Facilitators and Barriers to Systematically Scaling-up Family Planning Task-Shifting and Task-Sharing of Contraceptive Implants

In Nigeria, a shortage in human resources for health—fewer than two nurses and doctors per 1,000 people, with a notable lack of skilled birth attendants—contributes to poor health and development outcomes.

In 2014, recognizing the potential to mitigate the impact of this shortage and improve accessibility and cost effectiveness within the health system, Nigeria adopted its new task-shifting and task-sharing policy for emergency obstetric and newborn care services. This policy would make contraceptive services previously delivered by physicians, nurses, and midwives—namely the provision of implant and injectable contraceptives in addition to short-acting, nonclinical family planning methods—available through community health extension workers, who reside and work in their communities and provide basic components of primary health care.

Cross River State operationalized the National Family Planning task-shifting and task-sharing policy with technical support from the Evidence to Action Project and Pathfinder International, through the Saving Mothers, Giving Life Initiative. Our support included operations research and the development of a strategic scale-up plan.

DOWNLOAD NOW to see the barriers and facilitators E2A identified to scaling up Cross River State’s task-shifting and task-sharing policy to allow community health extension workers to provide implants.


  • Publication date: July 2019