title: Midwives as drivers of reproductive health commodity security in Kaduna State, Nigeria.
abstract: OBJECTIVE
  The significant improvement in the contraceptive prevalence rate in Kaduna State, Nigeria, from 8.4% in 2008 to 18.5% in 2013 is a notable achievement. This article analyses the role of midwives as drivers of reproductive health commodity security (RHCS) and their impact on contraceptive use in Kaduna State.
  
  
  METHODS
  The United Nations Population Fund (UNFPA) supported the bimonthly review resupply meetings facilitated by midwives at State and local government area (LGA) levels. The midwives deliver contraception to the LGAs for onward distribution to 6974 of the 25,000 health facilities across the country according to usage data from the previous 2 months. They also collect requisition, issue and resupply form data from the previous 2 months.
  
  
  RESULTS
  The active participation of midwives at the bimonthly meetings improved data timeliness by 23% and data completeness by 50% in 1 year. Only one health facility ran out of intrauterine devices and only 17% reported running out of female condoms. The total number of contraceptives issued increased from 31,866 in 2012 to 177,828 in 2013, resulting in a couple-year protection increase from 3408 in 2012 to 102,207 in 2013.
  
  
  CONCLUSIONS
  Creation of increased demand and engagement of midwives in providing family planning services, especially long-acting contraceptive methods, coupled with the removal of cost to the user and the strengthening of the supply chain have been major factors in more than doubling the contraceptive prevalence rate.
authors.affiliation: a United Nations Population Fund , Abuja , Nigeria ;
authors.forename: Audu
authors.initials: A
authors.lastname: Alayande
authors.affiliation: a United Nations Population Fund , Abuja , Nigeria ;
authors.forename: Fatima
authors.initials: F
authors.lastname: Mamman-Daura
authors.affiliation: a United Nations Population Fund , Abuja , Nigeria ;
authors.forename: Olanike
authors.initials: O
authors.lastname: Adedeji
authors.affiliation: b Kaduna State Ministry of Health , Kaduna , Nigeria.
authors.forename: Ado Zakari
authors.initials: AZ
authors.lastname: Muhammad
mesh_terms: D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003376:Counseling; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008880:Midwifery; D009549:Nigeria; D011247:Pregnancy; D060728:Reproductive Health; D014480:United Nations
keywords: Contraceptive prevalence rate; midwives; reproductive health commodity security; requisition, issue and resupply forms; review resupply meetings; stock unavailability; unmet contraceptive need