Chief Nursing Officer Victoria Okwute has been working at the Kuchingoro Primary Health Clinic in Nigeria’s capital city of Abuja for the past seven years. On a typical day, she provides family planning counseling, guidance for new mothers, antenatal care, primary health care, and delivers babies. Health workers like Okwute, 51, are the last, vital step in the global health supply chain. They put health commodities like contraceptives into the hands of clients and counsel them on proper use.
This is more important than ever in Nigeria, which is expected to be the third most populous country in the world by 2050. An estimated 8 million babies were born in Nigeria in 2023, about the same as adding the entire population of Sierra Leone.
The average unmet need for family planning in Nigeria is 18.6% but access varies widely between urban and rural areas, and is influenced by income, education, and religious and cultural beliefs.
Through our USAID-funded Global Health Supply Chain Program–Procurement and Supply Management (GHSC–PSM) project, Chemonics has distributed 12 million family planning products to facilities like Kuchingoro in Nigeria since 2016. These contraceptives can help prevent approximately 12,000 maternal deaths, 2 million unintended pregnancies, and 58,000 child deaths.
Access to family planning helps more women to avoid unintended pregnancies and space their births, thus helping to avert maternal deaths. Although trending downward, Nigeria accounted for more than a quarter of the world’s maternal deaths in 2020—approximately 82,000—according to the World Health Organization.
Janet Daniel, 38, is one of Okwute’s maternal health clients. “I have one child, but one died, and I miscarried one, so I am tired,” says Daniel, who fell ill after her miscarriage.
“She has lower abdominal pain,” Okwute says. “The scan showed an infection. We gave her an antibiotic for seven days.”
Nigeria is expected to be the third most populous country in the world by 2050. An estimated 8 million babies were born in Nigeria in 2023, about the same as adding the entire population of Sierra Leone.
She advises Daniel to wait at least three months before she conceives again and schedules a family planning appointment for the next day. By providing contraceptives and counseling, Okwute plays an important role in helping women like Daniel safeguard their health. Pregnancies that come too close together are risky because the mother’s body has not had sufficient time to recover, which could lead to placental abruption and hemorrhage, miscarriage, low birth weight, and pre-term birth.
Financing to procure and distribute a continuous flow of contraceptives to hospitals and clinics is a key challenge. To address this, Chemonics works with the Government of Nigeria and organizations such as the United Nations Population Fund (UNFPA) to identify a sustainable financing mechanism to reduce recurrent commodity procurement funding gaps. This includes providing technical assistance for developing the National Guidelines for State-Funded Procurement of Family Planning Commodities so that Nigeria's states can contribute funds for contraceptives to help reduce the unmet need.
Through GHSC–PSM and in coordination with UNFPA, Chemonics has also provided support to Nigeria on last-mile distribution of contraceptives and training of service providers on logistics management. GHSC–PSM coordinated with the Nigerian government on tracking distribution to states and service delivery points. Between 2018 and 2021, these efforts led to a seven-fold increase in couple-years of protection based on the number of commodities delivered to health facilities.
Okwute says that the number of clients visiting the family planning clinic has increased in recent years because of the reliability of the contraceptives supply.
“More women are coming, even with spouses, for family planning,” Okwute says. “[Because] the products are available.”