In a single program area in northern Nigeria, contraceptive use climbed from 2% to over 70%. This change wasn't caused by a new technology, but happened because of one new strategy: centering trust. In this episode, Jonathan Jackson and Amie Vaccaro sit down with Klau Pakos, CEO and co-founder of Lafiya, to unpack how their organization closes the "last mile" gap in family planning in some of the hardest-to-reach communities in Northern 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. Klau shares the visceral reality of women facing extreme maternal mortality risks, walks through how Lafiya became a true partner to the government rather than a vendor with a fixed model, and explains why they resist the pull of shiny new technology until it's proven necessary. As they put it, family planning "brings the foundation for everything else", creating ripple effects across health, income, and autonomy that data alone can't fully capture. A candid, practical conversation for anyone trying to scale impact alongside government systems.Related Resources:
Lafiya – Klau's organization, which trains local "Lafiya Sisters" to deliver family planning counseling and self-injectable contraceptives to underserved communities in northern Nigeria.
D-Prize – A seed funding organization that awards grants to entrepreneurs testing new business or charity models that distribute proven poverty-intervention technologies
Charity Entrepreneurship – An incubator program that helps founders launch high-impact, cost-effective charities.
Rethink Priorities: Cost-Effectiveness Analysis of Lafiya Nigeria – The independent modeling Klau references, estimating Lafiya's cost per DALY averted and per maternal life saved.
Sayana Press (DMPA-SC) via Pfizer – An all-in-one, self-injectable contraceptive that lasts for three months and is optimized for low-resource environments due to its lack of a cold chain requirement.
https://www.fp2030.org/ - A global partnership dedicated to advancing rights-based family planning, which the Nigerian government has contributed to for over a decade.
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Hosts: Jonathan Jackson and Amie Vaccaro
