PREFERRED CONTRACEPTIVE METHOD AMONG
FEMALE OF REPRODUCTIVE AGE IN ODOGUYAN,
IKORODU NORTH LOCAL COUNCIL DEVELOPMENT AREA,
LAGOS, NIGERIA
By: Ajibade Nurudeen Olabode
ABSTRACT
This research paper examines the preferred contraceptive method among females of reproductive age and the effectiveness of the traditional contraceptive finger ring method of family planning. Contraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimal spacing between birth, reducing maternal & child mortality, and improving the lives of women and children in general. The current prevalence rate for contraceptive use in Nigeria is very low in spite of the high rate of sexual activity and widespread awareness of the various contraceptive methods among Nigerians. As a result, there are many unintended pregnancies and illegal abortions contributing to a high maternal mortality ratio, which seems to indicate a large unmet need for contraceptive use.
The study employed an interviewer administer questionnaire to collect data from 221 participants selected using systematic sampling technique and double sampling technique to conduct 42 in-depth interviews. The data was analyzed and presented in frequency table and percentage, histogram, and pie chart.
The findings indicated that knowledge of any method of contraception was almost universal among the participants. The rate of ever use and current use of contraception was 47.51% and 38.92% respectively. However, the fear of side effects of modern contraceptive methods drove women away from practicing family planning while some relied on less effective (withdrawal/rhythm) traditional method. Traditional contraceptive finger ring given to the participants to prevent pregnancy was proved effective by the users in the study without any adverse effects. There is ample research evidence identifying the various factors that contributed to the low prevalence of modern family planning programs on a much larger scale, using community-oriented approaches and communication programs to reach out to all and sundry.
My findings show that the rate of contraceptive use was low in the study. However, this study highlights current methods and concepts in contraception, the reason for low contraceptive use, and practice among women in the reproductive age group (18-49 years) in Odogunyan, Ikorodu, Lagos, Nigeria. The need for Nigeria to generate a political priority and a will to make a change in maternal health indicators with the ultimate goal of providing direction to guide changes in the Nigeria population policy as it affects contraceptive use and family planning. Community-oriented approaches and communication programs are important.
Keywords: Health, Contraceptive method, Contraceptive finger ring, women of reproductive age.
INTRODUCTION
In the early days, human societies had the creation of as many children as possible, as a central value. Today, relatively few societies can afford this perspective, resulting in an increased attempt to limit and manage the birth rate of their families of which Nigeria is no exception.
The negative effect of a high fertility rate on woman and their children and the benefits of fertility control are well known. Too many or too closely spaced pregnancies and pregnancies of a woman at too young or too old age give rise to health risks for mother and infant, with associated higher maternal and neonatal mortality rates. The health of other children in the family is also affected. These factors, among others, provide health rationale for fertility regulation and family planning, which is now considered an essential element of preventive health care.
Contraceptive use has numerous health benefits such as preventing unplanned pregnancies, ensuring optimum spacing between births, reducing maternal and child mortality, and improving the lives of women and children in general.
The benefits of fertility regulation relate to the broader issue of the status of women. The ability of a woman to control her own fertility is one of her basic and important rights. It is presumed that better-regulated sexuality and fertility affect the status of women socially and economically. This is perceived to be reflected in their educational, health and economic status coupled with independence in the decisions on their role and being responsible for their total well-being.
Even though trends of increase in contraceptive use have been acknowledged widely, recent estimates show 54 million unplanned pregnancies, 79 thousand maternal death, and 1.2 million childhood mortality could have been prevented with universal access to effective family planning methods. Despite the aggressive efforts of government and non-governmental agencies to improve access to effective family planning methods in Africa over the past 3 decades, the dominant studies reported low levels of contraceptive use.
The most recent Nigeria Demographic and Health Survey (NDHS) data showed that only 14.5% of couples in the country reported using any method of contraception. However, the rate of contraceptive use is much higher in the southwest region of Nigeria. The NDHS report shows that 38% of women in southwest Nigeria are using any form of contraceptives. However, the findings from the National Bureau of Statistics and other smaller studies in the region suggest that the rate could be higher. Also, it is important to note that the smaller studies were conducted among specific populations (women attending antenatal care services and women residing the rural communities), which may explain their results.
Access to family planning services has significantly expanded in southwestern Nigeria over the past 10 years and contraceptive knowledge is almost universal among women, as such were previous estimates of contraceptive use. This at least provides a basis for further studies.
Many studies have reported low use of traditional contraception in Nigeria. Low levels of education, women’s and partner’s disapproval of modern family planning methods, religious beliefs, fear of side effects of modern contraception, women’s misconceptions of contraceptive side effects, use of unproven methods, and infrequent sex are among the reasons for non-use of contraception in Nigeria and Africa as a whole. However, many of the aforementioned reasons relate more to the use of modern contraceptive methods rather than natural or traditional family planning methods. Considering that contraceptive methods include the use of traditional methods such as withdrawal, and rhythm methods even though they are less effective, the concoction method was overlooked by many studies because there was not much-proven research done on it. This study is able to experiment and come out with an effective traditional method of contraception without any side effects reported yet.
Advance in the literature does not sufficiently explain the reasons for the low level of use of any form of contraceptive and traditional methods, particularly in Africa.
Early anthropological studies suggest that the use of traditional family planning methods (periodic abstinence) is common in African countries, especially southwestern Nigeria. It was noted that postpartum sexual abstinence has probably reduced, but the need to space children is still paramount. It is against this background that this research using a mixed-methods study to examine the level of contraceptive use, its determinants, prove an unproved method, reasons for non-use of contraception among women of the reproductive age group (18-49years) in Odoguyan, Ikorodu, Lagos. This study also begins with the assumption that the low level of traditional family planning methods in previous studies may be due to women’s reticence of reporting their contraceptive choices. Studies indicate that about half of men agreed that women who use contraceptives become promiscuous. Women might not be open to reveal if they are utilising any family planning method or simply reply negatively to wade off further questioning. The obvious consequences of the low use of contraceptives in the communities on the social and economic development of the inhabitant especially mothers and children are of major concern.
MATERIALS AND METHODS
Study Location
The study location is Odoguyan, Ikorodu North Local Council Development Area of Lagos State.
The study area covers some part of Ikorodu North (Odoguyan). In 2003, the existing Ikorodu LGA was split for administrative purposes into Local Council Development Areas. The lower-tier administrative units now number 6: Imota, Igbogbo/Bayeku, Ijede, Ikorodu North, Ikorodu West, and Ikorodu.
For the purpose of this research, Odoguyan belongs to Ikorodu North, and Odoguyan comprises Odonla, Odokekere, Rofo, and Idera were studied.
Study population
The study population is heterogeneous, conspiring Yoruba, Igbo, Hausa, etc. However, the Yoruba ethnic group owned the land and are in the majority. They are predominantly farmers, petty traders, artisans, white-collar jobs workers, etc.
Muslims and Christians dominate the district and some traditional believers. The area is densely populated, and the common language spoken are Yoruba, English, Igbo, and Hausa.
There are many health facilities, which are made up of hospitals, clinics, and maternity homes.
The analysis in this study was limited to women in their reproductive age.
The study population was women in their reproductive age from 18- 49 years who have lived in Ikorodu North for at least one year.
Sampling Technique
Selection of worship places in the community
Sixteen worship places were selected (Eight mosques and Eight churches) for the study. Thus, the sixteen worship places were conveniently chosen from all the communities under Odoguyan, to represent the whole of Odoguyan.
Selection of Respondents in Worship Places
Participants for the focus groups were selected with the assistance of some key informants in the various worship places through the systematic sampling technique. Double sampling technique was also adopted to get the sub-sample for further information.
In each focus group, I used the systematic sample method, out of 60, I used 1 in 3 to get my 20.
For the sub-sample I used the simple random technique by writing numbers on paper and folding then on another empty piece of paper without number for the respondents to pick, to get my 42 altogether.
Sample size
To obtain the sample size, I checked articles in different journals to obtain previously documented percentage prevalence of the use of contraceptives.
I found an article by the National Population Commission (2003) Nigeria Demographic and Health Survey. “Prevalence and determinants of the use of modern contraceptive method in southwest Nigeria 38%.
The prevalence 38% was used in the formula below to determine the sample size.
Sample Size (n) = z2pq
d2
where n = sample size
z = confidence interval at 95% (1.96) – given
p = prevalence of previous study = 38%
q = 1- p
d = precision (acceptable margin of error = 0.05)
n= z2pq
d2
n= (1.96)2 x 0.38 x 0.62
(0.05)2
n= 3.84 x 0.38 x 0.62
0.0025
n= 361.88 = 362
Sample size was found to be 362.
Inclusion & Exclusion
Inclusion: Female 18-49 years old
Exclusion: Female below 18 and above 49. Male is not included in the study.
Data Instrument
The instruments used for my project research were questionnaires: Paper Questionnaire
The questionnaires comprise five sections:
Section A: Socio-demographic information
Section B: Knowledge about Contraceptive
Section C: Attitude towards the Usage of Contraceptive
Section D: Awareness of traditional method of contraception
Section E: Feedback from the users of traditional contraceptive finger ring method.
(See Appendix 1)
Pre-test
Questionnaires were administered to 15% of the sample size before the commencement of the fieldwork. The purpose of this was to ensure that any mistakes in the framing of the questionnaire were corrected and/or sentences reconstructed if not well understood.
Validity & Reliability of Instrument used
The validity of the questionnaire was put to test by the Pre-test. At the end of the Pre-test, questions not well understood by the participants were reconstructed in order that the instrument may be valid for the questions asked.
The reliability of the questionnaire was shown to my supervisor for approval.
Distribution & Collection
The paper questionnaires were distributed manually
After the paper questionnaires were distributed and collected, they were collated in an Excel spreadsheet for further data analysis.
Ethical Consideration
Informed consent was sought from community elders, and religious leaders in various worship places. This enabled me to explain the purpose of the study to them since family planning issues are very sensitive within the traditional setup.
At the same time, conscious efforts were made to learn certain don’t of the various religions before entering the worship places and when entered. All information that is gotten from the respondents was treated as confidential.
The questionnaire was given satisfactory approval.
DATA ANALYSIS AND INTERPRETATION
This chapter presents the collated data of the questionnaire responses of participants, women between ages 18 – 49 years.
Questionnaire Response Rate
Total number of questionnaires = 240, total number of respondents to questionnaires = 221. Response rate = 92%.
Social Demographics Characteristics of Respondents
The Age, Marital status, Educational level, Occupation, Ethnic group, Number of children, Parity, Religion of the respondents were presented in pie chart and histograms for better understanding of the social demographic characteristics of the respondents.
Age Distribution of Respondents
Respondents were grouped into different age categories.
Table 1 Age response of participants
| VARIABLES | FREQUENCY | PERCENTAGE (%) |
| Age | ||
| 18-25 | 6 | 2.72 |
| 26-33 | 133 | 60.18 |
| 34-41 | 72 | 32.58 |
| 42-49 | 10 | 4.52 |
| TOTAL | 221 | 100 |
Ages of respondents varied greatly, with the majority of them coming from the age range of 26 – 33 (60.18%) and 34 – 41 (32.58%) with a minority age group of 18 – 25, and 42 – 49 forming 2.72% and 4.52% respectively.
Table 2. Occupation of Respondents
| OCCUPATION | Frequency | % |
| Farming | 4 | 1.80 |
| White collar job | 43 | 19.46 |
| Artisan | 156 | 70.59 |
| Unemployed | 18 | 8.15 |
| TOTAL | 221 | 100 |
Out of the 221 respondents:
About 1.80% of the respondents as seen below were engaged in farming for their livelihood, 19.46% were found to be in the formal sector, the majority of the respondents constituted 70.59% and were either artisans or traders, and 8.15% were unemployed.
Table 3. Religion of Respondents
| RELIGION | ||
| Islam | 101 | 43.75 |
| Christian | 110 | 50 |
| Traditional | 7 | 4.38 |
| Pagan | 3 | 1.87 |
| TOTAL | 221 | 100 |
From the table, it is also realized that a total of 43.75% are practicing Islamic religion, a majority of them (50%) believed in Christianity, 1.87% said they were pagans, and 4.38% were traditional worshippers.
Table 4. Ethnic group of the Respondents
| ETHNICITY | FREQUENCY | % |
| Yoruba | 122 | 55.20 |
| Igbo | 63 | 28.5 |
| Hausa | 21 | 9.51 |
| Ijaw | 11 | 4.98 |
| Others | 4 | 1.80 |
| TOTAL | 221 | 100 |
The largest ethnic groups within the study area as seen from the above table were the Yorubas, they formed 55.20%, followed by the Igbos, 28.50%, Hausa/ Fulani 9.51%, Ijaw 4.98%, the other ethnic group came from other countries: Ghana, Germany forming 1.80%.
MARITAL STATUS OF RESPONDENTS
Table 5. Distributions of marital status of Respondents
| MARITAL STATUS | Frequency | % |
| Single | 34 | 15.39 |
| Married | 115 | 52.03 |
| Widowed | 13 | 5.88 |
| Cohabit | 40 | 18.10 |
| Divorced | 19 | 8.60 |
| Total | 221 | 100 |
Only 15.39% of the respondents were found to be single, the majority of the respondents (52.03%) were married, 5.88% were widowed, 18.10% were cohabiting (living together through not legally married), and 8.60% responded they were divorced.
Table 6. Parity of the Respondents
| PARITY | Frequency | % |
| 1-2 | 97 | 43.90 |
| 3-4 | 108 | 48.87 |
| 5-6 | 14 | 6.33 |
| 7-8 | 2 | 0.9 |
| 9 above | – | – |
| Total | 221 | 100 |
The majority of the respondents interviewed preferred a parity of 3-4 (48.87%), 43.90% said they were interested in having 1-2 children, 6.33% preferred 5-6 children, and 0.9% claimed to want 7-8 children.
Table 7. Educational level of Respondents
| EDUCATIONAL LEVEL | Frequency | % |
| No schooling | 12 | 5.43 |
| Primary | 23 | 10.41 |
| Jss/Middle | 42 | 19.0 |
| Secondary | 96 | 43.44 |
| Tertiary | 46 | 20.82 |
| Others | 2 | 0.9 |
| TOTAL | 221 | 100 |
On the educational level, 5.43% said they had never schooled or had any formal education, 10.41% had primary education, 19% had education up to JSS or Middle school, respondents who had SSS, O/A level or Technical education 43.44%, 20.82% had tertiary education (Polytechnic/University level), 0.9% mentioned others.
Table 8. Distribution of respondents who have ever heard of family planning SS
| Have you ever heard of family planning | Frequency | Percentages % |
| Yes | 206 | 80.62 |
| No | 15 | 19.38 |
| TOTAL | 221 | 100 |
From the table, it is observed that knowledge about FP was relatively high among respondents, with a proportion of 80.62% having ever heard of family planning, this can partly be attributed to the aggressive family planning campaigns on electronics media and other sources, 19.38% however, had never heard of any family planning methods.
Table 9. Knowledge of family planning
| Knowledge of family planning method | Frequency | Percentage |
| Family planning gives couples the opportunity to plan the number and spacing of their children | 197 | 89.14 |
| Family planning is a way of allowing women to deny their husband sex | 17 | 7.70 |
| Family planning is a strategy designed to give power to women | 7 | 3.16 |
| Family planning is a plan to kill women by easily spreading HIV/ AIDS to them | – | – |
| TOTAL | 221 | 100 |
To find out the depth of knowledge respondents had on family planning. 89.14% said family planning gives couples the opportunity to plan the number and spacing of their children, 7.70% said, family planning is a way of allowing women to deny their husband sex, 3.16% responded that family planning is a strategy designed to give power to women.
Findings from the above reveal that, a large proportion of the respondents (89.14%) had accurate knowledge about FP by indicating FP gives couples the opportunity to plan the number and spacing of their children.
In order to further investigate the extent of people’s knowledge about family planning within the community, a focus Group Discussion (FGD) session was organized to determine participants’ knowledge base on FP, among other variables; the following were some of their responses.
Knowledge about family planning practice
To determine the participants’ knowledge about FP, findings from all the FGD session conducted within the community found that family planning is used for pregnancy prevention, a mechanism for child spacing, and FP is used to limit family size.
Table 10 Distribution family planning approval
| Does Your Spouse Approve Of FP | Frequency | Percentage (%) |
| Yes | 116 | 52.48 |
| No | 105 | 47.51 |
| TOTAL | 221 | 100 |
From the above table, it is realized that 52.48% of those interviewed indicated their spouses’ approval of family planning, and 47.51% said their spouses do not approve of family planning, the reason being that women would take advantage of FP to flirt with other men, the fact that some FP methods like the condom interrupts sexual satisfaction, quite a number of them also mentioned religion as reasons for non-approval.
Also, finding from FGD reveal that, few of the participants approved of FP since to them it helps one to plan the number of children they would want to have in the future, they also claim it helps improve the health status of mothers and their children and the fact that men’s approval would to a large extent increase coverage of FP. The majority, however, disapprove of FP for the reason that it is against their religion and the fact that, God said in the holy books that we should multiply and fill the earth.
Other reasons were the fact that it has severe side effects and the inability of one to enjoy sex to the fullest. They also said their spouses believed that approving FP is like giving a license to the wife to flirt with other men.
Table 11. Distribution of respondents who have ever used any family planning method.
| Ever used FP methods | Frequency | Percentage % |
| Yes | 105 | 47.51 |
| No | 116 | 52.48 |
| TOTAL | 221 | 100 |
47.51% of respondents interviewed said they had ever used family planning, and 52.48% responded they had never used any family planning method before. The reasons given were not different from those given by those who do not approve of FP.
Table 12. Distribution of respondents who have ever used any of the contraceptive methods
| Ever use of family planning methods (YES) | Frequency | Percentage |
| Pills | 93 | 42.08 |
| Condoms | 53 | 24.0 |
| Depo-provera | 25 | 11.31 |
| IUCD | 8 | 3.62 |
| Traditional | 20 | 9.04 |
| Withdrawal/rhythms | 18 | 8.15 |
| Others | 4 | 1.80 |
| TOTAL | 221 | 100 |
It is observed majority 42.08% have ever used the pills, 24% have used either male or female condoms, 11.31% had ever gone for Depo-Provera (hormonal injection every 3 months), 3.62% said they had used an Intrauterine contraceptive device (IUCD), 9.04% used traditional method (finger ring, herbal concoction), 8.15% used natural method of (withdrawal/rhythms), Others are 1.80% used lactational amenorrhea.
Table 13: Distribution of respondents who gave reasons for using a particular method.
| Reasons for using a particular method | Frequency | Percentages |
| Less costly | 56 | 25.34 |
| Easily accessible | 134 | 60.64 |
| Takes a longer period before re-use | 7 | 3.17 |
| Reliable | 23 | 10.40 |
| Others | 1 | 0.45 |
| TOTAL | 221 | 100 |
25.34% preferred a particular method because it is less costly, 60.64% said they preferred that method because it is easily accessible, 3.17% also said they used those methods because, it takes a longer period before re-use, 10.40% said they preferred the particular method because they are reliable, 0.45% said she used that method due to other reasons (prevention of pregnancy and HIV/ AIDS).
Table 14. Distribution of those who gave reasons for not using family planning methods.
| Reason for not using FP | Frequency | Percentages |
| Against my belief | 53 | 24.0 |
| Interrupts sex | 93 | 42.08 |
| Afraid of side effects | 25 | 11.31 |
| Inadequate knowledge in FP | 50 | 22.61 |
| TOTAL | 221 | 100 |
When respondents were asked to find out from those who answered NO to using any family planning method, the following responses were given; 24% said, they do not use family planning because it is against their religion, a large proportion (42.08%) did not practice family planning because, they believe it interrupts their sexual enjoyment, also 11.31% said, they do not use family planning because, they heard from their colleagues the side effect they had experienced from using family planning methods, 22.61% of them said they do not use family planning because they do not have adequate knowledge about family planning methods.
Table 15. Distribution of respondents who are aware of a place to get family planning method
| Do you know of a place to get FP | Frequency | Percentages |
| Yes | 182 | 82.35 |
| No | 39 | 17.65 |
| TOTAL | 221 | 100 |
When respondents were asked whether they knew of a place to get family planning methods, 82.35% knew of where to get FP methods, and 17.65% said they had no idea as to where to get family planning methods.
Table 16. Distribution of respondents who knew of a number of places to get family planning methods.
| How many of these places can one get FP services | Frequency | Percentages |
| 1 Place | 49 | 22.18 |
| 2 Places | 134 | 60.64 |
| 3 Places | 34 | 15.38 |
| Others | 4 | 1.80 |
| TOTAL | 221 | 100 |
When respondents were asked to find out how many of these places they knew of: 22.18% were aware of only one place, 60.64% were aware of two places, 15.38% were aware of three places, 1.80% of the respondents indicated others (herbalist).
Table 17. Distribution of respondents who were currently using contraceptive methods.
| Current use of contraceptive | Frequency | Percentages |
| Yes | 86 | 38.92 |
| No | 135 | 61.08 |
| TOTAL | 221 | 100 |
A total of 61.08% representing the majority indicated they were currently not using any family planning method or doing anything to delay pregnancy. This again was attributed largely to interruption of sexual enjoyment, fear of side effects, and the mindset of their spouse thinking they’ll be promiscuous among others. 38.92% however, said they are doing something to delay pregnancy.
Table 18. Distribution of respondents on how long they have been using a particular method.
| How long have you been using a particular method | Frequency | Percentages |
| One- six months | 7 | 3.16 |
| Seven- twelve months | 12 | 5.44 |
| Thirteen- Eighteen months | 15 | 6.78 |
| Nineteen- Twenty-four months | 22 | 9.97 |
| Twenty-five months and above | 30 | 13.57 |
| Not using | 135 | 61.08 |
| TOTAL | 221 | 100 |
When respondents were interviewed to find out when they started using a particular method, 3.16% said, they started only about one- six months, 5.44% said seven- twelve months, 6.78% thirteen- eighteen months, 9.97% nineteen- twenty-four months, however, about 13.57% had used the family planning method for over twenty- five and above months now, while 61.08 majority are not using.
Table 19. Distribution of attendance to family planning clinics.
| Do you attend FP clinic? | Frequency | Percentages |
| Yes | 73 | 33.03 |
| No | 148 | 66.97 |
| TOTAL | 221 | 100 |
When respondents were asked whether they attend any family planning clinic, 66.97% had never attended any family planning clinic before. This according to them was due to the fact that they could get FP methods or contraceptives easily at the various chemical shops around their vicinities. They also mentioned the lack of confidentiality at the various FP clinics, being mishandled by some health professionals, and religious and cultural beliefs among many others. 33.03% however, attend the FP clinics.
Table 20. Distribution of respondents who do not attend Family planning clinic
| Reasons for not attending FP clinic | Frequency | Percentages |
| No confidentiality at the facility | 58 | 26.27 |
| Being mishandled by the nurses | 18 | 8.14 |
| Too much time spent on the facility | 124 | 56.10 |
| Too far from my home | 9 | 4.07 |
| Others | 12 | 5.42 |
| TOTAL | 221 | 100 |
A question was asked of those who had never attended family planning clinics to find out reasons why they do not attend the clinics. The following were their responses, 26.27% said they do not attend family planning clinics because there is no confidentiality at the clinics, 8.14% said they hear stories that, the nurses sometimes mishandle them anytime they visited the facility, 4.7% do not visit clinics because they claimed the clinics were far away from their residence, a majority of them 56.10% do not attend family planning clinics because, they claimed too much time is spent at the facility, 5.42% of the respondents indicated other reasons different from the ones mentioned above. Some of the reasons were menopause, widowed, religious beliefs and finally, some also said they could easily get from chemical shops.
Table 21. Distribution of respondents whose spouses accompany them to FP clinic
| Does your spouse accompany you to FP clinic? | Frequency | Percentages |
| Yes | 22 | 13.75 |
| No | 138 | 86.25 |
| TOTAL | 221 | 100 |
86.25% do not accompany their partner to the family planning clinics, partly because they believed not only it is time-consuming but also see FP as women’s business, not theirs, only 13.75% do accompany their wives to the FP clinics.
Table 22. Distribution of respondents on whether their spouses showed interest after they return from family planning clinics.
| Does your spouse show interest after return from FP clinic? | Frequency | Percentages |
| Yes | 80 | 36.20 |
| No | 141 | 63.80 |
| TOTAL | 221 | 100 |
Respondents who said their spouses showed interest after their return from the clinic constituted 36.20%, whereas a large number 63.80% of them said, their spouses never showed interest after their return from the clinics.
Table 23. Distribution of respondents on spousal support in FP
| Does your spouse support you in FP | Frequency | Percentages |
| Yes | 62 | 28.05 |
| No | 159 | 71.95 |
| TOTAL | 221 | 100 |
A question to determine the level of partner support as revealed in the table above showed that an overwhelming proportion of 71.95% of the respondents said their spouses do not support them in family planning, and only 28.05% support their partners in family planning. The argument advanced by respondents for the abysmal spouse support was based on the basic reason that men claimed FP is the business of the woman while the man’s responsibility is to concentrate on how to make money to feed the family and to provide for other needs.
Table 24 Distribution of respondents on the way their spouses support them in FP
| In what ways does your partner support you in FP? | Frequency | Percentages |
| Planning number of offspring | 65 | 29.42 |
| Approving contraceptive use | 26 | 11.77 |
| Taking care of newborn | 104 | 47.05 |
| Seeking skill healthcare | 24 | 10.86 |
| Others | 2 | 0.9 |
| TOTAL | 221 | 100 |
A follow-up question was asked of respondents who said their partners support them in family planning to find out specifically what support they get from their partners. The responses gotten were: 29.42% said their spouses support them in planning the number of children to have, 11.77% said their partners support them by approving of contraceptive use and using themselves, a majority of them (47.05%) said their spouses support them by taking good care of their newborn and also being responsible, 10.86% supported their partners through helping to seek skilled healthcare in case of sickness, 0.9%, however, supported their partners in other ways, like providing financial support to their partners to practice family planning.
Again, findings from the FOCUS GROUP DISCUSSION (FGD) were not different from the above. The following were some of the responses; a few participants mentioned that their partners took care of the young ones anytime they are busy, their partners also find out what discussions they had with care providers on issues bordering on FP on their return from the clinic. The rest said their partners do not care about anything that has to do with FP matters, their spouses believed it is the responsibility of the woman to seek and protect herself through FP, the role of the man being working hard to take care of the family.
Table 25. Distribution of respondents as to whether they discuss the number of children they would like to have with spouses
| Do you discuss Number of children to have with your spouses? | Frequency | Percentages |
| Yes | 49 | 22.17 |
| No | 172 | 77.83 |
| TOTAL | 221 | 100 |
A question was asked to find out how many of them discussed with their partners the number of children they would like to have; 77.83% of respondents said they do not discuss with their spouses the number of children to have in the future, 22.17% said they do discuss with their partners the number of children to have.
Table 26. Distribution of what prevented respondents from discussing the number of children with their spouses
| What prevents discussing number of children? | Frequency | Percentages |
| Prerogative of men | 173 | 78.28 |
| God provides | 40 | 18.09 |
| Women must bring forth all children in their stomach | 6 | 2.73 |
| Who knows the child that will save you | 2 | 0.9 |
| TOTAL | 221 | 100 |
In finding out what factors made them not discuss with their partners the number of children they would want to have in the future, the responses were: 78.28% believed having children is the sole prerogative of the man and therefore do not see any need to discuss with her partner, 18.09% said they do not see the need to discuss with partners because they believe it is GOD Who gives children and therefore any number given to them by God is okay with them, 2.73% also said the woman is expected to bring forth all the children she had in her stomach and therefore there is no need to discuss with the spouse the number of children, 0.9% said who knows the child that can safe them, because nobody can predict tomorrow, the fear of unseen is being considered.
Table 27. Distribution on whether family planning should be the sole responsibility of women
| Sole decision-making by women | Frequency | Percentages |
| Yes | 154 | 69.68 |
| No | 67 | 30.32 |
| TOTAL | 221 | 100 |
A total of 69.68% believed using contraception should be the sole decision of females, while 30.32% believed it should be a shared responsibility between males and females. Also, findings from the focus group discussion came out with the following responses:
Views on whether males should be involved in FP: According to them, male involvement is necessary because men are the breadwinners of many homes, there is a need for their involvement so as to support their partners financially in terms of giving women money to go for FP methods or counseling services. Again, through discussing family planning issues with their partners, women would be in the position to choose the best method that suits them, hence, women who hitherto would have hidden to practice FP, would instead feel comfortable consulting their husbands in matters relating to FP methods, hence, leading to its effective and appropriate use. Others also think that involving men in FP would help improve FP coverage since men are the decision-makers in most families. This influence could be used to impress upon their partners to adopt FP methods. Yet, others do not agree with men’s involvement in FP issues, they contended that it is a woman’s business.
The majority of the participants in this group asserted that given men’s role in our traditional homes as the head of the family and the fact that, he is the decision maker of the family, it would not be out of place to involve them in matters bordering FP issues.
Table 28. Distribution on cost of contraceptive
| Cost of contraceptive (Naira) | Frequency | Percentage |
| 100-10,000 | 128 | 57.9 |
| 11,000-20,000 | 73 | 33.05 |
| 21,000-30,000 | 20 | 9.05 |
| 31,000-40,000 | – | – |
| 41,000 and above | – | – |
| TOTAL | 221 | 100 |
Respondents were interviewed to find out how much money they spend in acquiring family planning methods; 57.9% said it cost them about 100-10,000 of Nigerian currency to acquire a contraceptive, 33.05% said they spend about 11,000-20,000 nairas, 9.05% responded that they spend about 21,000-30,000 nairas to buy a contraceptive.
Table 29. Distribution of how respondents describe cost of contraceptive
| How would you describe cost of contraceptives? | Frequency | Percentages |
| Expensive | 19 | 8.60 |
| Moderate | 136 | 61.53 |
| Less expensive | 66 | 29.87 |
| TOTAL | 221 | 100 |
In finding out how contraceptive cost would have an effect on usage, 8.60% described the cost of contraception as expensive, 61.53% said the cost is moderate, and 29.87% said it is less expensive.
Table 30. Distribution of respondents on the benefit of family planning
| Benefit of family planning | Frequency | Percentages |
| Yes | 186 | 84.16 |
| No | 35 | 15.84 |
| TOTAL | 221 | 100 |
Respondents were interviewed to determine from them whether family planning has any benefit to them at all; 84.16% responded that they benefit from family planning, and 15.84% said they do not benefit from family planning.
Table 31. Distribution of benefits respondents stand to gain from family planning
| Benefit to gain from family planning | Frequency | Percentages |
| Women and children enjoy improved health | 46 | 20.8 |
| Experience fewer unplanned pregnancies | 112 | 50.69 |
| Women attain more education and employment | 54 | 24.43 |
| Enhances socio-economic status | 9 | 4.08 |
| TOTAL | 221 | 100 |
To explore their knowledge in family planning, questions were asked on the benefits one stands to gain when practicing FP, the responses were: 20.8% said practicing family planning would enable women and children to enjoy improved health, 50.69% said, practicing FP would enable them to experience fewer unplanned pregnancies and birth and also lower the rate of abortion, 24.43% said planning one family would help women control their fertility, hence being in the position to attain higher education and employment, 4.08% also said family planning would enhance both socio-economic status and improve the well-being of their families.
Table 32. Distribution of views on what motivate one to practice FP
| Strategies to motivate family planning practice | Frequency | Percentages |
| When couples are free to communicate issues on FP | 62 | 28.05 |
| When FP devices are accessible and affordable | 97 | 43.90 |
| When couples are assured of their children’s survival | 18 | 8.14 |
| When couples have knowledge of FP | 44 | 19.91 |
| TOTAL | 221 | 100 |
When respondents were asked their opinion on what strategies will encourage them to practice family planning: 28.05% said they would be motivated to use family planning if they were free to communicate with their spouses, 43.90% said when family planning devices are accessible and affordable, 8.14% also said, when couples are assured of the survival of their children, lastly, 19.91% said they would be encouraged to practice FP if they had adequate knowledge in family planning.
Table 33. Distribution of respondents who are aware of finger ring traditional method of family planning
| Are you aware of the finger ring traditional method of FP? | Frequency | Percentages |
| Yes | 98 | 44.34 |
| No | 123 | 55.66 |
| TOTAL | 221 | 100 |
From Table 33 above, it is observed that knowledge about the traditional method of contraception such as finger ring was known to some, 44.34% are aware of this method, and 55.66% had never heard of this method.
Table 34 Distribution of respondents on source of information on the finger ring method of FP
| How do you know about the finger ring method | Frequency | Percentages |
| Relatives/friends | 89 | 40.27 |
| Clinic | 12 | 5.42 |
| Traditional healer/herbalist | 16 | 7.23 |
| Social media | 45 | 20.36 |
| Never heard | 59 | 26.69 |
| TOTAL | 221 | 100 |
When respondents were asked to find out how they know about the traditional finger ring method of family planning, the majority 40.27% said they knew about it through their relatives and friends that are using the method, 5.42% said they were aware through a naturopath doctor when visiting the clinic, 7.23% said it was made known to them by herbalists, 20.39% said they heard about it on social media in different group, 26.69 never heard.
Table 35. Distribution of respondents who have ever used finger ring method of FP
| Ever used finger ring method? | Frequency | Percentages |
| Yes | 36 | 16.29 |
| No | 185 | 83.71 |
| TOTAL | 221 | 100 |
A total of 83.71% representing the majority indicated they had never used any traditional method of family planning, 16.29% responded they had ever used finger ring method of FP. The reasons given by those that had never used the finger ring method were not different from those given by those who do not approve FP.
Table 36. Distribution of respondents who are currently using finger ring method of FP
| Current use of finger ring method of FP | Frequency | Percentage |
| Yes | 15 | 6.8 |
| No | 206 | 93.2 |
| TOTAL | 221 | 100 |
When respondents were asked to find out if they are currently using finger ring method of FP, 6.8% said they are using it, and 93.2% said they were currently not using finger ring method of family planning because of non-approval of FP and inadequate knowledge.
Table 37. Distribution of respondents who would like to try the finger ring method of FP
| Would you like to try the finger ring method of FP? | Frequency | Percentages |
| Yes | 63 | 28.50 |
| No | 158 | 71.50 |
| TOTAL | 221 | 100 |
A total of 28.50% showed interest in trying the finger ring method of FP, and 71.50% showed no interest because of their non-approval of FP.
Before the production of the contraceptive finger ring, I did several meetings with some herbalists and other traditional healers who have knowledge of the traditional methods of FP. Most of them know different methods of family planning, some have knowledge of the ring method with different ways of producing it, and some know other methods like herbs in the form of medicine. The users of the ring these practitioners produced claimed it works for them but neither the practitioners nor the users know the mechanism of its action (how it works).
My research on those herbs showed they have properties that are good for contraception, e.gboeravinonesg&h: they are two retenoids isolated from boerhaviadiffusa which are anti-estrogenic, and others with anti-progesterone properties. After my research on every method, I prepared the metal ring with a combination of those herbs through conduction, convection, and radiation. In Physics, “energy is the quantitative property that must be transferred to an object in order to perform work; energy can be converted in forms, not created or destroyed.”
In order to understand the mechanism of the action of the contraceptive finger ring, after my production:
Before the usage of the ring, a hormonal profile test was carried out on an adult female of reproductive age (22-38 yrs), the progesterone was 10ng/ml which fell under the normal range reference value of the laboratory result: 4.0-25ng/ml. Furthermore, while the ring was in use by the same person, the level of progesterone drastically dropped to 2.9ng/ml which is below the normal range of reference value 4.0-25ng/ml. The hormonal profile test was carried out on 25 different females of reproductive age to check their hormonal level before the usage of the ring, they all have a normal range of progesterone, it fell between the normal reference value, but while the ring was in use, their progesterone drastically dropped below the normal reference value of the laboratory result.
Also, to know if there is any adverse effect on the hormones of the users, after the usage of the ring, another test was conducted, the progesterone level improved, showing it is producing gradually without any adverse effect.
It proved the ring works by stimulating the adrenal gland and ovaries to lower the level of progesterone production, if the levels of progesterone are low, the woman will not be able to become pregnant or sustain pregnancy.
The ring was introduced to the focus group with the details of its action and usage.
4.30. Table 38. Distribution of respondents on feedback if given the ring for FP
| Would you give feedback if you were given the ring for FP? | Frequency | Percentages |
| Yes | 63 | 28.50 |
| No | 158 | 71.50 |
| TOTAL | 221 | 100 |
When respondents were asked to find out if they would be able to give feedback after some months of using the ring for family planning, 28.50% that showed interest in trying the ring for FP said they were ready to follow the study, 71.50% said No because of non-approval of FP.
Table 39. Distribution of respondents on proper usage of the finger ring method of FP
| Would you be able to use the ring as directed? | Frequency | Percentages |
| I will | 63 | 39.38 |
| I may not | 158 | 60.62 |
| Don’t care | – | – |
| TOTAL | 221 | 100 |
From Table 39, all 39.38% that showed interest in using the finger ring method of family planning also said they would follow the instruction on how to use it, and 60.62% said they may not because they didn’t approve of family planning.
Table 40. Distribution of respondents on contact information if selected
| Would you be able to give your contact for feedback if you were given the ring for FP? | Frequency | Percentages |
| Yes | 63 | 39.38 |
| No | 158 | 60.62 |
| TOTAL | 221 | 100 |
When respondents were asked if they would give their contact information for feedback if the ring were given to them for family planning, the same 39.38% said they were ready to follow the study as long as it may take if it doesn’t cause any adverse effect on them, 60.62% said NO because of non-approval of family planning.
Table 41. Distribution of selected respondents on feedback of the Contraceptive finger ring given to them for preventing pregnancy.
| Are you still using the ring given to you for FP? | Frequency | Percentage |
| Yes | 38 | 90.48 |
| No | 4 | 9.52 |
| TOTAL | 42 | 100 |
Out of the total number of 63 (39.38%) respondents that showed interest in the finger ring method of family planning, 42 of them were selected due to the number of available contraceptive finger rings at the time of the study. Of the 42 selected, 38 (90.48%) which is the majority said they had been using the ring since it was given to them and were still using it, 4 respondents (9.52%) said they had stopped using the ring because they are ready to have babies, and will continue using it after giving birth.
Table 42. Distribution of respondents on the side effect of the contraceptive finger ring given to them for FP
| Do you experience any side effects while using the ring? | Frequency | Percentages |
| Irregular bleeding/ No menses | – | |
| Headache/Nausea | – | |
| Breast discharge | – | |
| All of the above | – | |
| None of the above | 42 | 100 |
| Others | – | |
| TOTAL | 42 | 100 |
To know the adverse effect the ring might caused on the users, questions were asked on the side effect the respondents experienced, surprisingly none of them reported any adverse effect. When probing further, two respondents said it regulates their irregular menses since they had been using the ring, all 42 (100%) respondents said they didn’t experience any side effect with the ring.
Table 43. Distribution of respondents on period of using the finger ring for FP
| How long have you been using the ring? | Frequency | Percentages |
| 1-6 months | 16 | 38.10 |
| 7-12 months | 9 | 21.43 |
| 13-18 months | 3 | 7.14 |
| 19-24 months | 6 | 14.29 |
| 25 months and above | 8 | 19.04 |
| TOTAL | 42 | 100 |
To find out the effectiveness of the ring before the proper study, I carried out a smaller study earlier with a small group, to test the instrument. Some of that smaller study group also took part in this study, hence, some of them are in the category of 19.04% that said 25 months above, 14.29% that said 19-24 months and 7.14% said 13-18 months, also 21.43% of the respondents said 7-12 months, 38.10% said 1-6 months.
Table 44. Distribution of respondents on how long it takes to conceive when they desire pregnancy without the usage of the contraceptive finger ring given to them
| Are you able to conceive when you stopped using the finger ring for FP? | Frequency | Percentages |
| 1-3 months | 3 | 7.14 |
| 4-6 months | 1 | 2.38 |
| 7-9 months | ||
| 10-12 months | ||
| 11 months above | ||
| Others | 38 | 90.48 |
| TOTAL | 42 | 100 |
When respondents were asked to find out how long it takes to conceive when they are ready to have a baby without the usage of the ring, 7.14% said 1-3 months, 2.38% representing one person said 4-6 months, and the majority (90.48%). Others said they wouldn’t know because they are not ready to have more babies, while some said it is not yet time for them to conceive, that they will know when they are ready for the pregnancy.
Table 45: Distribution of respondents on recommending the contraceptive finger ring method of FP to others.
| Would you like to recommend this method to others | Frequency | Percentages |
| Yes | 42 | 100 |
| No | ||
| TOTAL | 42 | 100 |
When respondents were asked to find out if they could recommend the finger ring method of family planning to others, All of them (100%) said yes, they can, but none of them claimed otherwise.
Table 46. Distribution of respondents on the effectiveness of the ring given to them for FP
| How would you grade the effectiveness of the Contraceptive finger ring given to you | Frequency | Percentages |
| Excellent | 28 | 66.67 |
| Very good | 12 | 28.57 |
| Good | 2 | 4.76 |
| Poor | ||
| Very poor | ||
| TOTAL | 42 | 100 |
In finding out the opinion of respondents on the effectiveness of the contraceptive finger ring given to them, 66.67% grade effectiveness as excellent, 28.57% said very good, and 4.76% said it is good.
Table 47. Distribution of respondents on reliability of finger ring method of FP
| Is this method reliable? | Frequency | Percentages |
| Yes | 42 | 100 |
| No | – | – |
| TOTAL | 42 | 100 |
When respondents were asked to find out if they could rely on the finger ring method of family planning, the whole respondents (100%) said yes because they had experienced the effectiveness of the method. None of them said NO because it doesn’t cause them any adverse effects, none experienced unplanned pregnancies.
Table 48: Distribution of respondents on whether their spouses get closer to them often without fear of unwanted pregnancy when using FP
| Does your partner take advantage of the FP to get closer to you often without any fear of unwanted pregnancy? | Frequency | Percentages |
| Yes | 26 | 61.90 |
| No | 16 | 38.10 |
| TOTAL | 42 | 100 |
Finally, respondents were asked to find out if their partners take advantage of FP usage to get closer to them often without any fear of unwanted pregnancy, the majority 61.90% said yes, it improves their partners’ feelings towards them, 38.10% said NO, their partners were not always around.
DISCUSSION
The majority of the women were above 25 years, however, some of them could not read and write in any language. At a relatively older age, the women might have had a high exposure to family planning issues that could be social, cultural, or religious yet their inability to read or write in any language could affect the extent to which they can synthesize issues affecting their health including that related to family planning, the above findings agreed with reviewed literature by (Takyi B.K 2000). The level of exposure to sexual relations poses a challenge to many women. Legitimizing sexual relations in the form of marriage gives most women pride and respect in society yet this desirable state is hardly achieved by some of them. Most of the women in this study were in active sexual relationships but only 52.03% were married.
The implication is that for most of the women who were unmarried, they may have desirable tendencies of preventing pregnancies, the non-use of family planning methods among this group and even among those married, results in self-induced abortions with resultant complications including anemia, infertility, and also death. The socio-cultural context of family planning use could be weakened by mixed cultural settings where there is likely to be little dominance of a cultural stand on family planning use by a tribe over others. The possible integration of sociocultural ideas could influence the acceptance or rejection of contraceptives.
In this study, even though Yorubas formed the majority group, there was relatively enough representation of other tribes including Igbos, Hausa/Fulani, Ijaw, and foreigners. This might have created intertribal marriages and therefore integration of cultural ideas on the use of family planning methods.
One of the objectives of this study was to examine the level of knowledge, approval, and practice of FP in Odoguyan in Ikorodu North, Lagos, Nigeria. The research revealed that an appreciable number of the respondents (80.62%) interviewed had ever heard of at least one FP method or the other. In investigating their level of knowledge in FP, an overwhelming number (89.14%) indicated correctly that family planning gives couples the opportunity to plan the number and spacing of their children. To further explore their knowledge base, respondents were asked the benefits they could get from family planning and the findings were: 20.8% said practicing family planning would help women and children enjoy improved health, 50.69% said practicing family planning would enable them to experience fewer unplanned pregnancies and births and also lower the rate of abortion, 24.43% said planning family would help women control their fertility, hence, being in the position to attain higher education and employment, 4.08% also said family planning would enhance both their socio-economic status and improve well-being of their families.
However, on FP approval, 52.48% indicated their approval of FP methods, while a moderate proportion (47.51%) said they disapprove of any FP methods. Reasons they gave for their disapproval stem mainly from socio-cultural, perceptions of side effects and religion. Culturally, the belief of some people in this community is that the more children one has the more the respect they command among their peers, hence, would not want to do anything to stop their spouses from having more children.
On the issue of religion, they all indicated that once it is spelled out clearly in the Holy books to bring forth and fill the world, they do not see any reason why they should approve of any FP whose ultimate aim is to cut down the number of birth. The above findings agreed with reviewed literature by (Odu O.O, Ijaduade K.T, et. al.(2006) who also contended that the major reasons for non-approval of FP by men were the fear of side effects and perception of FP as being against religion. The practice of FP has for some time now been a subject of concern among FP activists all over the world. This concern has brought about a paradigm shift in men and women in FP programs. The argument advanced for the inclusion of males in FP programs was the fact that men would encourage and support their partners in contraception. However, it is evidenced from the research findings that Odoguyan in Ikorodu North where this study was undertaken, needs much to be done on issues relating to the use of family planning if they are to move along with the rest of the world in trying to get many people taking active role in FP programs. This is because the findings from the community reveal that FP practice is not encouraging since a large proportion (61.08%) of respondents interviewed asserted that, currently they were not using any family planning method to either delay or avoid pregnancy, with only 38.92% agreeing to practicing FP.
Also, when asked whether respondents had ever used an FP method, 47.51% indicated they have ever used a FP method. however, a moderate proportion of 52.48% said they had never used any FP method. A further probe into the low and relatively low in FP practice among current users and ever used FP respectively revealed that 22.61% said they do not enjoy normal sex anytime they use an FP method. This assertion was once again reiterated in a focus group discussion conducted in Rofo estate, Odoguyan, where a female participant said “Using the condom as an FP method, to her partner is as if putting a toffee together with the wrapper into your mouth” for this reason, her partner would rather not have sex than to use any FP method.
Other reasons given were being afraid of side effects (11.31%), and religious beliefs (24%).
In an assessment of gender issues relating to contraceptive use, it was observed that educated and sexually active youth had a widespread knowledge of contraceptives. Obviously, such wide knowledge does not necessarily mean that such persons have adequate exposure to the use of contraceptives because other decision-making influences could determine its use or otherwise. Even though Pills (42.08%), Condoms (24%), Depo-provera (11.31%), IUCD (3.62%), Traditional method (9.04%), Withdrawal/rhythms (8.15%), Others identified lactational amenorrhea (1.80%).
However, the information gathered from respondents on low FP practice apart from those mentioned above, was the fact that most of them also complained that they would have used FP methods if they had other alternatives apart from the injection, IUCD, and Pills because they said they had experienced serious adverse effects such as infertility, weight gain/loss, irregular bleeding while using those mentioned, some of them had heard about female condom but have never seen it or known how to use it. They suggested among others that robust research should be conducted into coming out with a safer method of FP without side effects.
Another objective of this study was to look into certain factors that militate against the use of family planning in Odogunyan, Ikorodu North. To be in a better position to assess this objective, the following variables were considered. These were reasons given for not using the FP method, reasons for not attending FP clinics, and finally, what prevent them from discussing the number of children to have in the future.
Firstly, (22.61%) of the sample do not use FP, because they perceive it interrupts sexual satisfaction, 11.31% also had the perception that FP practice leads to side effects and therefore are not always comfortable using any FP methods. However, 24% do not use FP methods because of their religious affiliations and beliefs.
Secondly, 56.10% of women do not attend any FP clinic because they believe that too much time is spent at the facility trying to get any FP counseling from FP practitioners. 26.27% do not attend FP clinics because they believe that there is no confidentiality at the facilities, and that, almost all gathered are most likely to hear what you would have wished was discussed in private. 5% cited inaccessibility as a reason for not attending any FP clinic. They indicated that the facilities were far away from their residency. Lastly, 8.14% do not attend FP clinics due to the attitudes of some health professionals. They claim some of the nurses exhibit certain negative behaviors which sometimes put them completely away from the facility. On what prevents them from discussing the number of children they intend to have in the future, the majority (78.28%) mentioned that they believed having children is the prerogative of the man and therefore need not seek the opinion of her spouses, 18.09% also believed children are a gift from God, hence their reason for not discussing amongst themselves. Lastly, 2.73% believe a woman must have all the children from her womb: therefore, there is no need in discussing the number of children to have with spouses.
Previous studies have shown that the use of multiple channels of communication yields positive results, for male involvement in family planning (Kim et al. 1992) A study of male involvement in contraception, Ghana, Zambia Institute. Radio has been noted to be especially effective because almost all the respondents had at least a radio.
Also, Community Health Nurses and village Health Volunteers should begin to address FP and health messages to men and women. While at the same time, assuring them of the benefits they will enjoy from practicing family planning.
In addition, field- workers including Community Health Officers, Public Health nurses, and Village Health volunteers should approach men and women to explain and answer questions about health and family planning services. Occasionally, family planning sessions should be organized for the couples and encourage open discussion of family planning among couples’ group. There is a need to implement community-based strategies using different approaches, and interventions of stakeholders to increase knowledge, acceptance, and use of family planning on a grand scale at the national level.
Why is there no strong commitment to family planning and reproductive health issues in Nigeria in light of the magnitude of research information? The overall reason is a lack of political prioritization and commitment to safe motherhood issues. Political priority and commitment in political science is the process of ensuring that political leaders consider an issue to be worthy of sustained attention, and support that attention with the provision of financial, human, and technical resources commensurate with the severity of the problem. This goes in line with the literature reviewed by (Shiffman J, Okonofua FE. 2007) the state of political priority for safe motherhood in Nigeria.
If the same level of political will and commitment that was given by the Nigerian federal government to changing the national capital from Lagos to Abuja is equally extended to family planning, there will be a significant reduction in unplanned pregnancies and the catastrophically high maternal death rate. Therefore, safe motherhood program activities and research have to focus not only on the socio-cultural, medical, and technical dimensions alone but also on the political dimensions to bring about changes in maternal and child health indicators in Nigeria.
CONCLUSION
The level of knowledge of contraceptives among the women in the community cuts across all ages, marital status, and occupational backgrounds. 80.62% of the respondents had heard about family planning services while 19.38% indicated that they had never heard about FP services. This means most of the people have heard of the FP, but the knowledge does not commensurate with the use of contraceptives. Also, according to the findings of the research, male support in FP practice is discouraging with an overwhelming average proportion of (86.25%) not doing anything to support their partners in FP practices. This has led to some women secretly going to the maternal and child health clinic to meet the public health Nurses without the approval of their husbands. This most often than not generates a lot of tension in the marriage and sometimes leads to divorce when the husbands later discover their spouses hide to do it.
However, as found from the research, the knowledge of respondents in the community is moderate with a proportion of (47.51%) for non-approval of FP, with (52.48%) approving of family planning in Odoguyan Ikorodu North, Lagos, Nigeria. Again, as observed from the findings, a high proportion (61.08%) is not currently practicing FP as compared to only (38.92%) practicing FP in the community.
Yet, from the research findings, women’s attitudes, beliefs, and perceptions about FP in this community is not encouraging, many of them (47.51%) have the perception that FP especially condom interrupt their sexual enjoyment, also quite a number also mentioned religious and cultural beliefs as reasons for non-approval or non-use of FP methods, some also mentioned negative attitude of some health professionals as reasons for non-attendance of FP clinic, many of them also said too much time being spent on the facility, hence, it disturbed their daily activities as reasons for not practicing FP, the other reasons given are fear of infertility effect, fear of side effects, wanting a child, it was also found that the decision to use FP is largely influenced by closed relatives.
Generally, as can be seen from the above, it is evidenced that contraceptives use has not been encouraging in the community, hence, the need for family planning programmers within the Local Government to come up with a special package for FP, targeting specifically couples seminars, this time bringing on board community leaders like chiefs, elders, assemblymen and women, and lineage heads, whose views are normally known to be respected in our various traditional settings. Also, religious leaders should be enlightened and involved in planning mass media education programs. These measures when meticulously carried out would, to some extent, help attain some appreciable level of success in increasing the level of contraceptive use in the community.
RECOMMENDATION
The District Health Management Team (DHMT) should provide resources and motivate Public Health Nurses, Nurses, Midwives, Community Health Officers, and Village Health Volunteers to effectively mobilize the chiefs, elders, and lineage heads to participate and cooperate in family planning programs. When the concept is accepted by community leaders, it would be easier for other men and women to accept and practice without any hindrances. Also, outreach programs directed towards couples should be encouraged through the provision of education, communication, and family planning services. Efforts must also be made to explain to the people the benefits as well as possible side effects of the method one may wish to use. This will enable the people to make an informed decision in relation to the use of FP. This is necessary because the present situation shows that most people have heard of FP methods but they are not using them.
- Family planning should form part of the curriculum of social studies at the basic level. This would make it possible for the children to be introduced to FP at the early stages of their lives.
- Family planning centers should be established in the communities and managed by trained personnel to address geographical accessibility to contraceptive use.
- A study into the sociocultural effects on family planning usage is necessary to unearth the specific socio-cultural factors that are militating against the use of family planning.
- The District Health Management Team (DHMT) can make adequate use of religious bodies to teach women and their husbands about the need to use contraceptives.
- I also recommend further research in the area of traditional methods of family planning. There are lots of effective and safer traditional methods yet to prove, as this study was able to prove the significance of traditional contraceptive finger ring. This is because some people are more comfortable and confident in the use of traditional methods such as herbs without/less side effects than foreign ones with the fear of side effects. Most research findings suggest that increasing coverage for family planning services does not necessarily result in usage and that a missing ingredient is required to achieve that, yet it is not known.
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BRIEF PROFILE
Dr. Nurudeen Olabode Ajibade
Dr. Nurudeen Olabode Ajibade is a Public Health Consultant and Naturopathic Physician at A.N.S Integrative Medicine Clinic Limited, a multi-specialty healthcare and Research Institute, Ikorodu, Lagos State, Nigeria. He holds a Bachelor of Science degree (Bsc.) in Public Health and Complementary Medicine from ICT University, Messassi, Yaounde, Cameroon, with a Greek Award as the best-graduating student in Research project; Higher Diploma in Natural and Complementary Medicine from ICT University of America, Cameroon, with another Greek Award as overall best-graduating student; Diploma in Acupuncture from Katsu International University, Sri-Lanka; Master Diploma in Acupuncture therapy, India and a graduate of India Institute of Neuroscience.
Dr. Nurudeen Olabode Ajibade has undergone several Professional Certificate Programmes in different areas of Naturopathic Medicine and Public health namely: Public health Epidemiology through Harvard University and ICT University and won the best participant award. He is a specialist in different acupuncture techniques such as Auricular, Sujock, Scalp, Tung’s, Tan balance, Fascial, General acupuncture, Colour therapy, and Cupping among others, as well as an expert in Herbal medicine. He has undergone a clinical Internship program at Harvey Road General Hospital, Yaba, Lagos, Nigeria and he has participated in and received numerous Health program awards, namely:
An African Exemplary Leadership Award as the best scientific Health worker of the Year (2022), Research Director of the Association of Integrative Medicine Practitioners, Lagos, Nigeria; Fellow member of the Indian Institute of Neuroscience; Member of the Association of Commonwealth Practitioners of Natural/Herbal medicine; Member of Lagos state Traditional medicine board; Director of Medical team of A.N.S. Natural Healthcare Limited, all that on his mission to save humanity, toured round several states in Nigeria on quick health restoration programs, as Chief physician of the Medical team of A.N.S and restored several chronic cases within a short period using Acupuncture Therapy.
Dr. Nurudeen Olabode Ajibade is a senior lecturer at Green Center Academy For Natural Medicine Practitioners, Lagos, Nigeria. A Director and senior lecturer at A.N.S training institute, Lagos, Nigeria. He is also, a visiting lecturer at Dieu Mon Rapha College, Port Harcourt, Nigeria. He holds a doctor of philosophy degree, Ph.D (Honoris Causa) in Public Health and Naturopathic Medicine from African American University, Porto-Novo, Republic of Benin.
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For research in Science
ISSN 2659-0484
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Vol. 10 No 6
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