TY - JOUR T1 - Leading With LARCs in Nigeria: The Stars Are Aligned to Expand Effective Family Planning Services Decisively JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 179 LP - 185 DO - 10.9745/GHSP-D-16-00135 VL - 4 IS - 2 AU - James D Shelton AU - Clea Finkle Y1 - 2016/06/20 UR - http://www.ghspjournal.org/content/4/2/179.abstract N2 - Despite years of family planning effort in Nigeria, the modern contraceptive prevalence (mCPR) has reached only 10%. Yet a few recent seminal, well-executed programs have been outstandingly successful providing long-acting reversible contraceptives (LARCs)—both in the public and private sector, and in the North and South. Remarkably, the LARCs they provided were equivalent to 2% mCPR in 2015 alone.Accordingly, we advocate markedly increased support for: (1) private-sector approaches such as social franchising, particularly in the South, (2) mobile outreach, and (3) support to public clinical facilities, including expanding access through community health extension workers (CHEWs), particularly in the North. Success will require system support, quality, and concerted engagement from a variety of partners including the Government of Nigeria.Without significant progress in Nigeria, the global FP2020 goal appears unattainable. Fortunately, leading with LARCs along with wide choice of other methods provides a clear avenue for success.Provision of long-acting reversible contraceptives (LARCs)—IUDs and implants—has been highly effective, perhaps even revolutionary in the United States, in preventing unintended pregnancy, particularly with adolescents.1 No single method, or even 2 methods, can satisfy the diverse needs of all clients, and clients must have good choice and access to a wide variety of methods. Yet those same attributes that have made LARCs so popular in the United States—very high effectiveness, long duration of action, independence of the sex act, generally manageable side effects, potential for use without partner knowledge, and in the case of implants no need for a pelvic exam—appear to have wide appeal in Nigeria. Still, success with LARCs requires more than simple availability of the products. LARCs require service delivery approaches with a higher degree of wherewithal and quality than for shorter-acting methods. But as described below, such LARC-enabling approaches are beginning to thrive in Nigeria.LARCs appear to … ER -