Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.

BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.

Objectives: The significant improvement in the contraceptive prevalence rate in Kaduna State, Nigeria, from 8.4% in 2008 to 18.5% in 2013 is a notable achievement. This article analyses the role of midwives as drivers of reproductive health commodity security (RHCS) and their impact on contraceptive use in Kaduna State. Methods: The United Nations Population Fund (UNFPA) supported the bimonthly review resupply meetings facilitated by midwives at State and local government area (LGA) levels. The midwives deliver contraception to the LGAs for onward distribution to 6974 of the 25,000 health facilities across the country according to usage data from the previous 2 months. They also collect requisition, issue and resupply form data from the previous 2 months. Results: The active participation of midwives at the bimonthly meetings improved data timeliness by 23% and data completeness by 50% in 1 year. Only one health facility ran out of intrauterine devices and only 17% reported running out of female condoms. The total number of contraceptives issued increased from 31,866 in 2012 to 177,828 in 2013, resulting in a couple–year protection increase from 3408 in 2012 to 102,207 in 2013. Conclusions: Creation of increased demand and engagement of midwives in providing family planning services, especially long-acting contraceptive methods, coupled with the removal of cost to the user and the strengthening of the supply chain have been major factors in more than doubling the contraceptive prevalence rate.

Background: In 2015, the United Nations Development Programme (UNDP) noted that countries will need to meet the increasing demand for contraceptives by the over 600 million 15- to 19-year-olds around the world. Although the unmet need for contraception for Women of Child Bearing Age (WCBA) in Nigeria is 12.7%, the value is higher (35.3%) among adolescents aged 15 – 19 years. Additionally, the unmet need for family planning (FP) among WCBA in Kaduna state is 5.8%, with 33.3% of women aged 20-24 years in Kaduna reported to have had a live birth before the age of 18 years. This study sought to evaluate adolescent contraceptive use in three referral health facilities of Kaduna metropolis. Methods: This is a descriptive cross-sectional desk review of 5543 FP clients that attended three referral centers between 2014 and 2016. Data on their age, parity and the use of contraceptives were collected from the clinic registers and analyzed using SPSS 22. Results: The FP client age ranged from 12 to 57 years, of which only 3.6% were adolescent. The annual proportion of adolescent contraceptive users ranged from 3.1 – 4.1%. More than 96% of the adolescents had given birth to at least one child. Around 62% of the adolescents used injectable contraceptives but there was no IUD use reported by any adolescent. Conclusions: The low proportion of adolescent contraceptive users and their limited choice of contraceptive methods, emanating from multiplicity of client and provider bias, calls for innovative interventions to meet the contraceptive needs of adolescents.

Background: Globally, women and their unborn babies continue to die from preventable causes. This study aims to highlight the causes of maternal and perinatal deaths and bring to the fore areas that need to be improved in order to improve maternal and perinatal health indices in Gombe State. Methodology: Information for this report was obtained from Maternal and Perinatal Deaths Surveillance and Response (MPDSR) desk officers and chairmen across MPDSR supported health facilities in the state. Secondary data abstraction from registers was conducted using an electronic questionnaire and was analysed using SPSS version 23. Findings: The Maternal Mortality Ratio (MMR) was 1,092/100,000 livebirths in 2019 and 993/100,000 live births in 2020. Majority of the women (84.3% and 86.7% in 2019 and 2020 respectively) were severely ill at presentation, while most maternal deaths were as a result of eclampsia/pre-eclampsia and Post Partum Haemorrhage (PPH). Only 15.9% and 14.4% of maternal deaths in 2019 and 2020 respectively were reviewed. Perinatal asphyxia accounted for 36.4% and 31.8% of perinatal deaths in 2019 and 2020 respectively, while prematurity resulted in 24.7% and 35.6% of deaths in 2019 and 2020 respectively. The Perinatal Mortality Rates (PMR) were 78.3/1000 births in 2019 and 76.1/1000 births in 2020. Conclusion: Although MMR and PMR have been on a decline in Gombe state from 2018 till date, these figures are still far from achieving the SDG 2030 target. There is therefore the need to revive MPDSR activities in the state and improve emergency obstetric health care services.