RAPID ILORIN. Building a Future of Quality, A Happy People, A Happy City of Ilorin.

Transcription

1 RAPID ILORIN Building a Future of Quality, A Happy People, A Happy City of Ilorin

2 RAPID Ilorin Building a Future of Quality, A Happy People, A Happy City of Ilorin This booklet focuses on efforts to build a high quality future for the people of Ilorin city, and ensure that the people and city are happy.

3 Produced by the FUTURES Institute in collaboration with the Nigerian Urban Reproductive Health Initiative (NURHI), a Bill and Melinda Gates Foundation funded project in Nigeria. ISBN-13: Suggested Citation: NURHI Rapid Ilorin: Building a Future of Quality, A Happy People, A Happy City of Ilorin. Nigerian Reproductive Health Initiative (NURHI) [JHU-CCP, USA; Abuja, Nigeria]. NURHI 2013

4 CONTENTS Urbanization in Nigeria...2 Ilorin s Population Dynamics...6 Population of Development...10 Health...20 Education...28 Infrastructure...35 Economy...39 What can we do?...43 Table of contents iii

5 Urbanization in Nigeria Ilorin Population Dynamics Population and Development: The Crucial Links What Can We Do? This booklet has four sections: 1. Urbanization in Nigeria; 2. Ilorin population dynamics; 3. Population and development: their crucial linkages; and 4. What can we do? I

6 Urbanization in Nigeria Photo by Ryan Paetzold Let us start by examining Ilorin s urbanization in the broader context of urbanization in Nigeria. Urbanization in Nigeria 2

7 Nigeria Urban/Rural Population After 2010, Nigeria became more urban than rural 200 Population (in millions) Urban Population Rural Population International statistics show that Nigeria experienced and is till experiencing one of the fastest rates of urbanization in the world. The graph above depicts the actual and projected growth of Nigeria s urban and rural populations with Nigeria s urban population almost doubling the rural population In 1950, Nigeria had over 30M rural population but less than 4M urban population. Over the years, Nigeria s rural and urban populations continued to grow, but after 1990, the rural population grew more slowly, whereas urban growth became very rapid. In 2005, Nigeria s rural population numbered over 75M compared to 65M urban population. By 2010, the urban and rural populations were nearly equal. It is projected that by 2015, three years from now, Nigeria s urban population will be almost 94M while the rural population will be around 82M. More people will be living in Nigeria s cities and the country s rapid urbanization rate is expected to continue into the future. Urbanization in Nigeria 3

8 Nigeria has a Vision for Urban Development The National Urban Development Policy calls for: Providing adequate shelter for all Poverty reduction and economic empowerment Ensuring environmental sustainability Good governance and development The Urbanization process is irreversible in Nigeria and must therefore be turned into opportunities for growth Permanent Secretary, Federal Ministry of Housing and Urban Development, Nigeria 2005 presentation Nigeria s National Urban Development Policy calls for Providing adequate shelter for all Poverty reduction and economic empowerment Ensuring environmental sustainability Good governance and socio-economic development As the Permanent Secretary of the Federal Ministry of Housing and Urban Development emphasized, the urbanization process is irreversible. Nigerians must turn urbanization and its challenges into opportunities for growth. Urbanization in Nigeria 4

9 However, there are challenges with policy implementation which is resulting in poor quality of life for city residents, especially among the urban poor. One of the key challenges in policy implementation of the urbanization plan is the rapid growth in the population of cities. This creates a situation where the government is unable to: - Maintain and expand infrastructure Provide adequate, high quality social services Create an environment that is conducive to economic development However, there are challenges with policy implementation which is resulting in poor quality of life for city residents, especially among the urban poor. One of the key challenges in policy implementation of the urbanization plan is the rapid growth in the population of cities. Such rapid growth has created a situation where the government is unable to: Maintain and expand much needed physical infrastructure Provide adequate, high quality social services for various sectors of the population Create the environment that is conducive for economic development Urbanization in Nigeria 5

10 Ilorin s Population Dynamics Photo by Bonnie NURHI Let us now examine closely Ilorin s population characteristics. Ilorin s Population Dynamics 6

11 Let s Focus on 5 Urban Areas Ilorin East Ilorin South Ilorin West Irepodun Offa For this presentation, whenever I say Ilorin city, I am referring specifically to the combined information of these 5 LGAs: Ilorin East, Ilorin South, Ilorin West, Irepodun and Offa. Ilorin s Population Dynamics 7

12 Current Situation of Ilorin 1.1 million total population of the 5 LGAs On average, each woman has more than 4 children 27% of married women use a modern method of family Almost 400 maternal deaths per year NURHI/MLE Baseline Report 2010 At present, the five focus urban LGAs of Ilorin have a combined total population of 1.1 million. On average, each woman in Ilorin city has given birth to more than 4 children in her lifetime (total fertility rate is 4.2 children per woman). An estimated 27% of currently married women are using a modern method of family planning. Every year at present, as many as 400 Ilorin mothers die due to pregnancy-related reasons. Ilorin s Population Dynamics 8

13 Ilorin Population Structure 2011 Population of Ilorin, projected using the 2006 census Male Female Ilorin has a young population There are more people in the non-working ages (younger than 15 yrs and those 65 yrs and over) than people in the working ages (15-64 yrs) 42% of population is under age 15 Because information on the age and sex composition at the LGA level is not readily available, we applied the age and sex percentage distribution of the state to the five focus LGAs of Ilorin in order to obtain numbers by age and sex. Ilorin has a young population, with 42% of the entire population under 15 years of age, and very large segments of the youth population concentrated in the ages 5-9 and Despite more older children (ages 5-14 yrs), even the population in the youngest age group (0-4) is much larger than the population in ages 15-19, or 20-24, or any of the older adult ages. Overall, Ilorin has more people in the nonworking ages (younger than 15 years + 65 years and older) than in the working ages Ilorin s Population Dynamics 9

14 Population & Development Photo by lisago Let us now look at the implications of Ilorin s population characteristics on development. Population & Development 10

15 Population and Economic Development are Linked A much larger working age population compared to the population in young dependent ages was a key factor in the Asian development miracle. As families became smaller, dependency declined even more. Greater emphasis on population quality than quantity meant increased investments by the state More and better educational opportunities emerged Greater productivity Investment in modern agriculture RAPID: Computer Programs for Examining the Socioeconomic Impacts of Population Growth Studies all over the world show that population and economic development are linked. Because fertility rates had been declining, a much larger working age population compared to the population in the young dependent ages emerged. This was a key factor in the Asian development miracle, or what the Asian tigers experienced. As families became even smaller, the percentage of the population in the young dependent ages declined, and the percentage of the population in the working ages grew even larger, resulting in significant declines in dependency. The governments of the Asian tigers also emphasized population quality rather than quantity, and Asian state leaders increased investments to improve the quality of the population. More and better educational opportunities emerged from increased government investments on education. More and better educated working force meant greater productivity that allowed even more economic investments. More investments included investments in modernizing agriculture, using modern equipment and technology along with fewer but skilled agricultural workers. Population & Development 11

16 A key component to the success of Asian tigers: investment in family planning Increased investments in family planning programs and services Improved access and increased use of modern contraceptives Contributed to improved quality of life and escalated economic development Photo by Bonnie NURHI Asian tigers A key component of the success of the Asian tigers was investment in family planning. Family planning investments led to improved access and increased use of modern contraceptives in these Asian countries. As a result, family planning contributed to improved quality of life and rapid escalation of the economic development of the Asian tigers. Population & Development 12

17 Modern Contraceptive Use Percentage of Women using Modern Contraceptives Percentage of Women Using Modern Contraceptives NURHI/MLE Baseline Report 2010 and DHS Surveys The graph shows that the percentage of currently married women using modern contraceptives in Ilorin (27%) is only slightly higher than the corresponding figure for urban Nigeria (26%). What is also notable is that the levels of modern contraceptive use for Ilorin city and that of urban Nigeria are much lower than national-level percentages of women using modern contraceptive methods in Jordan (42%), Morocco (55%), Indonesia (57%) and Thailand (80%). NURHI scenario projects that contraceptive prevalence will increase from 26% in 2011 to 65% in In contrast, the base scenario assumes that contraceptive prevalence will increase from 26% in 2011 to 48% in Population & Development 13

18 Couples in Ilorin want to Plan their Births Only 1 in 5 married women want a child in the next 2 years Only 1 in 6 married men want a child in the next 2 years 20% of married men and women do not want any additional children More than half of married women say it would be a big problem if they were to become pregnant in the next few weeks NURHI/MLE Baseline Report 2010 What is significant, however, is that married couples of Ilorin want to plan their births. This was clearly indicated by data from the Measurement Learning and Evaluation survey conducted in 2011: Only 1 out of every 5 married women ages want a child in the next 2 years. Only 1 out of every 6 married men want a child in the next 2 years. 20% of married men and women do not want any additional children More than 50% of currently married women say it would be a big problem if they were to become pregnant in the next few weeks Clearly, married women and men of the city of Ilorin want to plan their childbearing. They need access to family planning services! Population & Development 14

19 Ilorin has an opportunity to improve the quality of life of its population 2 Potential Futures: Scenario 1: Maintain Current Trends: What if things continued as they are now? Scenario 2: Investment in Family Planning: What will happen if there is an investment in family planning and unmet need is met? Ilorin has an opportunity to improve the quality of life of its urban population. We can illustrate this by looking at the potential future scenarios. Scenario 1 answers the question What if things continued into the future as they did before and now? This is also called the base (or reference) scenario. This scenario uses past trends in contraceptive prevalence increase in the urban areas of Nigeria based on the 1999 to 2008 Nigeria Demographic and Health Surveys. These national demographic surveys showed an average of 1.06 percentage point increase in contraceptive prevalence in the urban areas of Nigeria between 1999 and Scenario 2 answers the question: What will happen if there is improved investment in family planning and unmet need is met? Population & Development 15

20 Nigerian Urban Reproductive Health Initiative (NURHI) is a Project that is Supporting Quality Family Planning in 4 Nigerian Cities: Ilorin Abuja FCT Ibadan Kaduna NURHI aims to increase modern family planning use by 20 percentage points in each city by providing high quality services that couples can access. Photo by Shiraz Chakera NURHI, or the Nigeria Urban Reproductive Health Initiative, is a project implemented by a consortium led by Johns Hopkins Bloomberg School Public Health Center for Communication Programs, other international development agencies and Nigerian organizations in partnership with local government health departments. NURHI is supporting the provision of accessible and high-quality family planning services in four Nigerian cities: Ilorin, Abuja FCT, Ibadan and Kaduna. NURHI aims to increase modern family planning use by 20 percentage points in each city through the provision of high quality services that couples can access. Population & Development 16

21 Population Projection Scenarios Projected Total Populations in 5 Ilorin LGAs Number of People Ilorin Base Projection Ilorin NURHI Projection Under the Base Scenario wherein contraceptive use in the five Ilorin urban areas will increase gradually as they did before, the 1.12 population is projected to continue to increase to 1.84 M in Under the NURHI scenario where contraceptive use increases significantly, the total population of the five Ilorin LGAs will be about 1.63 M in The difference in total populations between the base scenario and the NURHI scenario for Ilorin becomes larger over time. By 2035, the difference in population will exceed 210,000. Population & Development 17

22 Photo by Bonnie NURHI Health Photo by Bonnie NURHI Education Infrastructure Photo by The Gates Foundation Economy Photo by Bonnie NURHI Let us now examine the development implications of these population projection scenarios on Ilorin s socio-economic development concerns, more specifically, health, education, infrastructure, and the economy. Population & Development 18

23 All stakeholders need to appreciate the linkages of population factors with broader development issues like housing, education, health, agriculture, energy, environment, gender concerns, food security and the security of life and property. Nigeria National Policy on Population for Sustainable Development : January 2004 As we examine the implications of projected population changes on selected social and economic development concerns in Ilorin cities, let us also keep in mind the emphasis placed by Nigeria s 2004 National Policy on Population for Sustainable Development on the linkages of population factors with broader development issues like health, education and housing. Population & Development 19

24 Health Photo by Bonnie NURHI Let us now examine the implications of the two future scenarios on the health sector of Ilorin s urban areas. Health 20

25 The key challenges to reducing infant mortality include population, declining resources and wide geographic variations. Major challenges to reducing maternal mortality include a dearth of skilled personnel and a shortage of family planning facilities. Nigeria Millennium Development Goals: Report 2010 Nigeria s MDG Report for 2010 states that reducing infant mortality requires addressing the population challenge, for which the key intervention is family planning. The MDG Report also cites the need to reduce maternal mortality by addressing challenges that include the shortage of skilled health personnel and family planning facilities. Health 21

26 Family Planning Reduces Risky Births Family Planning Acts by Reducing Births in the Following Categories, Called the 4 Too s: Too young: women who give birth before age 18 Too old: women who give birth after age 35 Too many: more than 5 births Too close: births spaced less than 24 months Studies all over the world show that family planning reduces high-risk births. High risk births refer to the 4 TOOs or births that are: Too young Refers to women who give woman before age 18. This means that these women are so very young and are still developing and growing physically and emotionally. Too old Refers to women who give birth after age 35. Too many Refers to women who have already given birth to many children. This refers to more than 5 births. Too close When a birth occurs too soon after a previous birth. Global studies show that a birth occurring less than 24 months after a previous birth has a high risk of mortality. Health 22

27 Risky Births Percentage of births with any risk factor Year Ilorin base Projection Ilorin NURHI Projection In 2011, approximately 64% of births had one or more of the risk factors (4 Too s) just cited. The projections demonstrate that the percentage of births with any of the High Risk factors just cited would be higher under the base scenario projection for Ilorin, compared to lower proportions that are high risk under the NURHI projection. By 2035, the NURHI scenario would have only about 47% high risk births compared to 57% for the base scenario. High risk births result in maternal and infant deaths and are very expensive to attend to at health facilities. Health 23

28 Number of Maternal Deaths Averted 228 Maternal Deaths Averted ,530 Maternal Deaths Averted Maternal Deaths 363 Ilorin Base Projection Ilorin NURHI Projection While gradual FP increase would help prevent maternal deaths, the number of maternal deaths that would occur in Ilorin cities under the base scenario would still be higher than maternal deaths under the NURHI scenario with significant increases in modern FP use. Through NURHI, a cumulative total of 228 maternal deaths can be averted in Ilorin cities in the 4 years between 2011 and The cumulative number of maternal deaths averted between 2011 and 2035 could exceed 2,530, as more and more high-risk pregnancies are prevented from occurring over the 24-year period. Health 24

29 Under 5 Deaths Averted Under 5 Deaths Averted 2,920 Under 5 Death Averted D 37,767 37,767 Under Under 55 Averted Averted ,775 4,873 Ilorin Base Projection Ilorin NURHI Projection Moreover, the number of deaths occurring to children under 5 in the five Ilorin urban areas would be lower under the NURHI projection scenario compared to the base scenario. Through increased use of modern contraceptives, a greater number of high-risk pregnancies are prevented from occurring, and as a result, larger numbers of deaths to children under 5 are prevented. As the graph shows, higher modern FP use can avert a cumulative number of nearly 40,000 deaths to children under 5 years of age from 2011 to Health 25

30 Infant Mortality Rate Year Ilorin Base Projection Ilorin NURHI Projection Infant Deaths Averted: 1,867 between ,133 between If we focus on infant mortality alone, the difference between the NURHI and base projection implies nearly 2,000 infant deaths averted in the 4 year period between 2011 and A cumulative number of almost 20,000 infant deaths is averted between 2011 and 2035 because of significant increases in modern contraceptive use under the NURHI scenario. Because of family planning and reduced numbers of high risk births, the infant mortality rate will also decline. In 2011, the estimated infant mortality rate was 75 infant deaths per 1,000 live births. By 2035, the infant mortality rate for Ilorin cities would be 38 under the NURHI projection scenario compared to a much higher 60 IMR under the base projection scenario. Health 26

31 Health Benefits of Investing in Family Planning Reduction in the number of maternal, infant, and child deaths Increase life expectancy Freed resources that can be invested in strategies to improve quality and access to essential health services Reduction in the strain on health staff and infrastructure NURHI/MLE Baseline Report 2010 The projection scenarios for the health sector of the five Ilorin urban areas illustrate the health benefits of investing in modern family planning services, including Reduction in the numbers of maternal, infant and child deaths. Increasing life expectancy. Resources freed up so that these can be invested in strategies and interventions to improve the quality of and access to essential health services. Reduced strain on health staff and infrastructure. Health 27

32 Education Photo by The Gates Foundation Let us now focus on the education sector. Education 28

33 Primary School Aged Children Children aged 6 11 years old Number of School Aged Children (thousands) Ilorin Base Projection Ilorin NURHI Projection The number of primary school aged children- or children ages 6 to 11 years of age in the five Ilorin urban areas was estimated to be a little over 195,000 in This number will be about 247,000 under the base scenario projection compared to around 188,000 under the NURHI scenario. The impact of much higher modern FP use under the NURHI projection becomes noticeable starting 2020 and thereafter, with projected numbers of primary school aged children even smaller than current estimated numbers. Education 29

34 Primary Teachers Required WHO standard of 1 teacher to 25 pupils Ilorin Base Projection Ilorin NURHI Projection Teacher/Student Ratio of 30:1 The current standard is 1 teacher for every 25 students. This translates into 6,493 primary teachers required at present. Meeting the same standard in the future will require more than 8,200 primary school teachers in 2035 under the base projection scenario compared to a little less than 6,300 under the NURHI projection scenario. Education 30

35 Quality of Primary Teachers Ilorin needs to increase the number of teachers that are qualified. National Bureau of Statistics: Social Statistics in Nigeria 2009 As the previous page showed, the number of primary teachers required is much larger under the base scenario compared to fewer numbers under the NURHI projection scenario. But the figures in this previous page refer only to efforts to meet the increasing numbers of school children or efforts to accommodate increasing quantities (numbers) of children. The current distribution of primary school teachers by educational background in Ilorin cities is shown in the pie chart. While 63% of primary teachers are graduates with NCE credentials, there is also a need for additional resources to ensure that all primary teachers of Ilorin cities are highly qualified and have graduate or higher educational background and NCE status. Education 31

36 National Universal Basic Education Act Current policy goes beyond universal primary education and has set a target of universal basic education. National Universal Basic Education Act Through its National Universal Basic Education Act, Nigeria occupies a unique place among African countries for its ambitious objective of free basic education for all children between the ages of 6-15 years. Thus, the current policy goes beyond universal primary education and sets a higher target of providing universal basic education for the country s youth. Education 32

37 Basic Education Aged Children Primary and Junior Secondary (Ages 6 15) Number of School Aged Children (thousands) Ilorin Base Projection Ilorin NURHI Projection This objective is assessed in terms of current and projected numbers of basic education-aged children in Ilorin. Children in the basic education age group numbered about 305,000 in 2011 and will reach approximately 395,000 in 2035 under the base scenario. Meeting the national basic education policy will be a challenge for the five focus urban areas of Ilorin especially under the base scenario with larger numbers of children ages 6-15 years compared to smaller numbers under the NURHI scenario. Education 33

38 Education Benefits of Investing in Family Planning Reduction in the strain on teachers and infrastructure Freed up resources that can be invested in strategies to improve the quality of education and prepare the next generation to participate in the global economy Assist in meeting the goal of universal basic education NURHI/MLE Baseline Report 2010 Overall, the education benefits of investing in family planning include: Reduced strain on teachers and the education infrastructure. Resources freed up which can be invested in strategies to improve the quality of education and prepare the next generation to participate in the country s efforts to be a major participant in the global economy. Helping Ilorin urban areas to achieve the Education sector goal of universal basic education. Education 34

39 Infrastructure Photo by Bonnie NURHI Let us now turn to the infrastructure sector. Infrastructure 35

40 Housing Requirements Average household size of 3.8 people Ilorin Base Projection Ilorin NURHI Projection Average Household Size from MLE Baseline 2011 If we apply the MLE survey figure of 3.8 average household size in Ilorin to the projected total population, we can come up with estimates of housing requirements. At present, housing requirements for the five Ilorin urban areas approximate 296,000. The base projection scenario will require over 485,000 housing units compared to around 429,000 under the NURHI projection scenario. We are looking here only at the quantity or numbers of houses, and we do not assume anything here about housing quality. Infrastructure 36

41 Solid Waste Generation Annual Production of Waste (in kilograms) Ilorin Base Projection Ilorin NURHI Projection Photos by: Bonnie NURHI Source: Babayemi et al., 2009 A study by Babayami ( 2009) estimated that in Ilorin each person generates about 157 kg of solid waste per year. This translates into as much as 176 million kilograms of waste generated in This figure will increase to a total of 289 million kilograms of waste generated in Ilorin in 2035 under the base scenario, compared to 256 million kilograms of waste under the NURHI scenario. Increasing populations over time mean more solid waste, but the quantity of solid waste that would be produced will be much more under the base scenario. Infrastructure 37

42 Infrastructure Benefits of Investing in Family Planning Reduction in the strain on housing requirements Likely reduction in the percentage of people living in slums or other forms of temporary housing Reduction in the amount of trash that is generated which will improve the sanitation condition of the city NURHI/MLE Baseline Report 2010 Investing on improving family planning services, with a defined focus on modern FP, yields benefits in physical infrastructure that include among others: Reduced strain on housing requirements Likely lowered numbers and percentages of the population living in temporary housing or in slum areas Reduced amount of trash that is generated - which in turn will help improve sanitation conditions of the city. Infrastructure 38

43 Economy Photo by Bonnie NURHI Finally, let us look at the implications of the two projection scenarios on the economy. Economy 39

44 Number of New Jobs Needed for People Entering the Workforce Ilorin Base Projection Ilorin NURHI Projection MLE Baseline Survey 2011 We can observe the impact of two family planning projection scenarios on the economy through the number of people entering the work force and therefore in need of new jobs. At present, over 15,000 new jobs are needed. The difference between the base projection scenario and the NURHI projection becomes apparent after 15 years or so, around 2030, as higher modern FP use in the NURHI projection scenario result into smaller numbers of people in the working ages 15 to 64 years compared to larger numbers needing jobs under the base projection scenario. In 2035, the number entering the workforce and needing new jobs can reach 18,000 under the base projection scenario compared to a little less than 12,000 for the NURHI scenario. Economy 40

45 Number of Child Dependents Ilorin Base Projection Ilorin NURHI Projection At present, over 467,000 comprise the population less than 15 years of age in the five Ilorin urban areas. Thereafter, the projected numbers of child dependents or those in ages 0 to 14 years will be higher under the base scenario projection compared to the NURHI scenario. In 2035, an estimated 476,000 children is projected for the NURHI scenario compared to the much larger number of 634,000 children under the base projection scenario.. Economy 41

46 Economic Benefits of Investing in Family Planning Reduction in the strain on employment requirements Likely reduction in the percentage of people in the working ages that are unemployed Reduction in the number of dependents which will assist families in moving out of poverty NURHI/MLE Baseline Report 2010 In summary, the economic benefits of investing in family planning in Ilorin s cities include: Reduced strain on employment requirements Likely reduction on the percentage of the population in the working ages that are unemployed. Reduction in the number of dependents will assist families in moving out of poverty Economy 42

47 What Can We Do? Photos by: Mike Blyth (left), others by Bonnie NURHI In summary, the economic benefits of investing in family planning in Ilorin s cities include: Reduced strain on employment requirements Likely reduction on the percentage of the population in the working ages that are unemployed. Reduction in the number of dependents will assist families in moving out of poverty What can we do? 43

48 Men and women in Ilorin cities want to plan their births We should help ensure that Ilorin s women and men have access to high quality family planning services. We should support them in achieving their own family planning decisions. As we have seen from the MLE data showed earlier, couples, men and women of Ilorin cities want to plan their families. They need our help. We should help ensure that Ilorin s women and men have access to high quality family planning services. We should support them in achieving their own family planning decisions. What can we do? 44

49 Policy Response Improving access and utilization of high quality family planning services will: Enable couples to space their children Reduce the number of maternal and child deaths Photo by Bonnie NURHI Thereby support Ilorin in reaching the MDGs and becoming a flourishing and prosperous city. Ilorin couples have expressed their need to plan their births. This requires prompt response from officials and leaders at all levels to ensure that policies, resources and services promote access to high quality family planning services in order to facilitate utilization of such services. This will: Enable couples to space their children.. Reduce the number of maternal and child deaths. And thereby support Ilorin in reaching the Millennium Development Goals of improved health, productivity and quality of life and become a flourishing and prosperous city. What can we do? 45

50 What Needs to be Done Right Now? Release of the funds that have been obligated for family planning Ensure that the released funds are used for family planning services Speak out, and encourage other leaders to speak out, about the important role of family planning in preventing maternal and child deaths It will take the voices of leaders from all sectors to illustrate the importance of preventing these deaths What needs to be done right now? Ilorin authorities should release funds that have been obligated for family planning We should all help ensure that released funds are used for family planning services. We should speak out, and encourage other leaders to speak out about the important role of family planning in preventing maternal and child deaths and in contributing to social and economic development. It will take the voices of leaders from all sectors to illustrate the importance of family planning in preventing these deaths and in supporting our developmental goals. What can we do? 46

51 Family Planning is something I support because we need to space our children, support safe motherhood and we need to take care of our children. Nigeria s Minister of Health November 2011 th From thisdaylive.com 18 November 2011 Finally, let us end with a quotation from our Minister of Health. What can we do? 47

52 Nigerian Urban Reproductive Health Initiative (NURHI) is a Project that is Supporting Quality Family Planning in 6 Nigerian Cities: Abuja FCT Kaduna Ilorin Ibadan Benin Zaria NURHI aims to increase family planning by 20 percentage points in each city by providing quality services that couples can access Nigeria Urban Reproductive Health Initiative (NURHI), is a project implemented by a consortium led by Johns Hopkins Bloomberg School Public Health Center for Communication Programs, other international development agencies and Nigerian organizations in partnership with local government health departments. NURHI is supporting the provision of accessible and high-quality family planning services in four Nigerian cities: Kaduna, Abuja FCT, Ilorin and Ibadan. NURHI aims to increase modern family planning use by 20 percentage points in each city by providing quality services that couples can access. NURHI 48

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