Adolescents 360 Evaluation: What do service providers think about contraceptive service provision to 15–19 year old girls in Nigeria?

What are service providers’ perspectives of contraceptive service provision to adolescent girls in Nigeria?

In Nigeria, the Adolescents 360 (A360) program aims to make contraception relevant to girls in order to increase uptake. In the South, A360 does this through connecting contraception to girls’ lives and dreams, combining counselling with Saturday sessions. In the North, A360 targets married girls and their husbands, using maternal and child health as an entry point.

However, programmatic data to June 2018 showed a heavy skew towards uptake of short-term methods over long-acting reversible contraceptives. A360 felt that this skew could be grounded in service provider bias, and wanted to know more about service providers’ perspectives and the role they might be playing in service delivery.

Using a participatory action research approach, the evaluation team set out to investigate these issues. We found that, despite a desire to serve girls with any method of contraception of her choice, aided by the additional training received from A360, service providers are confronted with implicit and systemic biases that prevent them from doing so in reality. This is confounded by pervasive myths and misconceptions associated with long-acting contraception in the community, and other factors outside the service providers’ control.