Search results for: Fidelis Chigondo

Authors: Fidelis Chigondo

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This study focuses on investigating the effectiveness of watermelon rind in phenol removal from aqueous solution. The effects of various parameters (pH, initial phenol concentration, biosorbent dosage and contact time) on phenol adsorption were investigated. The pH of 2, initial phenol concentration of 40 ppm, the biosorbent dosage of 0.6 g and contact time of 6 h also deduced to be the optimum conditions for the adsorption process. The maximum phenol removal under optimized conditions was 85%. The sorption data fitted to the Freundlich isotherm with a regression coefficient of 0.9824. The kinetics was best described by the intraparticle diffusion model and Elovich Equation with regression coefficients of 1 and 0.8461 respectively showing that the reaction is chemisorption on a heterogeneous surface and the intraparticle diffusion rate only is the rate determining step. The study revealed that watermelon rind has a potential of removing phenol from industrial wastewaters.

Keywords: biosorption, phenol, biosorbent, watermelon rind

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Authors: F. Chigondo, G. Chitabati

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Hexavalent chromium is toxic and is widely used in many industries hence efficient and economical methods must be explored to remove the chromium(VI) from the environment. The removal of Cr (VI) from aqueous solutions onto polyaniline coated maize tassel was studied in batch mode at varying initial metal concentrations, adsorbent doses, pH and contact times. The residual Cr (VI) concentrations before and after adsorption were analyzed by Ultraviolet–visible spectroscopy. FTIR analysis of the polyaniline coated maize tassel showed the presence of C=C, C=N, C-H, C-N and N-H groups. Adsorption conditions were deduced to be pH of 2, adsorbent dosage 1g/L, Cr(VI) initial concentration of 40mg/L contact time of 150 minutes and agitation speed of 140rpm. Data obtained fitted best to the Langmuir isotherm (R2 = 0.972) compared to the Freundlich isotherm (R2 0.671. The maximum adsorption capacity was found to be 125mg/L. Correlation coefficients for pseudo first order and pseudo second order were 0.952 and 0.971 respectively. The adsorption process followed the pseudo-second order kinetic model. The studied polyaniline coated maize tassel can therefore be used as a promising adsorbent for the removal of Cr (VI) ion from aqueous solution.

Keywords: polyaniline-coated, maize tassels, adsorption, hexavalent chromium

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Authors: Evelyn Lami Ashelo Allu, Fidelis A. Emuze

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This study aims to contribute to the pursuit of environmental sustainability through the built environment practices of design and construction. Activities within the built environment and particularly within the construction industry have a significant role in ensuring environmental sustainability. The adoption of Lean principles and approaches would ensure that project deliverables are sustainable. This is because the processes that integrate lean principles reduce waste, add value to productivity, ensures customer satisfaction and are mindful of future productivity. Additionally, the lean principles for development are sustainable in themselves and thus promotes environmental sustainability. The study encourages further research with other methodologies and recommends the development of monitoring and evaluation mechanisms in order to promote the global concern for environmental sustainability.

Keywords: built environment, construction, design, lean, sustainability

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Authors: Babagana Mohammed, Fidelis Patrick Afangide

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This research investigated the possibility of using waste low-dense polyethylene and waste plastic bottles for the production of interlock pavement blocks. In many parts of the world, interlock pavement block is used widely as modern day solution to outdoor flooring applications and the blocks have different shapes, sizes and colours suiting the imagination of landscape architects. Using suitable and conventional mould having a 220 x 135 x 50 mm³ shape, the interlock blocks were produced. The material constituents of the produced blocks were waste low-dense polyethylene and waste plastic bottles mixed in varying, respective percentage-weight proportions of; 100%+0%, 75%+25%, 50%+50% and 25%+75%. The blocks were then tested for unconfined compressive strength and water absorption properties. The test results compared well with those of conventional concrete interlock blocks and the research demonstrates the possibility of value recovery from the waste streams which are currently dumped in open-spaces thereby affecting the environment.

Keywords: pavement blocks, polyethylene, plastic bottle, wastes, valorization

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Authors: Arum Kingsley Chinedu, Ugwuowo Fidelis Ifeanyi, Oranye Henrietta Ebele

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The Poisson regression model (PRM) is a nonlinear model that belongs to the exponential family of distribution. PRM is suitable for studying count variables using appropriate covariates and sometimes experiences the problem of multicollinearity in the explanatory variables and outliers on the response variable. This study aims to address the problem of multicollinearity and outliers jointly in a Poisson regression model. We developed an estimator called the robust modified jackknife PCKL parameter estimator by combining the principal component estimator, modified jackknife KL and transformed M-estimator estimator to address both problems in a PRM. The superiority conditions for this estimator were established, and the properties of the estimator were also derived. The estimator inherits the characteristics of the combined estimators, thereby making it efficient in addressing both problems. And will also be of immediate interest to the research community and advance this study in terms of novelty compared to other studies undertaken in this area. The performance of the estimator (robust modified jackknife PCKL) with other existing estimators was compared using mean squared error (MSE) as a performance evaluation criterion through a Monte Carlo simulation study and the use of real-life data. The results of the analytical study show that the estimator outperformed other existing estimators compared with by having the smallest MSE across all sample sizes, different levels of correlation, percentages of outliers and different numbers of explanatory variables.

Keywords: jackknife modified KL, outliers, multicollinearity, principal component, transformed M-estimator.

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Authors: Adeoti Adebowale, Abduljaleel, Ejiogu Fidelis Onyekwo

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Form and image development are fundamental to creative expression in visual arts. The form is an element that distinguishes the difference between two-dimension and three-dimension among the branches of visual arts. Particularly, the sculpture is a three-dimensional form, while the textile design is a two-dimensional form of its visual appearance. The visual expression of each of them is embedded in the creative practice of the artist, which is easily understood and interpreted by the viewer. In this research, an attempt is made to explore and analyse sculptural forms adopted as a motif for wax print in textile design, aiming at breeding yet another pattern and motif suitable for various design uses. For instance, the dynamics of sculptural form adaptation into other areas of creativity, such as architecture, pictorial arts and pottery, as well as automobile bodies, is a discernible image everywhere. The research is studio exploratory, while a camera and descriptive analysis were used to process the data. Two sculptural forms were adopted from the Department of Fine and Applied Arts, Federal Capital Territory College of Education Zuba-Abuja, in this study due to the uniqueness of their technique of execution. The findings resulted in ten (10) paper designs showing the dexterity of studio practice in the development of design for various fashion and textile uses. However, the paper concludes that sculptural form is a source of inspiration for generating design concepts for a textile designer.

Keywords: exploration, design, motifs, sculptural forms, wax print

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Authors: Chukwu Fidelis Ndubuisi, Madufor Michael Ozims, Asogwa Vivian Ndidiamaka, Egenamba Juliet Ngozi, Okonkwo Stephen C., Kamah Chukwudi David

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Deflection of the vertical is a quantity used in reducing geodetic measurements related to geoidal networks to the ellipsoidal plane; and it is essential in Geoid modeling processes. Computing the deflection of the vertical component of a point in a given area is necessary in evaluating the standard errors along north-south and east-west direction. Using combined approach for the determination of deflection of the vertical component provides improved result but labor intensive without appropriate method. Least square method is a method that makes use of redundant observation in modeling a given sets of problem that obeys certain geometric condition. This research work is aimed to computing the deflection of vertical component of Owerri West local government area of Imo State using geometric method as field technique. In this method combination of Global Positioning System on static mode and precise leveling observation were utilized in determination of geodetic coordinate of points established within the study area by GPS observation and the orthometric heights through precise leveling. By least square using Matlab programme; the estimated deflections of vertical component parameters for the common station were -0.0286 and -0.0001 arc seconds for the north-south and east-west components respectively. The associated standard errors of the processed vectors of the network were computed. The computed standard errors of the North-south and East-west components were 5.5911e-005 and 1.4965e-004 arc seconds, respectively. Therefore, including the derived component of deflection of the vertical to the ellipsoidal model will yield high observational accuracy since an ellipsoidal model is not tenable due to its far observational error in the determination of high quality job. It is important to include the determined deflection of the vertical component for Owerri West Local Government in Imo State, Nigeria.

Keywords: deflection of vertical, ellipsoidal height, least square, orthometric height

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Introduction: Digital innovations have been useful in supporting a client’s contraceptive user journey from awareness to method initiation. The concept of contraceptive self-care is being promoted globally as a means for achieving universal access to quality contraceptive care; however, information about this approach is limited. An important determinant of the scale of awareness is the message construct, choice of information channel, and an understanding of the socio-epidemiological dynamics within the target audience. Significant gains have been made recently in expanding the awareness base of DMPA-SC -a relatively new entrant into the family planning method mix. The cornerstone of this success is a multichannel promotion campaign themed Discover your Power (DYP). The DYP campaign combines content marketing across select social media platforms, chatbots, Cyber-IPC, Interactive Voice Response (IVR), and radio campaigns. Methodology: During implementation, the project monitored predefined metrics of awareness and intent, such as the number of persons reached with the messages, the number of impressions, and meaningful engagement (link-clicks). Metrics/indicators are extracted through native insight/analytics tools across the various platforms. The project also enlists community mobilizers (CMs) who go door-to-door and engage WRA to advertise DISC’s online presence and support them to engage with IVR, digital companion (chatbot), Facebook page, and DiscoverYourPower website. Results: The result showed that the digital platforms recorded 242 million impressions and reached 82 million users with key DMPA-SC self-injection messaging in the three countries. As many as 3.4 million persons engaged (liked, clicked, shared, or reposted) digital posts -an indication of intention. Conclusion: Digital solutions and innovations are gradually becoming the archetype for the advancement of the self-care agenda. Digital innovations can also be used to increase awareness and normalize contraceptive self-care behavior amongst women of reproductive age if they are made an integral part of reproductive health programming.

Keywords: digital transformation, health systems, DMPA-SC, family planning, self-care

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The Delivering Innovations in Selfcare (DISC) project aims to increase access to self-care options for women of reproductive age, starting with self-inject subcutaneous depot medroxyprogesterone acetate (DMPA-SC) contraception services. However, the project has faced challenges in ensuring the continuous availability of the commodity in health facilities. Although most states in the country rely on the federal ministry of Health for supplies, some are gradually funding the procurement of Family Planning (FP) commodities. This attempt is, however, often accompanied by procurement delays and purchases inadequate to meet demand. This dilemma was further exacerbated by the commencement of demand generation activities by the project in supported states which geometrically increased commodity utilization rates and resulted in receding stock and occasional service disruptions. Strategies: The project deployed various strategies were implemented to ensure the continuous availability of commodities. These include facilitating inter-facility transfer, monthly tracking of commodity utilization, and alerting relevant authorities when stock levels reach a minimum. And supporting state-level procurement of DMPA-SC commodities through catalytic interventions. Results: Effective monitoring of commodity inventory at the facility level and strategic engagement with federal and state-level logistics units have proven successful in mitigating stock-out of commodities. It has helped secure up to 13,000 units of DMPA-SC commodities from federal logistics units and enabled state units to prioritize supported sites. This has ensured the continuity of DMPA-SC services and an increasing trend in the practice of self-injection. Conclusion: A functional supply chain is crucial to achieving commodity security, and without it, health programs cannot succeed. Stakeholder engagement, stock management and catalytic interventions have provided both short- and long-term measures to mitigate stock-outs and ensured a consistent supply of commodities to clients.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, commodities, stock-out

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Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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Authors: Oluwaseun Adeleke, Samuel Ikan, Anthony Nwala, Mopelola Raji, Fidelis Edet

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Background: The risks associated with each pregnancy is carried almost entirely by a woman; however, the decision about whether and when to get pregnant is a subject that several others contend with her to make. The self-care concept offers women of reproductive age the opportunity to take control of their health and its determinants with or without the influence of a healthcare provider, family, and friends. DMPA-SC Self-injection (SI) is becoming the cornerstone of contraceptive self-care and has the potential to expand access and create opportunities for women to take control of their reproductive health. Methodology: To obtain insight into the influences that interfere with a woman’s capacity to make contraceptive choices independently, the Delivering Innovations in Selfcare (DISC) project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach and data collected analyzed using a codebook and Atlas-TI. The research team members came together for participatory analysis workshop to explore and interpret emergent themes. Findings: Insights indicate that women are increasingly finding their voice and independently seek services to prevent a deterioration of their economic situation and achieve personal ambitions. Women who hold independent decision-making power still prefer to share decision making power with their male partners. Male partners’ influence on women’s use of family planning and self-inject was most dominant. There were examples of men’s support for women’s use of contraception to prevent unintended pregnancy, as well as men withholding support. Other men outrightly deny their partners from obtaining contraceptive services and their partners cede this sexual and reproductive health right without objection. A woman’s decision to initiate family planning is affected by myths and misconceptions, many of which have cultural and religious origins. Some tribes are known for their reluctance to use contraception and often associate stigma with the pursuit of family planning (FP) services. Information given by the provider is accepted, and, in many cases, clients cede power to providers to shape their SI user journey. A provider’s influence on a client’s decision to self-inject is reinforced by their biases and concerns. Clients are inhibited by the presence of peers during group education at the health facility. Others are motivated to seek FP services by the interest expressed by peers. There is also a growing trend in the influence of social media on FP uptake, particularly Facebook fora. Conclusion: The convenience of self-administration at home is a benefit for those that contend with various forms of social influences as well as covert users. Beyond increasing choice and reducing barriers to accessing Sexual and Reproductive Health (SRH) services, it can initiate the process of self-discovery and agency in the contraceptive user journey.

Keywords: selfcare, self-empowerment, agency, DMPA-SC, contraception, family planning, influences

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background The Delivering Innovations in Selfcare (DISC) project promotes universal access to quality selfcare services beginning with subcutaneous depot medroxy progesterone acetate (DMPA-SC) contraceptive self-injection (SI) option. Self-inject (SI) offers women a highly effective and convenient option that saves them frequent trips to providers. Its increased use has the potential to improve the efficiency of an overstretched healthcare system by reducing provider workloads. State Social and Behavioral Change Communications (SBCC) Officers lead project demand creation and service delivery innovations that have resulted in significant increases in SI uptake among women who opt for injectables. Strategies Service Delivery Innovations The implementation of the "Moment of Truth (MoT)" innovation helped providers overcome biases and address client fear and reluctance to self-inject. Bi-annual program audits and supportive mentoring visits helped providers retain their competence and motivation. Proper documentation, tracking, and replenishment of commodities were ensured through effective engagement with State Logistics Units. The project supported existing state monitoring and evaluation structures to effectively record and report subcutaneous depot medroxy progesterone acetate (DMPA-SC) service utilization. Demand creation Innovations SBCC Officers provide oversight, routinely evaluate performance, trains, and provides feedback for the demand creation activities implemented by community mobilizers (CMs). The scope and intensity of training given to CMs affect the outcome of their work. The project operates a demand creation model that uses a schedule to inform the conduct of interpersonal and group events. Health education sessions are specifically designed to counter misinformation, address questions and concerns, and educate target audience in an informed choice context. The project mapped facilities and their catchment areas and enlisted the support of identified influencers and gatekeepers to enlist their buy-in prior to entry. Each mobilization event began with pre-mobilization sensitization activities, particularly targeting male groups. Context-specific interventions were informed by the religious, traditional, and cultural peculiarities of target communities. Mobilizers also support clients to engage with and navigate online digital Family Planning (FP) online portals such as DiscoverYourPower website, Facebook page, digital companion (chat bot), interactive voice response (IVR), radio and television (TV) messaging. This improves compliance and provides linkages to nearby facilities. Results The project recorded 136,950 self-injection (SI) visits and a self-injection (SI) proportion rate that increased from 13 percent before the implementation of interventions in 2021 to 62 percent currently. The project cost-effectively demonstrated catalytic impact by leveraging state and partner resources, institutional platforms, and geographic scope to scale up interventions. The project also cost effectively demonstrated catalytic impact by leveraging on the state and partner resources, institutional platforms, and geographic scope to sustainably scale-up these strategies. Conclusion Using evidence-informed iterations of service delivery and demand creation models have been useful to significantly drive self-injection (SI) uptake. It will be useful to consider this implementation model during program design. Contemplation should also be given to systematic and strategic execution of strategies to optimize impact.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, innovation, service delivery, demand creation.

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