ABSTRACT
This
study was undertaken to examine the choice of family planning among women
attending primary health care centres in Esan West local government area. The study was limited to Esan West Local
Government Area of Edo state. Questionnaires were designed to elicit
information which served as the basis for assessment of the various research
questions of the study. The population of the study comprised of women
attending antenatal care in Esan West Local Government Area of Edo State. The sample for the study was
145 subjects (or respondents). The simple random sampling technique was used to
select the sample for the study. Research results were analyzed using tables,
frequency counts, percentages and mean score. The study found that: Level of
education was seen as one of the social-cultural factors, influencing the
choice of family planning. The custom of the people is also another factor
affecting their use of family planning, Religion is also seen as one of the
strongest factor affecting the use of family planning, prohibits the use of
modern contraceptive methods. The social class of the individuals or couples was
also found to be another factor affecting the both the use and the type of
family planning favored by a couple. In the quest to promoting health among
women and in the selection of best strategies/practices the researcher makes
the following recommendations: There should be constant periodic health
campaigns in communities and not once in a decade. There should be a tight
supervision of the effectiveness of antenatal care centre sib their operation. There
should be formulation and proper implementation of good health policies and a
constant evaluation of same. Government should create a platform were the poor
gets equal or easier access to health care compares to the rich; this will
cater for the economic constraints associated with adopting health strategies. Cultural
biases against health care should be discouraged or even prohibited by the
government.
TABLE OF CONTENT
Title
Page- - - - - - - - - i
Certification-
- - - - - - - iii
Dedication- - - - - - - - - iv
Acknowledgement- - - - - - - v
Abstract- - - - - - - - - viii
CHAPTER ONE:
INTRODUCTION
Background
to the Study- - - - - - 1
Statement
of problem- - - - - - - 7
Purpose
of the Study- - - - - - - 7
Research
Questions- - - - - - - 8
Scope
of the Study- - - - - - - 8
Limitation
of the Study - - - - - - 9
Significance
of the Study - - - - - - 9
Definition
of Terms- - - - - - - - 9
CHAPTER TWO:
REVIEW OF RELATED LITERATURE
Concept of Family Planning- - - - - - - 10
Methods of Family Planning- - - - - - - 12
Benefits of Family Planning- - - - - - - 14
Socio-Cultural Factors Influencing the
Utilization of Family Planning 16
Family Planning and Human Rights- - - - - - 22
Family Planning in Developing Countries- - - - - 24
Family Planning in Developed Countries- - - - - 25
Summary of literature review- - - - - -
CHAPTER THREE:
METHODOLOGY
Research
Design of the study - - - - - - 29
Population
of the study- - - - - - - 29
Sample
and Sampling Technique- - - - - - 30
Research
Instrument- - - - - - - - 30
Validity
- - - - - - - - - 30
Reliability
Method of Data Collection - - - - - 31
Method
of Data analysis - - - - - - - 31
CHAPTER FOUR:
DATA ANALYSIS AND DISCUSSION OF FINDINGS
Discussion
of Findings - - - - - - 32
CHAPTER
FIVE: SUMMARY, CONCLUSION AND
RECOMMENDATIONS
Summary - - - - - - - - 39
Conclusion- - - - - - - - - 40
Recommendations
- - - - - - - - 40
REFERENCES- - - - - - - - 41
Appendix- - - - - - - - - 43
CHAPTER
ONE
INTRODUCTION
1.1
Background to the Study
Family planning is the
“intentional prevention of conception through the use of various devices,
sexual practices, chemicals, drugs, or surgical procedures” (en.wikipedia.com,
2021). The concept of family planning is used interchangeably with
contraceptives. There are many different types of family planning methods which
have so far been developed for the purpose of preventing conception. The
current methods in existence have been categorized in to five groups.
1. We
have “hormonal methods” which are currently being regarded as the most common
methods of birth control (Sai, 2013). Hormonal methods which appear in the form
of Birth control pill, Depo-provera, Lunelle, Vaginal ring all contain
manufactured forms of the hormones oestrogen and Progesterone. All the
different types containing the mentioned hormones work in three ways;
i.
Firstly by preventing woman’s ovaries
from releasing an egg each month;
ii.
Secondly by causing the cervical mucus
to thicken making it hard for sperm to reach and penetrate the egg.
iii.
Lastly by thinning the lining of the
uterus which reduces the likelihood that a fertilized egg will implant in the
uterine wall (Williamson, Parkes, Wight, Petticre, and Hart, 2009).
2. The
second category of birth control methods is “barrier methods”. These family
planning methods work by physically preventing sperm from entering the female
reproductive system. These devices include Male condom, Female condom,
Spermicides, Diaphragm, Cervical cap and Contraceptive sponge.
3. The
third category of birth control method is “withdrawal” and “sterilization”.
Withdrawal involves the removal of the erect penis from the vagina prior to
ejaculation; on the other hand, sterilization involves the surgical closing,
tying or blocking of the fallopian tube so eggs cannot travel through the
uterus. There also exists male sterilization which is the surgical closing of
tubes that carry sperm from the testicles to the penis.
4. The
forth category of birth control methods is abstinence. As a means of
conception, abstinence is the voluntary refraining from sexual intercourse.
This method is regarded as the only family planning method that is 100%
effective in the prevention of both pregnancy and sexually transmitted
diseases.
5. The
last category of birth control methods is the fertility awareness method which
is often called “natural family planning”. Apart from abstinence and withdrawal
method, this is the third method that does not rely on devices or medication to
prevent pregnancy. The natural family planning method uses the natural
functions of the female body and menstrual cycle to calculate ovulation. It
requires abstinence from sexual intercourse during the ovulation period. (Williamson,
Parkes. Wight, Petticre and Hart , 2009).
According to Gribble
and Haffey, (2008) Demographers regard withdrawal and abstinence as traditional
methods while the other methods are regarded as modern methods of
contraception. The vast majority of the African countries and national
governments encourage citizens to make use of available family planning methods
to promote small family sizes and prevent unwanted pregnancies. All these come
as an overall initiative to slow population growth and avoid some of the
consequences of population growth. A
combination of good access to family planning services and increased family
planning use has led to a decline in fertility rates in many developed and
developing countries. Access to quality, voluntary family planning services and
increasingly higher levels of family planning awareness are credited for
supporting declines in family sizes. For fertility to fall to low levels, many
factors are key, this include a significant increase in the use of family planning.
Sufficient evidence exist to show that the high fertility in Africa as a
continent is not because women in Africa want to have more children than women
in other regions; the skewed rates reflects the prevalence of family planning
use as well as challenges in accessing family planning services in this
particular region. Clearly most people in developed countries want and are
having smaller families than in the past. This development has been greatly
helped by the wider availability of quality, safe and affordable family
planning services in some regions. However the opposite is observed in some
other regions such as Africa; many people are still having more children than
they want (Gribble, Haffey and James 2011).
The WHO, (2008)
estimates indicated that sub-Saharan Africa had about 14 million unintended
pregnancies, with almost half occurring among women aged 15-25 years. Today,
there are 24.8 percent of women who want to use family planning but lack access
leaving them with no other options but to continue having unwanted pregnancies.
According to the Millennium Development Goals report, one in four women who
wish to delay or stop child bearing is not using any family planning method.
Achieving the desired population growth rates will require expanded access to
family planning especially in the poorer countries. People regardless of their
age must have access to a wide range of family planning methods at all stages
of their reproductive lives (WHO, 2000). The impact access to family planning
has on the rate of fertility in Nigeria is of vital importance. It therefore
requires urgent attention from national governments. Family planning has been a common problem
with the developing countries in the world. Due to lack of family planning the
population of the developing countries, using Nigeria as a typical example when
unchecked, increases geometrically. The lack of family planning which led to an
increase in Nigeria population is as a result of lack of women education,
poverty etc. It is a common observation to everybody that what we often say is
a blessing could turn to be a curse as in the case of the increasing population
of a country. The only way this can be prevented is through the use of birth
control or family planning and this is one of the major way in which Nigeria
population can be reduced. One question that always comes to mind is that if
fertility is not controlled and it grows beyond its carrying capacity, then
there will be a huge problem in population control, as we all know over
population is a problem to a country especially the developing countries. It is
important to know that whatsoever happens in any society always begin from the
family. However, another question that can really come to mind is this. What is
family planning? Though many authors have defined it in various ways, Family
planning is defined as a process whereby parents or couples have their children
by choice and not by chance by this we mean that couples can control the number
of children they want and when they want them (Online Journal of Community
Health, 2014).
Although more people
use family planning now than ever before, more than half of the couples in the
developing countries use family planning today compared with 10% in the 1960s.
This dramatic increase in family planning use has caused fertility to decline
much more rapidly in the developing countries and if this is achieved it can
lead to the attainment of optimal population which is the best type of
population(Richards, 2012).
The primary care system
in Nigeria came to provide package such as immunization, micro-nutrient
support, family planning counselling, pre-natal and post-natal care, health
education and basic curative care (The family manager 2013). Various
governments have tried to implement policies aimed at reducing the population
growth through family planning programs. A better access to good quality
reproductive health service particularly family planning is the key to
improving health status, especially for women.
In
Africa 18 percent of women use modern contraceptive as a family planning method
and those women begin childbearing in their teens and have an average of six
children or more which has led to a high birth rate. In Nigeria, where family
planning is receiving government support, various agencies have been saddled
with the responsibility of promoting and educating the people concerning its
use. The Planned Parenthood federation is one agency, also family planning
clinics have been set up in hospitals to encourage people to plan their
families, and avoid unwanted pregnancies bearing only the number of children
they can adequately catered for (UNICEF, 2017).
Rosen
and Conly (2014) stated we see the need, through family planning, to prevent
the health risk of frequent child bearing, and also to reduce the high toll of
illness and death associated with pregnancy and child birth and to prevent the
spread of sexually transmitted diseases (STD) including HIV/AIDS. We must
explicitly state that despite various efforts made by the Nigeria government to
discourage high fertility or birth increase through the use of contraceptive,
awareness campaigns, and prolonged breastfeeding by mother’s etc. popular
growth rate is still rising.
The
research would try to ascertain how the social-cultural factors (such as norms,
values, education, religion, social-class, custom) are affecting the use of
family planning in Esan West Local Government Area of Edo State. Family
planning has different meaning to people, to some, it is a method of giving
birth to children by choice and not by chance, to health workers, it is the
spacing of children. It can also be having only as many children as one can
provide for, so that one can give the children proper care, enough food and
opportunities for a happy life. The methods of family planning used are;
Traditional methods (through calendar, rhythm, withdrawal and abstinence) folk
methods (such as pills, condoms, vaginal methods, injection, inter-uterine,
contraceptive devices (IUD), female sterilization, spermicide, impacts diaphragm
etc. family planning and disease such as AIDS (Acquired Immune Deficiency
Syndrome). Family planning services must also include access to long acting
clinical method.
In
Nigeria, the trend of marrying many wives and having many children is still high
despite the reduction in child mortality made possible by improvement in modern
health care system. At the end of the research, we should know the concept of
family planning, and the various choices of family planning practicable in Esan
West Local Government Area of Edo State.
It
was against the background of the projected world population growth especially
in the developing countries and considering the consequences associated with
current patterns of population control measure. In Africa, not all governments
considered rapid population growth to constitute a problem to development.
However, those countries that considered a rapid rise in their population as a
major obstacle to development attempted to reduce the growth rate, countries
such as Ghana, Kenya, Nigeria, Gambia adopted policies and programmes towards
fertility and birth control in the countries.
Donald,
light and Keller (2013), argued that three out of the very four married couples
using contraceptive favored the most effective methods, the pills the IUD and
the sterilization. Sterilization is the most popular method for couples who
have been married for ten years or longer. The increasing use of sterilization
as a form of contraceptive is an indication that couples are more willing to accept
the irreversibility of the decision to terminate childbearing.
Despite
the availability of these contraceptive, population is still increasing people
still feel that having large families is better, especially in the rural areas.
However, educating the people on how to use family planning methods would make
them more susceptible to its use which would invariably check population
increase.
1.2
Statement of Problem
Over a long period of
time the issue of family planning has been neglected because so many believe
that children are blessings from God and children are to be given birth by
chance and not by choice which is the opposite of family planning and this has
an effect on Nigeria’s population. Observably in Esan West communities, nuclear
families are made up of, minimum, Six (6) members. Uncontrolled proliferation
is an immortalized trend. Parents continue to give birth to children even
though they are struggling to feed the ones they already have. Not to mention
clothing and giving them quality education. The researcher is of the opinion
that the factors responsible for this tendency are, most likely than not,
socio-cultural. Hence this research work is carried out to examine the choice of
family planning in Esan West Local Government Area.
1.2
Purpose of the Study
The main purpose of
this study is to examine the choice of family planning among women attending
primary health care centers in Esan West Local Government Area of Edo State.
The objectives of this study are as follows;
Ø To
examine the factors influencing the choice of family planning in Esan West
Local Government Area.
Ø To
examine the factors responsible for the ineffectiveness of family planning in
Esan West Local Government Area.
Ø To
examine the problem facing the development of family planning in Esan West
Local Government Area.
Ø This
research work is also designed to suggest workable solution to the problem of
family planning in Esan West Local Government Area of Edo State.
1.3
Research Question
Ø What
are the factors influencing the choice of family planning among women in Esan
West Local Government Area?
Ø Does
social class influence the use of family planning?
Ø How
does education influence the use of family planning?
Ø Do
societal norms/values influence the use of family planning?
1.5
Significance of the Study
It is expected that this study will
make the following contributions;
·
It
will provide necessary information and create awareness on the extent of
utilization of family planning in Esan West Local Government Area.
·
It
is expected that this study will shed light on the factors responsible for the
lack and inefficient utilization of family planning among families in Esan
West.
·
The
study is also expected to proffer solutions to these factors hindering the
utilization of family planning among families in Esan communities and in Edo
state as a whole.
·
It
brings to the awareness of women the different types of family planning
methods.
1.6
Scope of the Study
This
research work is limited to Esan West Local Government Area of Edo State; it is
to examine the different methods of family planning available in Esan West.
1.7
Limitation of the Study
The researcher expects
to encounter certain problems/challenges in the course of the study such as
failure of respondents to return all administered questionnaires, irregular
completion of questionnaires.
1.8 Definition of Terms
HIV:
Human Immune Deficiency Virus: This is a virus that causes AIDS.
AIDS-
Acquired Immune Deficiency Syndrome: This is a disease caused by HIV which
paralyzes all the immune system in the body.
Birth
rate:
The number of births per number of women between the age of fifteen and
forty-nine.
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