.g HR), funding and sustainability in the
journey to States’ ‘self reliance’.
Seamless DG data collation and
documentation the ‘bane’ of either approach.
DG activities funding ‘paucity’ and poor
DG-SD linkages major constraints for
State-led FP DG.

11. Quote…
The Challenge Initiative Nigeria
10
“…TCI is working in partnership with the State; and for social mobilization/health education, we
are driving the process but gaining the technical support from TCI. By that, I mean that the State
creates the platform... We have drawn up our workplan and have a standard workplan for family
planning (through TCI’s support). Currently, we able to build family planning into our other
programs – Maternal Newborn and Child Health Week (MNCH-W) for example. As a result of the
support, we are also able to expand more, the entire State 23 Local Government Areas (LGAs)
have benefitted, even though TCI is only working in eight LGAs. There’s also that relationship and
cooperation going on among different stakeholders for demand generation as a result of TCI…”
Dr. Doris Nria
State Health Educator/State Counterpart DG.
Rivers State, Nigeria.

12. Conclusion
The Challenge Initiative Nigeria
11
The TCI BU DG Strategy Model of State-led approaches for FP/CBS demand
generation/social mobilization offers cities/LGAs/States long-term solutions to program
coordination, ownership, and sustainability for demand generation activities for FP/CBS
and possibly other program areas.
References:
1. SOCIAL MOBILIZATION: Improving Social Norms in Favor of Family Planning through Social Mobilization.
2. Demand Driven City Engagement: A TCI Technical Brief.
3. The Hub Year 5 TCI DG Strategy Statement – 2019/2020.
4. NURHI 2 Demand Generation Strategy – 2015-2020.
5. https://tciurbanhealth.org/demand-driven-model/
6. https://www.gatesinstitute.org/challenge-initiative-tci

13. Conclusion
The Challenge Initiative Nigeria
12
Oluchi Bassey
Facebook.com/luchy.kalu
Ivoryluchy
oluchibassey@gmail.com
@DrOlyB