Our Approach
We upskill nurses and distribute 3-month injectable contraceptives free of charge. We can achieve this by identifying and leveraging local health networks - a community of trained nurses and midwives, whom we call Lafiya Sisters.
Our model is simple:
1. We recruit and upskill Lafiya Sisters in family planning counselling.
2. We procure DMPA-SC (”Sayana Press”) and transport it to the most deprived areas.
3. The Lafiya Sisters distribute contraceptives and provide family planning counselling to women who need it the most.
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Trust-Building
Our Lafiya Sisters are midwives and nurses trained by NANA Girls and Women Empowerment Initiative and are a key part of our distribution model.
Lafiya Sisters live in the rural and hard-to-reach communities and they are in the best position to reach our target audience.
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Cost-Effective
Lafiya Sisters inform women about their family planning options and teach them how to administer DMPA-SC (Sayana Press), a self-injectable contraceptive recommended by the World Health Organisation.
The contraceptive costs USD $0.85 to manufacture and lasts for up to three months.
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Scalable
Our partner organisation NANA has trained over 1000 women to become qualified health professionals. This network is easy to deploy following our two-day comprehensive family planning training.
The at-scale cost-effectiveness is competitive with GiveWell's top charities.
Our Theory of Change
Our theory of change is a visual representation of how we want to achieve our goal: reducing maternal mortality and morbidity in Nigeria. We want to do this in the most cost-effective way possible and focus on scaling our solution in a neglected area. Our theory of change depends on several assumptions, highlighted in blue, and is underpinned with evidence, highlighted in pink.
Why Sayana Press?
Quick and Discreet: Use of Sayana Press is not visible in the body, unlike an implant, female condom or IUD. Further, it is easily self-injectable and only has to be used four times per year. An injection protects for 13 weeks and doesn’t require a cold chain to transport.
Cheap: Through a pricing agreement with supplier Pfizer, the price is capped at only $0.85 per dose.
Greater Effectiveness: Sayana Press is easy to use and has high effectiveness. Specifically, Sayana Press has 94% efficacy with typical use, and >99% with correct use. During our pilot, 56% of surveyed users cited wanting to use Sayana Press due to its high effectiveness (n=349).
Self-injectable: This feature will allow us to maximize the cost-effectiveness. In 2024, our Lafiya Sisters will hand out four doses per person, rather than one, so our users can self-administer the next doses at home providing them with contraceptive coverage free of charge for a year. We will send out SMS reminders to remind women when to take the next dose. Women who do not have mobile phones will receive a calendar.
Preferable to other methods:
Condoms leave the agency to the man and many condoms are needed to prevent pregnancy for the long term.
The pill has more side effects and needs to be taken daily to be effective. Its daily use makes it less discreet.
The IUD is complex to administer and there is a shortage of trained providers.