FACTORS MILITATING AGAINST FAMILY PLANNING AMONG WOMEN ATTENDING ALIMOSHO GENERAL HOSPITAL LAGOS
Abstract
Family planning is a crucial component in the fight against maternal and infant mortality and morbidity. It is crucial to both reproductive health and general healthcare. Despite the efforts of the government and other non-governmental family planning service providers, Nigeria’s suburbs and rural areas still have relatively high fertility rates. Despite the high fertility rate, modern family planning methods have not been widely accepted or used for a variety of reasons.
This study’s goal is to identify the barriers to family planning that women in Lagos state, Nigeria’s Alimosho General Hospital face. It is a descriptive cross-sectional study that included 364 women between the ages of 15 and 49 who were recruited using the multi-stage sample method. All respondents were married (100%) and 135 (37%) of them had more than five children. Of the respondents, 139 (37%) were between the ages of 15 and 24. 48.7% of respondents (roughly half) lacked a formal education.
Few people were now utilizing a contraceptive technique, however the majority of people who weren’t using one cited availability, a lack of proper understanding about family planning, and a fear of its side effects as their main deterrents. Religion (p-value 0.01), family context (p-value 0.001), age (p-value 0.01), and male engagement (p-value 0.001) were the most important sociodemographic factors influencing the use of family planning services. The utilization of family planning services among the rural women was poor, with religion, fear of side effect and husbands’ disapproval among other reasons being the main reasons for non use.
CHAPTER ONE
INTRODUCTION
1.1.1. Background of study
Family planning has the potential to save about 30% of maternal fatalities and 10% of child deaths, making it one of the most cost-effective and health-promoting activities in public health promotion. Thus, FP helps to achieve the Millennium Development Goals (MDGs) by promoting healthy birth spacing and lowering pregnancy-related mortality and morbidity. The majority of the developing world has seen considerable (albeit unequal) improvements in the use of contraceptives as a result of decades of study and investment in family planning programs, which has led to dramatically enhanced program coverage and biomedical technology. There are many 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 simpler and more effective surgical techniques. However, not all of these methods are available in many developing countries.
However, according to Demographic and Health Surveys (DHS), 40% or more of women who recently gave birth said that the pregnancy was either unwanted or sought later in life in numerous countries, including several with fairly high rates of contraceptive prevalence. In some nations, the percentage of married women who lack access to contraception might reach up to 40% or more. Both of these situations reveal, to varying degrees, flaws in the programs and methods used, including contraceptive failures for a variety of reasons, as well as individual and environmental factors like partner opposition or women’s experiences with or concerns about side effects that need to be addressed. Contraceptive knowledge, needs, and motivations change over the course of a person’s life as male and female adolescents begin sexual activity before marriage or cohabitation (possibly with multiple partners) or at the time of marriage, as couples decide whether or not to start a family (if they haven’t already accidentally done so), as they gain experience with contraception (or its lack), as well as with pregnancy and childbearing, as they consider spacing out their children, and as they consider stopping. Some men and women will get remarried after a divorce and elect to have another kid; other people will choose to avoid getting married or bear children (whether they are wanted or not). There are numerous environmental and contextual settings, and the personal trajectories are even more varied. Meeting these evolving demands with thorough knowledge on pregnancy risks, acceptable contraceptive alternatives, and proper and consistent usage is a challenge for the educational and medical sectors. Interventions address adolescent misconceptions about ineffectual techniques as well as unfounded worries about the harmful effects of contraception.
Family planning is a crucial component in the fight against maternal and infant mortality and morbidity. It is crucial to both reproductive health and general healthcare. It significantly contributes to the decrease in maternal and newborn morbidity and mortality. It offers significant advantages in terms of health and development to individuals, families, communities, and the entire country. In order to improve reproductive health, it aids women in preventing unintended pregnancies and reducing the number of children. By doing so, it helps reach the Health for All Policy Target as well as the Millennium Development Goals (MDGs). Between 1990 and 2020, the MDGs call for a decrease of 75% in maternal mortality and a reduction of 2/3 in child mortality. As a result, efficient use of family planning services is essential for achieving these objectives, which will enhance health and speed up regional development. Access to family planning also has the ability to limit population increase and, over time, lower the risk associated with green gas emissions. In a similar vein, it has been calculated that using family planning would prevent 4.6 million Disability Adjusted Life Years in total. 16 It has been estimated that 17% of all married women worldwide would prefer to avoid pregnancy but are unwilling to utilize any type of family planning, despite the significance and advantages of doing so. Because of this, 25% of all pregnancies are unplanned, especially in developing countries. This leads to an estimated 18 million abortions annually, which raises maternal morbidity and injury rates. Only 10% of the world’s women live in Sub-Saharan Africa, but this region is responsible for 40% of all pregnancy-related fatalities globally and 12 million undesired or unplanned pregnancies each year. Despite evidence of the critical importance of family planning, the projected contraceptive prevalence in sub-Saharan Africa is low at 13%, while in Nigeria it is believed to be 8.0% with a 17% unmet demand. This significantly adds to the high number of unwanted pregnancies that end in induced abortion and the difficulties that follow. Nigeria has been found to be responsible for 10% of maternal mortality worldwide despite having only 2% of the global population. Despite the efforts of the government and other non-governmental family planning service providers, Nigeria’s suburbs and rural areas still have relatively high fertility rates. Despite the high fertility rate, modern family planning methods have not been widely accepted or used for a variety of reasons. The provision of family planning services in Africa is hampered by poverty, inadequate program coordination, and declining donor financing. Additionally, cultural norms that encourage high fertility, religious hurdles, side effect anxiety, and a lack of male participation have all greatly weakened family planning initiatives.
1.2 Problem Statement
Maternal mortality risk is influenced by a woman’s reproductive lifespan, her number and timing of pregnancies, as well as co-morbidities and obstetric treatment. The number of maternal fatalities, the maternal mortality rate (MMRate), the maternal mortality ratio (MMRatio), and the lifetime risk of maternal death are four metrics that can be used to quantify the impact of these factors.
The maternal mortality rate (MMRate) is the annual rate of maternal deaths per 1,000 women of reproductive age (15– 49 years). Although the MMRatio is expressed per 100,000 live births, it has the same numerator. A measure of female mortality connected to pregnancy is the lifetime risk of maternal death, which is the cumulative likelihood that a woman would pass away from maternal causes during her reproductive life. While the MMRatio is an indication of risk per pregnancy due to poor access to and quality of obstetric treatments, both the MMRate and lifetime risk of maternal death immediately respond to fertility rates and hence quantify the risk of maternal death per woman. Maternal mortality rates decrease when the number of pregnancies declines since, obviously, there is no maternal mortality risk when there is no pregnancy.
High maternal mortality is unacceptable in Nigeria. Effective contraceptive programming should be the current and future way to lower the risk and unplanned pregnancies since legal, political, and cultural access to abortion create internal conflict. There aren’t many public statistics on the usage of family planning services in Nigeria, particularly in the north, where recent studies have shown high rates of maternal morbidity and mortality. As a result, this study will be carried out to look into how family planning is used by women in Imo, Northern Nigeria.
1.3 Research Questions
- What is the level of knowledge of family planning among women of child-bearing age in rural areas of Lagos State?
- What are the attitudes of rural women of child-bearing age towards family planning?
- What is the level of use of family planning products/methods and services among rural women of child-bearing age?
- What are the factors associated with utilization of family planning services among rural women of child-bearing age?
1.4 General and Specific Objectives
1.4.1 General Objective
To assess the determinants of utilization of family planning services among women of child bearing age in rural areas of Lagos state, Northern Nigeria.
1.4.2 Specific Objectives
- To determine the level of knowledge of family planning among women of child-bearing age.
- To determine the attitudes of rural women of child-bearing age towards family
- To determine the level of use of family planning products and services among rural women of child-bearing
- To determine the factors associated with utilization of family planning services among women of child-bearing
1.5 Scope of the study
Women between the ages of 15 and 49 who lived in Alimosho, Lagos State for a period of six months were included in the study. It investigated the determinants of family planning service use and determined the knowledge, attitude, and variables mitigating against family planning services.
1.6 Significance of Study
High mother and newborn mortality can result from high fertility rates and insufficient birth spacing. Worldwide, there are thought to be 600 000 maternal deaths per year; the majority of these occur in underdeveloped nations. According to the WHO, unsafe abortions account for 13% of these fatalities. Induced abortion, used by around 50 million women worldwide, frequently leads to high rates of maternal morbidity and mortality. Family planning and birth spacing are thus two ways to prevent these deaths. The international community has embraced the promotion of family planning and the use of contraceptives as a key method for lowering maternal mortality and achieving the Millennium Development Goals. Africa is known for having a high percentage of access to contraceptives (57%), which results in unintended births, an increase in the demand for abortions, and deaths from unsafe abortions.
High maternal mortality is unacceptable in Nigeria. Effective contraceptive programming should be the current and future way to lower the risk and unplanned pregnancies since legal, political, and cultural access to abortion create internal conflict. There aren’t many public statistics on the usage of family planning services in Nigeria, particularly in the north, where recent studies have shown high rates of maternal morbidity and mortality. In addition to educating the public, this study will also provide literature on the topic.
1.6 Limitations
- Cultural influences and beliefs may hinder the respondents from giving clear
Therefore, research assistants were recruited from these communities in order to respect their culture and to ease acceptance by the community members.
- Perception by respondents that the interviewers want to impose the idea of contraception use on them may arise. Hence, the research assistants were adequately trained on conducting interviews thereby minimally reducing the chances of perception of contraception imposition among.
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Kothari CR. Research Methodology: Methods and Techniques. 1990. www2.hcmuaf.edu.vn/data/quoctuan/Research Methodology
Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health.
Lancet. 2012; 380(9837):149-56.
UNICEF. The state of the world’s Children 2009. New York: United Nations Children’s Fund; 2009.
Federal Ministry of Health of Nigeria. Saving newborn lives in Nigeria: newborn health in the context of the integrated maternal newborn and child health strategy. Abuja, Nigeria: Save the Children and ACCESS; 2009.
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