What is needed to improve quality of implant removal services in Nigeria? results of a landscape assessment.

Stunning recent increases in subdermal contraceptive implant use, especially in sub-Saharan Africa, necessitate availability of quality implant removal services. In Nigeria, service delivery capacity and coverage for removal are lacking, despite strong government commitment and rapid uptake; there is a dearth of knowledge about barriers to quality implant removals in Nigeria. To determine access to and quality of contraceptive implant removal services, a landscape assessment was conducted in two states in Nigeria, focusing on four conditions for quality delineated in the Global Implant Removals Task Force framework. This mixed-methods approach integrated results from a desk review, a survey of health facilities and family planning managers, review of implant service statistics, and key informant interviews with providers and diverse stakeholders. Seventy percent of providers ( This study identified numerous challenges to quality implant removal, including poorly trained providers, inadequate supplies, underutilization of data on removals, and inability to manage difficult removals. As demand for implant removals skyrockets, providers need improved training in implant removal, appropriate job aids, supportive supervision, and effective procurement systems to ensure availability of supplies and equipment for removal. Tracking removals and reasons for removal in information systems and the Family Planning dashboard could sensitize providers to need for implant removals and improve data for decision-making in facilities and health systems.

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© 2023 Adetiloye, Danladi, Haws, Anoke, Odio, Ugwa, Nganje, Enne, Afolabi, Adebola, Eze and Christofield.

Déclaration de conflit d'intérêts

The handling editor AEB declared a shared parent affiliation with the authors OnA, RH, and MC at the time of review.