Project Materials

FACTORS MILITATING AGAINST FAMILY PLANNING AMONGST WOMEN IN RURAL COMMUNITIES

CHAPTER ONE

INTRODUCTION

1.1 The Background of the Study 

About 30% of maternal and 10% of child mortality could be prevented with family planning, making it one of the most economical and health-promoting public health promotion initiatives.

One Therefore, by promoting healthy birth spacing and lowering pregnancy-related mortality and morbidity, FP helps achieve the Millennium Development Goals (MDGs).

2 Several decades of study and investment in family planning programs have led to large (although uneven) increases in the use of contraceptives across the majority of the developing world, as well as significantly better program coverage and biomedical technology.

3. Various hormonal regimens and delivery methods for women (e.g., pills, injectables, implants, patches, vaginal rings, medicated intrauterine devices) as well as improved male and female condoms, spermicides, cervical caps and other vaginal barriers, post-coital (emergency) contraception, improved fertility awareness-based methods, and easier and more efficient surgical procedures for tubal ligations and vasectomies are among the contraceptive options, not all of which are available in many developing nations.

However, according to Demographic and Health Surveys (DHS), 40% or more of women who recently gave birth stated that they had intended to have the child later or never. This is true in many countries, even nations with relatively high rates of contraceptive prevalence.

5. In certain nations, the percentage of married women who do not have access to contraception can even reach 30 to 40 percent or higher.

6. Program and methodological shortcomings, such as contraceptive failures for various reasons, as well as situational and personal factors like partner resistance or women’s experiences or concerns about side effects that need to be addressed, are reflected to varying degrees in both of these situations.

7. The information, needs, and motivations surrounding contraception change over the course of a person’s life as male and female adolescents engage in sexual activity before marriage, cohabitation (possibly with multiple partners), or marriage, as couples decide whether and when to start having children (if they haven’t already unintentionally done so), as they gain experience with contraception (or lack thereof), pregnancy, and childbearing, consider spacing and stopping, and may face an additional 10 or 20 years of reproductive risk.

Others will have children (wanted or unwanted) outside of marriage or be motivated to avoid it. Some women and men will divorce, remarry, and choose to have another kid. There are numerous contextual and environmental circumstances, and the individual trajectories are even more varied.

Meeting these evolving demands with thorough information about pregnancy risks, appropriate contraceptive alternatives, and proper and consistent usage is a challenge for the health and education sectors.

Interventions include dispelling myths about ineffective practices and dispelling irrational concerns about the negative effects of contraceptives that teenagers may already have.

It is necessary to provide a comprehensive service package that is linked to other sexual and reproductive health inputs and tailored to the unique and evolving needs of individuals and couples.

8. By now, there is a substantial body of evidence regarding how to improve client-provider interactions, make family planning settings more user-friendly, and involve both men and women in the discussion of contraceptive options.

These include factors like ease of use and partner cooperation, potential effects on sexual expression (e.g., coitus-dependent or independent methods), safety, efficacy, side effects, acceptability, accessibility, and cost.

Individuals or couples seeking long-acting reversible or permanent methods, women or men who wish to use a method without their partners’ knowledge, postpartum and breastfeeding women, women receiving post-abortion care, women who have had unprotected intercourse (including rape victims), couples seeking to use a natural method, unmarried adolescents who require dual protection, and women approaching menopause are among the clients for whom guidelines have been established for counselling.

Regarding the medical aspects of contraception for both male and female users, the body of evidence has also grown significantly.

For women of all reproductive ages with specific health issues, such as heavy smokers or those with chronic illnesses undergoing long-term medication treatments (e.g., antihypertensive agents, antiretroviral drugs), method-specific medical eligibility criteria have been established.

Current research is evaluating the risk and protective factors of specific approaches in relation to specific diseases (e.g., endometriosis, cardiovascular disease, breast, cervical, or testicular cancers).

A key defence against maternal and infant morbidity and mortality is family planning. It is a crucial part of both reproductive health and primary care. It significantly lowers the morbidity and mortality rates of mothers and newborns.

It offers significant health and development advantages to people, families, communities, and the country as a whole. It improves reproductive health by assisting women in limiting the number of children they have and preventing unintended pregnancies.

In doing so, it advances the Millennium Development Goals (MDGs) and the Health for All Policy’s target.

13. The MDGs ask for 75% decrease in maternal mortality and two-thirds reduction in child mortality between 1990 and 2015. As such efficient adoption of family planning services is crucial for the fulfilment of these goals thereby enhancing health and speeding development across the areas.

15Access to family planning also has the ability to manage population increase and in the long run minimise green gas house emission with it related risk. 13. Similarly it has been projected that preventing undesired pregnancies by the use of family planning will avert a total of 4.6million Disability Adjusted Life Years.

16 Despite the relevance and benefits of family planning, it has been estimated that roughly 17% of all married women globally would prefer to avoid pregnancy but are not willing to utilise any kind of family planning.

17 As a result, 25% of all pregnancies are unwanted mainly in underdeveloped parts of the world. As a result, an estimated 18 million abortions occur annually, which raises maternal morbidity and injury rates. 14, 17 Although just 10% of women worldwide reside in Sub-Saharan Africa, the region is responsible for 40% of all pregnancy-related fatalities globally and 12 million unintended or unwanted pregnancies annually.

Nigeria has an estimated 8.0% contraceptive prevalence and 17% unmet family planning demand, while sub-Saharan Africa has a low prevalence of 13% despite evidence of the critical importance of family planning.

This is a major factor in the large number of unwanted pregnancies that result in induced abortion and the difficulties that follow. Nigeria has been found to be responsible for 10% of maternal mortality worldwide, although making up only 2% of the global population.

Despite the efforts of the government and other non-governmental family planning service providers, Nigeria’s suburban and rural areas have a comparatively high fertility rate.

Despite the high fertility rate, modern family planning techniques have not been widely accepted or used for a variety of reasons.

In Africa, poverty, inadequate program coordination, and declining donor financing make it difficult to provide family planning services.

Furthermore, religious hurdles, fear of adverse effects, lack of male engagement, and traditional views that encourage high fertility have all played a key role in undermining family planning interventions for women.

1.2 Statement Of The Problem 

Only 15% of Nigerian women who are currently married use some form of birth control, according to the NDHS 2013, which is only a two percentage point increase from the NDHS 2003.

Ten percent of women who are currently married use modern methods of contraception, while five percent utilise traditional methods.

The three most widely utilised modern procedures are injectables (3 percent), male condoms (2 percent), and the pill (2 percent). Less than 1% of all other contemporary techniques are used. Remarkably, 3% of people utilise withdrawal as a form of birth control.

The peculiarities of women’s backgrounds influence their use of contraception. From just 2% of women aged 15 to 19 to 22% of women aged 40 to 44, the percentage of married women currently taking some form of contraception increases with age.

Then, among women aged 45 and above, the usage of contraception declines. Among contemporary techniques, women under 35 are more likely to use condoms, whilst women between the ages of 35 and 44 are more likely to utilise injectables.

Currently married urban women are far more likely than their rural counterparts to use any kind of contraception (27 percent versus 9 percent). Each of these approaches is used more frequently in urban than rural regions.

In North West Nigeria, 4.3% of married women between the ages of 15 and 49 who are currently married utilise contraception, compared to 3.2% and 15.6% in North East and North Central Nigeria. In Southern Nigeria, South East (29.3%), South South (28.1%), and South West (38.0%) have the highest rates of use.

There are notable differences between nations and the six (6) geopolitical zones. With barely 0.5% utilising any contemporary method (pills: 0.2%, IUDs: 0.2%, injectables: 0.1%, while 0.0% use implants, male condoms, LAM, regular day methods, and female sterilisation), Kano State has the lowest rate of contraceptive use in the North (0.6%).