THE INFLUENCE OF FAMILY PLANNING CAMPAIGN AMONG MARRIED WOMEN IN ETSAKO EAST LGA, EDO STATE

 

ABSTRACT

The governments of Nigeria together with other stakeholders involved in the provision of family planning services have put in place various strategies and policies to increase uptake of family planning services. This is aimed at increasing contraceptive prevalence, reducing Total Fertility Rate (TFR), reducing unmet need for family planning services as well as reducing maternal and child deaths. Despite the various strategies and policies, total fertility remains high at 4.6% while the national contraceptive adoption level is at 46% far below the projected rate of 70% by vision 2030 and the unmet need for contraceptive stands at a national level of 26%. Etsako East LGA has a low CPR indicated by high maternal and child deaths. The purpose of this study was to examine the factors influencing adoption of modern family planning methods by married women in Etsako East LGA, Edo State, Nigeria. The dependent variable for the study was adoption of modern contraceptives by married women. Independent variables were couples desire for large families, women economic status, community attitude and women’s close social networks. The study adopted a descriptive study design. The theoretical framework that guided the study was the Diffusion of Innovations Theory and the Social Networks Theory. The target population was 28,787. The sample size for the study was 397 married women which was obtained using the Krecjie and Morgan Table (1970). The sampling procedure adopted was multistage random cluster sampling. Data was collected using interview guides. Data was analyzed using frequencies, percentages, multiple regression, spears rho and presented on tables. The findings of the study will be important in designing the post 2015 agenda by the government and other stakeholders involved in provision of reproductive health services in Nigeria. The findings of the study indicate that by taking the coefficient of determination, couples desire for a large family as a factor contribute 28.4 % variability in adoption of modern family planning practices also a statistical significant relationship between economic status and adoption of modern family planning practices by married women was observed. The study recommends that national and county governments should strive to improve transition rates from primary to secondary school to raise the education levels among women which would promote better understanding of reproductive rights and the benefits of modern family planning methods by women.

 

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

The widespread adoption of modern family planning methods represents one of the most dramatic changes of the twentieth century. The growing use of contraceptives  around the world gives couples the ability to choose the number and spacing of their children and has tremendous socio economic benefits. Yet despite the impressive gains, contraceptive adoption is still low and the need for contraception high in some of the World’s poorest and most populous places (Smith &Ashford, 2009).

The right to contraceptive information and services is grounded in basic human rights

(United Nations population Fund 2008). Also the International conference on Population and Development (ICPD) held in Cairo in 1974 and The Convention on the Elimination of all Forms of Discrimination Against women (CEDAW) 1979 recognize the rights of couples and individuals to be informed and to have access to effective and acceptable methods of family planning. Osotimehin and starrs (2015) in a research on maternity noted that women who plan their births, stay healthy, complete their education, work more, accumulate higher income and raise healthier and better educated children..

Attempts to control population increase are as old as mankind. Evidence from medical history indicates that our fore bears spaced their children through traditional means which were handed down either verbally or in writing from generation to generation as far back as the Stone Age. Before the introduction of modern methods of family planning, Africans had their own traditional methods of fertility regulation. Nigerian culture for instance used myths, rituals and herbs in attempts to regulate women fertility. Although many of these traditional methods of family planning have no harmful effects on a woman’s health some have dangerous counterproductive effects on a woman’s health (Aninyei, Onyesom, Ikuhor, Uzuegbu & Ofili (2008). Nonetheless the complete effectiveness of many traditional methods has remained doubtful. Much as traditional methods are still used as primary methods of fertility control in African societies, modern family planning is thought to influence fertility worldwide.

According to the most recent data available on contraceptive prevalence among women of reproductive age in recent Demographic Health surveys (DHS), modern contraceptive prevalence among married women in Asia varied from 14% in a

Azerbaijan, 20% in Armenia, 22% in Pakistan, 34% in Philippines, 35% in Cambodia, 49% in India (West off, 2012).Sub- Saharan Africa has the highest average fertility rates in the world.  In 2009 the Total Fertility Rate (TFR) or the average number of births per woman was 5.1, more than twice that in South Asia, 2.8 times  that of Latin America and 2.2 times that of the Caribbean ( World Bank ,2009).Adoption of modern family planning methods in Africa has been traditionally low and cultural resistance to modern family planning methods high (Caldwell& Caldwell 1987).  According to the United Nations Department of Economic and Social Affairs (2009) the Contraceptive Prevalence Rate (CPR) varies widely across Africa from 1.2% in Somalia  to 60.3% in South Africa. Geographic variation in family planning use was apparent with countries in Southern Africa reporting the highest level of contraceptive use followed by countries in East Africa. With a few exceptions, West and Central African countries reporting the lowest rates of adoption of modern family planning methods.

Low contraceptive use and high unmet need for family planning has resulted in an increase in unintended pregnancies which are associated with negative health consequences such as increased infant and maternal ill health and death.  The 2008 / 2009 Nigeria Demographic Health Survey (KDHS) reveal that, about 43% of all births in Nigeria are mistimed (Nigeria National Bureau of Statistics, 2010). Nigeria has comparatively good and facilitative policy frameworks on population issues. It was the first country in Sub Saharan Africa to establish a National Family Planning Programme in 1967 (Ajayi & Kevole, 1998). The National Council for population and development NCPD was established in 1982 to guide population policy and

coordinate all research activities in the country (Republic of Nigeria, 1987). The efforts

of the government, Non Governmental organizations (NGOs) and donors in promoting easily available and accessible Family Planning (FP) services has paid off as recent Demographic Health Studies in Nigeria show that knowledge of

contraceptive use is nearly universal and that over 90%  of men and women are aware of at least one method of family planning (KNBS, 2010).

Despite the knowledge of modern family planning, unmet need for contraception remains at approximately 26% which has been largely attributed to limited male involvement in modern family planning endeavors, inadequate service provision, poor access to family planning commodities, lack of support for family planning practices as well as lack of women empowerment on reproductive health , persistent desire for large families by couples and negative attitude towards modern family planning

(Republic of Nigeria, 2004).  Besides the high population growth rate estimated at 2.9% in 2010 remains a key challenge in attainment of the goals of Nigeria vision 2030 which targets a Contraceptive Prevalence Rate of 70% (National Council for

Population and Development, 2012). While modern contraceptive use increased from about 27% in 1993 to 39 % in 2009 there is an increasing trend in reporting fear of side effects and health concerns as important reasons for non use among younger women under the age of thirty (KNBS 2010).

To date Nigeria’s population is estimated to be 37.8 million  with a current growth rate of 2.9% per annum which is considered to be high (National reproductive Health services, 2009- 2015). Currently the CPR stands at 46% (KDHS, 2008) .The unmet need of modern FP is 26 % with the rural areas reporting higher unmet need than urban areas. KDHS (2008/2009) reveals that 53% of married women in urban areas are more likely to use modern contraceptives as compared to 47% of the rural counterparts (KNBS, 2010). Whereas evidence from literature around the world reveals a near universal knowledge of modern family among women of reproductive age, this has not translated into complete utilization of modern contraceptives  by married women. This is clearly reflected by the unmet need for contraceptives of 26% in Nigeria and a CPR of 46% which is way below the projected CPR of 70% by the Nigeria Vision 2030. From the literature reviewed it is evident that knowledge about modern family planning methods is high among couples (90%). However this has not equally translated into uptake; this study seeks to identify factors that influence the uptake of modern family planning by married women in Etsako East LGA, TransNzoia County.

1.2 Statement of the Problem

Globally there still exists wide variations and slow pace of decline in fertility in spite of the decline in fertility throughout the world over the years (Munshi & Myaux, 2006). The slow decline in fertility is attributed to low contraceptive adoption among women of reproductive age (15-49 years). This could be attributed to among other factors couples desire for large families, women economic status, women’s close social networks and community attitude towards modern family planning.

Family planning saves lives and can improve the health of women, children and the society as a whole. According to Bernstein et al (2006) gaining control of one’s reproductive choices and fertility has health benefits for both mother and child. In 2000, about 90% of global abortion related and 20% obstetric related mortality and morbidity could have been averted by the use of effective modern contraceptives by women wanting to either postpone or stop having children. Frequent pregnancies can lead to maternal deaths. Children of deceased mothers are likely to be farmed out to relatives, forced on the streets and to die. Children born within eighteen months of each other (live births) are at a greater risk of fetal death, low birth weight, prematurity and being of small size for gestational age in both rich and poor communities (Bernstein et al 2006).

As much as the government, Non-Governmental Organizations and International agencies have put in place measures to ameliorate rapid population growth, high fertility rates and low adoption of modern contraception methods has remained a major challenge in Nigeria since independence (Republic Of Nigeria, Nigeria Population Situation Analysis, 2013). The current population growth rate is 2.9% per year which is considered high (National Reproductive Health Survey, 2009). The contraceptive prevalence rate is 46% with women in rural areas being the most disadvantaged. The

Total fertility rate still remains high at 4.6% (KDHS 2008/20009). Further the State of Nigeria population Report shows that approximately 1.1 million currently married women would like to delay or stop child bearing but are not using any modern contraceptives and another 1.8 million have unplanned births each year (NCDP 2012).

Edo State is one of the fifteen highly populated counties in Nigeria characterized by high infant mortality rates of 58/1000 and maternal mortality rates of 333/100,000 which could be attributed to low contraceptive adoption rates in the county. The county is also far from achieving the fourth and fifth Millennium Development Goals that are enhanced through the use of modern contraceptives (Edo State Integrated plan 2013-2017).  The current study therefore sought to establish factors influencing adoption of modern family planning methods by married women in Etsako East LGA, Edo State, Nigeria.

1.3 Purpose of the study

The purpose of the study was to investigate factors influencing the adoption of modern family planning methods by married women in Etsako East LGA, Trans Nzoia County, Nigeria.

1.4 Objectives of the study

The following objectives guided the study

1. To determine the extent to which couples desire for large families influence the adoption of modern family planning practices by married women in Etsako East LGA, Edo State.
2. To investigate the extent to which women economic status influences the adoption of modern family planning methods by married women in Etsako East LGA, Edo State.

• To establish the extent to which women close social networks influence the adoption of modern family planning practices by married women in Etsako East LGA, Edo State.

1. To investigate the extent to which the attitude of the community towards modern family planning methods influence the adoption of modern family planning methods by married women in Etsako East LGA, Edo State.

The study  sought to answer  the following research questions.

• To what extent does couples desire for large families influence the adoption of planning methods by married women?
• How women close social networks influence the adoption of modern family planning methods by married women?
• To what extent does women economic status influence the adoption of modern family planning methods by married women?
• To what extent does the attitude of the community about modern family planning methods   influence the adoption of modern family planning by married women?

1.6 Research Hypothesis

The study  tested the following hypothesis;

1 .H0: Couples desire for large families has no influence on adoption of modern contraceptives by married women.

H1: Couples desire for large families influence adoption of modern contraceptive methods by married women.

2. H0: Women economic status does not influence adoption of modern contraceptives by married women.

H1: Women economic status influence adoption of modern contraceptives by    married women.

3. H0: Women’s close social networks do not influence adoption of modern contraceptives by married women.

H1: Women close social networks influence adoption of modern of modern family planning methods by married women.

4. H0: Community attitude towards modern contraceptives does not influence adoption by married women.

H1. Community attitude towards modern contraceptives influence adoption of modern family planning methods by married women.

1.7 Significance of the study

Access to and use of contraceptives may improve economic outcomes and reduce poverty by allowing women to optimally time births, increase women’s investment in education and participate in the labor market during their reproductive age (Ashraf, 2006). Government efforts through the Ministry of Health and the NCPD should be intensified to increase awareness and uptake of modern family planning methods in order to increase the participation of women in economic activities and to strengthen their economic security and well-being as well as that of their families. It is hoped that the findings of this study will be of use to the Ministry of Health and the government as a whole in recognizing that family planning has a crucial role in addressing economic development among women. The findings of this study will also be important in helping National and County governments to reverse the stagnation in the adoption and use of modern family planning methods through vigorous information campaigns against misconceptions about modern family planning methods which may hinder uptake of modern contraceptives. The findings will thus be important in helping the government to attain its population goals enshrined in vision 2030 and the National Council for population and Development in developing responsive programmes to address women contraceptive needs.

The findings of the study may also be of use to the post 2015 development frameworks in family planning by Non-Governmental Organizations, government and Community Based organization which must recognize the lack of control that women and girls have over their own bodies which pose as a hindrance to the adoption of modern family planning methods.

1.8 Limitations of the Study

The study population consisted of married women in rural areas most of whom had low literacy levels. This forced the researcher to use interview schedules which was time consuming. The topic on reproductive health is viewed as sensitive by some respondents which could result to unwillingness to participate in the study by some respondents and dishonest responses by others. To address this problem the researcher created rapport with the respondents and assured them of confidentiality that information being collected was purely for study and is important for policy making about women reproductive health issues. Also, the researcher ensured that interview items were structured in such a way that respondents were comfortable to give responses without feeling that their privacy is being intruded. Financial and time constraints caused the researcher to limit the area of study to Etsako East LGA as opposed to the whole of Kwanza Sub County.

1.9. Delimitation of the study

The study was carried out in Etsako East LGA, Edo State and only focused on responses from married women as units of analysis. The study findings were only based on adoption of modern family planning methods as opposed to traditional and natural family planning methods.

 

THE INFLUENCE OF FAMILY PLANNING CAMPAIGN AMONG MARRIED WOMEN IN ETSAKO EAST LGA, EDO STATE

Sharing is caring!