The Last Mile of Family Planning: Lessons from Lafiya in Nigeria

Originally published on Dimagi.com

Klau Pakos, CEO and co-founder of Lafiya, on closing the family planning last mile in Northern Nigeria, where contraceptive use jumped from 2% to over 70% by meeting women where they already are.

In a single program area in northern Nigeria, contraceptive use climbed from 2% to over 70%. That change wasn’t driven by a new technology, but by one strategy: centering trust.

Klau Pakos is the CEO and co-founder of Lafiya, an organization tackling the family planning delivery gap in some of the hardest-to-reach communities in Nigeria. Women in these communities often already know about contraception, but too often travel hours to a clinic only to be turned away empty-handed. Lafiya’s answer is the Lafiya Sisters: trusted local health workers who bring counseling and self-injectable contraceptives directly into communities.

In conversation with co-hosts Jonathan Jackson and Amie Vaccaro, Klau shares the visceral reality of women facing extreme maternal mortality risk, walks through how Lafiya became a true partner to government rather than a vendor with a fixed model, and explains why the organization resists the pull of shiny new technology until it’s proven necessary. A candid, practical conversation for anyone trying to scale impact alongside government systems.

Listen to the full podcast here.

In this episode

• How the Lafiya Sisters took contraceptive use from 2% to over 70% in one Nigerian program area

• Why the fix was distribution and trust, not new technology or awareness campaigns

• Sayana Press (DMPA-SC): a self-injectable, three-month contraceptive built for last-mile delivery

• Becoming a true partner to government instead of a vendor with a fixed model

• Why Lafiya resists shiny new technology, AI included, until it’s proven necessary

• What the data on maternal health outcomes will never fully capture