Our Approach

We upskill nurses and distribute 3-month injectable contraceptives free of charge. We can achieve this by identifying and leveraging local health networks - a community of trained nurses and midwives, whom we call Lafiya Sisters.

Our model is simple:
1. We recruit and upskill Lafiya Sisters in family planning counselling.
2. We procure DMPA-SC (”Sayana Press”) and transport it to the most deprived areas.
3. The Lafiya Sisters distribute contraceptives and provide family planning counselling to women who need it the most.

  • Trust-Building

    Our Lafiya Sisters are midwives and nurses trained by NANA Girls and Women Empowerment Initiative and are a key part of our distribution model.

    Lafiya Sisters live in the rural and hard-to-reach communities and they are in the best position to reach our target audience.

    Learn more about Lafiya Sisters here

  • Cost-Effective

    Lafiya Sisters inform women about their family planning options and teach them how to administer DMPA-SC (Sayana Press), a self-injectable contraceptive recommended by the World Health Organisation.

    The contraceptive costs USD $0.85 to manufacture and lasts for up to three months.

    Learn more about Sayana Press here

  • Scalable

    Our partner organisation NANA has trained over 1000 women to become qualified health professionals. This network is easy to deploy following our two-day comprehensive family planning training.

    The at-scale cost-effectiveness is competitive with GiveWell's top charities.

    Learn more about our impact here

Our Theory of Change

Lafiya Nigeria theory of change

Our theory of change is a visual representation of how we want to achieve our goal: reducing maternal mortality and morbidity in Nigeria. We want to do this in the most cost-effective way possible and focus on scaling our solution in a neglected area. Our theory of change depends on several assumptions, highlighted in blue, and is underpinned with evidence, highlighted in pink.

Why Sayana Press?

  1. Quick and Discreet: Use of Sayana Press is not visible in the body, unlike an implant, female condom or IUD. Further, it is easily self-injectable and only has to be used four times per year. An injection protects for 13 weeks and doesn’t require a cold chain to transport.

  2. Cheap: Through a pricing agreement with supplier Pfizer, the price is capped at only $0.85 per dose.

  3. Greater Effectiveness: Sayana Press is easy to use and has high effectiveness. Specifically, Sayana Press has 94% efficacy with typical use, and >99% with correct use. During our pilot, 56% of surveyed users cited wanting to use Sayana Press due to its high effectiveness (n=349).

  4. Self-injectable: This feature will allow us to maximize the cost-effectiveness. In 2024, our Lafiya Sisters will hand out four doses per person, rather than one, so our users can self-administer the next doses at home providing them with contraceptive coverage free of charge for a year. We will send out SMS reminders to remind women when to take the next dose. Women who do not have mobile phones will receive a calendar.

  5. Preferable to other methods:

  • Condoms leave the agency to the man and many condoms are needed to prevent pregnancy for the long term.

  • The pill has more side effects and needs to be taken daily to be effective. Its daily use makes it less discreet.

  • The IUD is complex to administer and there is a shortage of trained providers.