IntegratE Project Boosts Community Access to Family Planning Services in Kano

Mahdi Garba (Lead writer)

For more than five years, Dauda Musa has run a patent medicine shop in Rano Local Government Area (LGA), Kano. In 2023, after receiving formal training through the IntegratE project, he began offering family planning services, an example of how building the capacity of patent medicine vendors can improve access to reproductive health services, by bringing them closer to underserved communities.

“Before the training, we were just operating, but when professionals came and trained us on how to provide family planning services, everything improved,” he recounted. “On my part, I will describe this training as a success because I have gained a lot of knowledge, and I now understand when to refer a patient to a bigger facility.”

The training, facilitated by Society for Family Health (SFH) under the IntegratE project, followed the three-tier accreditation of Patent and Propriety Medicine Vendors (PPMVs) instituted by the Pharmacy Council of Nigeria. Tier one includes individuals with a secondary school certificate, but no formal healthcare training; tier two covers those with some health qualifications, such as nurses or Community Health Extension Workers (CHEWs), who may wish to run a PPMV shop; and tier three applies to pharmacy technicians trained in health institutions or schools of health technology.

Using this structure, the IntegratE project trained Musa, categorized as tier one PPMV based on his qualification, to sell condoms and resupply pills. CHEWs and other health professionals are classified as tier two, and pharmacy technicians are tier three.

Musa shared that what excites him most is having the knowledge to counsel people in the Rano community on the benefits of family planning. “Probably because I live in the city centre, men are the ones who mostly come to me to buy condoms but there are men that come with their wives for counselling and buying pills,” he explained. “Each day, we get three to four people who seek these services.”
 
Regulating and professionalising PPMVs

Kano State has one of the highest total fertility rates in Nigeria, at nearly 6.8. The state is also experiencing rapid population growth, with around 1,000 births recorded daily, this further strains health facilities and puts pressure on the state’s limited resources.

However, family planning needs in Kano remain largely unmet. The modern contraceptive prevalence rate (mCPR) among women aged 15–49 is only 10.6%, an increase from 5% in 2018. Challenges such as cultural misconceptions, stockouts of commodities, and a shortage of trained health workers are issues that limit progress.

To close this gap, vendors in tiers two and three of the PPMV structure are trained to provide long-acting reversible contraceptive (LARC) services. LARCs such as implants placed under the skin and intrauterine contraceptive devices (IUCDs) offer women safe, effective and longer-lasting protection from pregnancy without the need for daily use. LARCs provide women a longer term contraception, protecting them from pregnancywith choice and control over their reproductive health.

The reach of IntegratE in Kano

According to Zainab Abdulsalam, State Technical Advisor for the IntegratE project, the goal is to ensure that the PPMVs provide quality family planning services while complying with regulations. She explained that the project is being implemented in 10 other states, Kaduna, Lagos, Nasarawa, Niger, Gombe, Yobe, Bauchi, Enugu, Sokoto and Borno. In Kano State alone, IntegatE operates in 43 of the 44 LGAs.

Abdulsalam expressed optimism that coverage will soon extend to Tofa, the only LGA that has not been reached yet.

The first phase of the IntegratE project was launched in Kaduna and Lagos states in 2017. Building on its success, according to the technical advisor, the second phase which includes Kano was rolled out in 2021 and has since expanded to other states.

In Kano, the project has trained 60 community pharmacists and 832 PPMVs, bringing the total to 892 providers. “We have seen great improvement in the services they provide. They provide quality family planning services; they provide counselling cards and other family planning tools.” she emphasised.

Women choosing child spacing

Bahijja Usaini Sulaiman, a 35-year-old mother of four from Rano, recalled that she first learned about child spacing after she gave birth to her first child. “It is because of the advantage of these pills I collect here [Musa’s medicine shop] that I introduced others to them. I have introduced more than 10 women to these pills,” she said proudly.

Another Rano resident, Khadija Sani Ibrahim, has used contraceptives for nearly a year. As a mother of thress, she explained that child spacing supports the health of both mother and child, “There are situations where a pregnant woman has a baby she is[still breastfeeding. It will be difficult for the woman to take care of the baby in her womb and the one she is nursing. I encourage other women to start child spacing.”

In Sabon Garin Bauchi community of Wudil LGA, Hajara Adamu, a tier two CHEW, expressed satisfaction with the growing awareness among women about child spacing in her community. She shared that 10 to 20 women visit her shop every week for family planning services. “Most women ask questions about the side effects of the injections and implants and I take time to explain that the reaction depends on body type. When I explain [like that], most of them understand.”

The road to sustainability

Abdulsalam explained that while the IntegratE project have made provisions for sustainability, a key challenge is whether the State is prepared to fully take ownership. Although the State shows signs of willingness, she noted that SFH cannot yet ascertain the level of commitment. For long-term impact, the state government must prioritise integrating PPMVs into their health systems, ensuring sustained training and supervision, in addition to commodity supply as part of family planning policies. Contrary to common perceptions about their lack of knowledge, Abdulsalam emphasised that PPMVs are often eager to comply with regulations when properly supported.