Investigating improvements in access to family planning for women with disabilities; a study of a disability-inclusive intervention in Kaduna city, Nigeria

INTERVENTION: A cluster‐randomized controlled trial will be used to evaluate interventions delivered under the IFPLAN project at health facility and community levels in comparison to ‘standard’ state provision of family planning services, in the context of state‐wide and national broadcast media and advocacy for both arms. Clusters in the intervention arm will receive interventions that aim to address supply‐side and demand‐side barriers to accessing family planning among women with disabilities. Demand‐side activities evaluated by the trial will include interpersonal communication activities, such as: a) selection, training and delivery of structured group sessions by inclusive champions; b) the use of audio devices for group listening to radio stories and discussion sessions; c) the use of a board game to engage young people in the messages, myths and benefits of family planning; d) printed materials to aid discussions; e) community drama; f) household visits for people with disabilities in the home where needed; and g) town hall meetings. Intervention activities to support the supply side will focus on providing more inclusive service provision for people with disabilities, and activities will include accessibility audits, disability‐inclusive training, and participatory scorecard assessments of family planning services. Intervention implementation will also be supported by an adaptive management approach, using data to target and adjust programme components. Randomization will be conducted based on the health facility catchment area, with a total of 38 clusters. Cluster assignment to the intervention and control arms will be conducted at one timepoint before the start of the trial during a multi‐stakeholder event organised by Sightsavers. Clu CONDITION: Access to family planning amongst women of reproductive age with disabilities ; Pregnancy and Childbirth PRIMARY OUTCOME: Access to family planning measured at endline based on a composite of beliefs about using services if needed, including: knowledge of at least three modern contraceptive methods available; where to access modern family planning; provider location and list of available family planning services; and belief that they could use services if they needed them. SECONDARY OUTCOME: ; 1. Knowledge of family planning; 2. Demand for family planning; 3. Use of family planning (modern method); 4. Unmet need for family planning; 5. Perceived attitudes towards women with disabilities; All measured via a survey at endline; INCLUSION CRITERIA: The participants in the trial will be women with disabilities, matched with women without disabilities from the same cluster. These women will be evenly distributed across control and intervention arms. Participant eligibility will be determined based on the following INCLUSION CRITERIA: 1. People who identify as women, aged 18‐49 years (in this context we do not expect to find any trans men) 2. For women with disabilities, they must report at least ‘a lot’ of difficulty on at least one of the si Xquestions in the Washington Group short set or the enhanced question on self‐care, or ‘daily’ and ‘a lot’ to the questions on depression or anxiety 3. For women without disabilities, they must be from the same cluster and aged within +/‐5 years of the woman with disabilities