INTRODUCTION

1.1 Background Information

Family planning is widely recognized as one of the most effective and cost-efficient public health interventions, playing a critical role in reducing maternal and child morbidity and mortality.

It has the potential to prevent approximately 30% of maternal and 10% of child deaths, contributing significantly to the achievement of Millennium Development Goals (MDGs) through healthier birth spacing and reduced pregnancy-related complications.

Advancements in family planning over the decades have led to improved program coverage and biomedical technologies. Contraceptive options now include a variety of hormonal methods (e.g., pills, injectables, implants, patches, vaginal rings), improved male and female condoms, spermicides, cervical caps, post-coital contraception, and more effective surgical techniques like tubal ligations and vasectomies.

Despite these advancements, many countries, including those with high contraceptive prevalence rates, still experience significant unmet needs for contraception. For example, Demographic and Health Surveys (DHS) indicate that up to 40% of women who recently gave birth report that the pregnancy was unwanted or mistimed.

Unmet need for contraception remains high, ranging from 30% to 40% in various regions. These issues reflect both programmatic inadequacies and personal or situational barriers, such as partner opposition or fears of side effects.

Family planning is a cornerstone of primary health care and reproductive health, offering essential benefits to individuals, families, communities, and nations.

It allows women to prevent unwanted pregnancies and manage the number of children they have, which contributes to overall reproductive health and helps meet the MDGs and the Health for All policy targets.

The MDGs set ambitious goals to reduce maternal mortality by 75% and child mortality by two-thirds between 1990 and 2020. Effective utilization of modern family planning methods is crucial to achieving these targets, improving health outcomes, and accelerating development.

Family planning also has broader implications, including controlling population growth and reducing greenhouse gas emissions. Estimates suggest that preventing unwanted pregnancies through modern family planning could avert 4.6 million Disability-Adjusted Life Years (DALYs).

Despite its significance, about 17% of married women globally wish to avoid pregnancy but do not use modern family planning methods, leading to 25% of pregnancies being unintended, particularly in developing regions. This results in approximately 18 million abortions annually, contributing to high maternal morbidity and mortality.

Sub-Saharan Africa, home to 10% of the world’s women, accounts for 12 million unwanted pregnancies and 40% of global pregnancy-related deaths each year. The contraceptive prevalence in Sub-Saharan Africa is low, estimated at 13%, and Nigeria’s rate is even lower at 8%, with a 17% unmet need for family planning.

This low utilization contributes to high rates of unintended pregnancies and induced abortions with associated complications. Despite Nigeria’s efforts through government and non-governmental programs, family planning uptake remains low due to factors such as poverty, poor program coordination, dwindling donor funding, traditional beliefs favoring high fertility, religious barriers, fear of side effects, and lack of male involvement.

1.2 Statement Of The Problem 

The number and timing of pregnancies significantly influence maternal mortality risks, which are also affected by factors such as co-morbidities and the quality of obstetric care. These risks can be quantified through several measures:

• Maternal Mortality Rate (MMRate): The number of maternal deaths per 1,000 women of childbearing age (25–45 years) per year.
• Maternal Mortality Ratio (MMRatio): The number of maternal deaths per 100,000 live births, reflecting the risk per pregnancy.
• Lifetime Risk of Maternal Death: The cumulative probability of a woman dying from maternal causes over her reproductive lifetime.

Both the MMRate and lifetime risk of maternal death are directly related to fertility rates, indicating the risk of maternal death per woman. Conversely, the MMRatio highlights the risk per pregnancy, influenced by access to and the quality of obstetric services. Lowering the number of pregnancies can reduce maternal deaths, as the absence of pregnancy inherently eliminates the risk of maternal death.

In Nigeria, maternal mortality remains alarmingly high. Access to abortion, constrained by legal, political, and cultural barriers, exacerbates the situation. Effective contraceptive programming is critical for mitigating these risks and reducing unwanted pregnancies.

Despite the importance of modern family planning methods, there is limited published data on their use in Nigeria, particularly in the northern region, where high rates of maternal morbidity and mortality have been observed.

This study aims to investigate the use of modern family planning methods among childbearing women in Taraba State, Northern Nigeria, to provide insights into current practices and identify areas for improvement in family planning programs.

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