Nigeria

The most populous country in Africa, Nigeria accounts for approximately one-sixth of Africa's people. In 2008, it was estimated that 46% of Nigerians lived in an urban environment. Nigeria has at least 10 cities with over 1 million residents: Ibadan and Lagos in the South West, Kaduna and Kano in the North West, Abuja in the North Central, Maiduguri in the North East, Benin City and Port Harcourt in the South South, and Enugu and Owerri in the South East. In 2008, 66% of Nigeria’s urban population was reported to be living in slums with little access to basic amenities.

Nigeria has some of the worst poverty and health statistics in Africa; 92% of the population lives on less than U.S.$2 per day. In addition, Nigeria has one of the highest infant mortality rates (100 deaths per 1,000 live births) and an adjusted maternal mortality ratio of 800 per 100,000 live births.

Approximately 42% of the country’s population is under the age of 15 and 55% are between the ages of 15 and 49. Nigeria’s young age distribution is due in part to its high fertility as the average number of children born to a woman in Nigeria is 5.7. Having a large family is highly valued, thus decreasing the acceptance of modern contraception to space or limit births.

The country program of the Urban Reproductive Health Initiative in Nigeria (NURHI) is being implemented in Abuja, Benin City, Ibadan, Ilorin, Kaduna, and Zaria. NURHI, led by The Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP), is a 5-year (2009-2014) integrated family planning (FP) project. The project is designed to assist the government of Nigeria in revitalizing its FP program in the six selected urban centers.

NURHI will focus its efforts on promoting spacing and limiting methods, especially increasing access among the lowest and second-lowest wealth quintiles, in an effort to significantly increase contraceptive prevalence rate (CPR) by 2014 in the selected cities of Nigeria.

This will be accomplished by:

• developing cost-effective interventions for integrating quality FP with maternal and child health and HIV services;
• improving the quality of FP services for the urban poor with emphasis on high volume clinical settings;
• testing innovative private-sector approaches to increase access to and use of FP by the urban poor;
• developing interventions that create demand for and sustain the use of contraceptives; and
• increasing funding and financial mechanisms and a supportive policy environment for ensuring success to FP supplies and services for the urban poor.