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This project will examine the sustainability of Bill & Melinda Gates Foundation implemented family planning (FP) programs in urban Nigeria. Most FP evaluations focus on program impacts at or toward the end of the program. Very little has been done to consider longer term impact after program operations have ceased. However, the most effective, integrated FP programs should result in both process (i.e., quality of services) and outcome (e.g., modern FP use) effects that outlive the program. We will consider the longer term return on investment for the NURHI program. Specifically, we will estimate the impact of NURHI efforts after those efforts have formally concluded. This will be done by comparing two sites: one where the program concluded (Ilorin) and the other where program activities continued (Kaduna). Our focus will be on longer term impact of behavioral outcomes (chief among the modern contraceptive use) and social norms as well as service access and quality, and provider practices. We define these longer term impacts as 'sustained impact.' The information we generate will provide crucial information about what works and does not over a longer horizon than is usually considered in family planning impact evaluations. An understanding of the longer term implications of a program's components will allow for design of far more impactful programs.

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