CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Family planning is a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country (Park, 2013).
The availability of family planning does more than enable women and men to limit family size. It safeguards individual health and rights, and improves the quality of life of couples and their children. Family planning is an important strategy in promoting maternal and child health (Umbeli et al., 2013). It improves health through adequate spacing of births and avoiding pregnancy at high risk maternal ages and parities. The most important proximate determinant of fertility is the use of family planning (Rajaretnam, 2016). Where contraceptive use is widespread fertility is low. Rajaretnam has demonstrated that even if there is no reduction in the family size of individual couples, delaying child bearing will bring about a decline in fertility and population growth rate (Rajaretnam, 2016). Lack of adequate information and ignorance are key factors militating against family planning practice in Nigeria (Adinma, 2015).
Many potential informational barriers exist to contraceptive use. Women must be aware of the methods available, must know where supplies of these methods can be obtained and they must know how to use the method they choose (Chandhick et al., 2013). Each year an estimated 500,000 women die of complications due to pregnancy, child bearing or unsafe abortion (Winikoff, 2017).
In some areas of Nigeria, one in five women report having experienced an unwanted conception, of these 58% had an abortion and an additional 9% attempted unsuccessfully to end the pregnancy (Okonofua et al., 2015). It is estimated that about 25% of women who have abortion in Nigeria experience serious complications (Bankole, 2016). Adoption of family planning measures will reduce unwanted pregnancies and criminal abortions to its barest minimum. Pregnancy is the main reason that women in the reproductive age group die at a higher rate than men (Maine et al., 2015). Most maternal deaths occur among poor women who live in remote rural areas and have difficult access to hospital.
Knowledge on contraceptive methods is an important factor for an individual to use and not use the methods, so that the status of knowledge has the paramount importance for policy makers and programmers. NDHS report (2013) showed that knowledge on at least one modern method of family planning in Nepal is universal among both women and men. Knowledge of modern contraceptives among the respondents is universal, with 99% of women being aware of at least one modern method of contraceptive. The respondents and stakeholders showed a positive attitude in their support of family planning programs, and more than half of the respondents knew where to obtain contraceptive methods. Around 56% of the women were practicing family planning at the time the survey was conducted, with their main reasons being fertility desire despite the side effects of some methods, and to maintain their standard of living (NDHS, 2013).
Based on this background the researcher therefore want to evaluate the knowledge and acceptance of family planning methods amongst women of reproductive age in Esan West Community.
1.2 Statement of Problem
The mid-term survey of Nigeria Demographic and Health Survey (2013) showed that the knowledge on any contraceptives methods was universal among women of reproductive age (15-49) years. Specific knowledge on various contraceptives methods have improved over the years. For instance knowledge of contraception has improved significantly from the baseline of 2006 to the mid survey of 2009. Likewise, majority (67%) of women had ever heard of the IUD in 2006, this increased to 75% in 2009. However, nearly half (49%) of women of reproductive age had ever heard of traditional methods in 2006, this has increased to 66% in 2009. The mean number of method known has increased from 7.2 to 7.6 among women of reproductive age (NDHS, 2013).
Several studies have reported positive changes in Nigerians knowledge of and attitude toward family planning. But there are still some blockade factors. The issue of family planning in Nigeria is the study of women, who as child bearers have been the target of organized family planning activities (Kaye et al., 2014). Access to contraception is associated with adequate birth spacing and reduced risk of adverse birth outcomes, including preterm birth and low birthweight (Kaye et al., 2014; Goldthwaite et al., 2015). The choice depends on a complicated mixture of social, cultural and psychological influences (Caldwell and Caldwell, 2014).
The principles of informed choice focuses on the individual; however, it also influences a range of outside factors such as: social, economic and cultural norms, gender roles, social networks, religious and local beliefs. To a large extent, these community norms determine individual childbearing preferences and sexual and reproductive behaviour. It is usually thought that community and culture affect a person’s attitudes towards family planning, desire for sex of children, preferences about family size, family pressures to have children and whether or not family planning accords with customs and religious beliefs (Dixon – Meuller, 2010; Greenwell, 2013).
Based on these information, there is need for the determination of the knowledge and acceptance of family planning method amongst women of reproductive age in Esan West community.
1.3 Research Questions
The following questions are designed to guide this study;
- What is the level of knowledge of women of reproductive age on family planning methods?
- What is the level of acceptance of family planning methods among women of reproductive age?
- What type of contraceptive methods are utilize by women in the rural community?
1.4 Objective of Study
The broad objective of this study is to determine the level of the knowledge and acceptance of family planning method amongst women of reproductive age in Esan west community.
1.4.1 Specific Objectives of the Study
The specific objectives is to;
- To assess the level of knowledge of women of reproductive age on family planning methods
- Identify the level of acceptance of family planning methods among women of reproductive age.
- Determine the type of contraceptive method utilize by women in the community.
1.5 Significance of the Study
The finding of the study will provide information on the level of the knowledge and acceptance of family planning method amongst women of reproductive age in Esan west community. It will as well act as bases for policy formulation, health enlightenment campaign on the importance of family planning. It will also provide information in the available methods of control of child bearing in the community. it will also aid as a guide in family planning counseling.
1.6 Scope of Study
The research is delimited to all women of reproductive age in some communities in Esan West Local Government Area of Edo State, Nigeria. Esan West Local Government Area is geographically located in 608’E/6.750N, and 6.13330E. It is an area of 502km2 and a population of 125,842 as at the 2006 population census.
1.7 Operational Definition of Terms
Knowledge: facts, information, and skills acquired through experience or education; the theoretical or practical understanding of a subject.
Acceptance: the action of consenting to receive or undertake something offered.
Family: In the context of human society, a family (from Latin: familia) is a group of people affiliated either by consanguinity (by recognized birth), affinity (by marriage or other relationship), or co-residence or some combination of these.
Planning: The process of making plans for something.
Family planning: is the practice of controlling the number of children in a family and the intervals between their births, particularly by means of artificial contraception or voluntary sterilization.
Reproductive age: In women, whose years of life are between menarche and menopause, roughly from ages 12 to 49.
Community: A community is a small or large social unit (a group of people) who has something in common, such as norms, religion, values, or identity.
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