Supporting Measurement and Replication Techniques for Family Planning High Impact Practices: An Assessment of the Scale, Reach, Quality and cost of Implementation in Nigeria- R4S study

The Family Planning High Impact Practices (HIP) initiative is a multi-organization effort started in 2010 that aims to highlight evidence-based practices that are vetted by experts against specific criteria, and that, when scaled up, will maximize impact in family planning (FP). HIPs are identified based on demonstrated impact on contraceptive use, scalability, sustainability, cost-effectiveness, and applicability in a wide range of settings. The HIP initiative is supported by more than 30 organizations that play a key role in developing, reviewing, disseminating, and implementing HIPs. The goal of this assessment was two-fold: 1) to generate evidence to help countries reflect on and optimize implementation of HIPs and 2) to inform harmonized, globally and locally relevant measurement standards for HIPs. The approach for measuring scale, reach, quality and cost was replicated in each country. HIPs varied by country and covered immediate postpartum FP (IPPFP), community health workers (CHWs), post-abortion FP (PAFP), pharmacies and drug shops (PDS), and mass media (MM). In Nigeria, the study was conducted in two states – Kadouna and Lagos states and covered four HIPs: IPPFP, PFPA, PDS and MM. This assessment of scale, reach, quality and cost of HIP implementation used a cross-sectional, observational design with the following data sources: 1. Key informant interviews (KIIs) with FP program managers and relevant social and behavioral change (SBC) technical leads within health promotion-focused units in the Ministry of Health (MOH) supplemented with desk review of relevant national level documents (all HIPs). 2. KIIs with program managers at managing authorities and desk review of relevant records or documents (all HIPs). 3. Service statistics (IPPFP, PAFP, PDS). 4. Health facility assessment (IPPFP, PAFP), a survey with FP providers (IPPFP, PAFP) and a survey with PDS. 5. Analysis of SBC strategies/plans and mass media products (MM). 6. Activity-based costing (all HIPs).