Despite the invaluable benefits associated with family planning, available evidence shows that many of those that should be using it are unable to access its services.
Although Nigeria has set a goal of 36 percent contraceptive prevalence rate (CPR) by 2018, it currently has a 15 percent CPR. Similarly, the country’s unmet need for contraception was reported to be 18.9 percent in 2018, according to the National Demographic Health Survey (NDHS). Women with unmet need are those who do not want any more children or want to delay the next child, but don’t use any form of family planning method.
However, experts recommend the use of family planning for persons who are in the reproductive ages of between 15 and 49.
Studies also show that family planning provides huge benefits to many households, including helping mothers to regain their health after delivery, providing more time for women to bond with their children and husbands among others.
According to the World Health Organisation (WHO), Family planning could prevent up to one-third of all maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies, and stop childbearing when they have reached their desired family. Consequently, family planning is said to be a lifesaver by some researchers.
A critical look at recent data shows that family planning uptake in the country is generally low. It is illogical that women that have achieved the number of children they desire and those who want to delay the next pregnancy, are not using family planning despite the numerous benefits that are associated with it. The question is why is this so and what are the factors hindering more women from accessing family planning services?
A study, ‘Barriers to Contraceptive Uptake among Women of Reproductive Age in a Semi-Urban Community of Ekiti State, Southwest Nigeria’ found that although, contraceptive awareness among the respondents was high 496 (98.6 percent), only 254 of the 503 participants were using modern contraceptive methods, resulting in a Contraceptive Prevalence Rate (CPR) of 50.5 percent.
However, among those not using any form of contraceptives, some identifiable barriers to contraceptive use included desire for more children, 62 (39.5 percent), partner disapproval, 40 (25.5 percent), and fear of side-effects, 23 (14.6 percent). Factors associated with contraceptive uptake similarly included marital status and one’s educational level. While religion was a hindrance, traditional worshippers had the least uptake of contraceptives.
It is interesting to note that one of the obstacles to contraceptive uptake played out in the lives of a couple, that recently announced the birth of their new baby: “We felt we were done, but God feels we should be blessed again,” stated the husband. The question to ask is when they attained the initial two children they desired as planned; did they subsequently initiate the use of contraception to prevent further conceptions? The couple said, “No”.
Hence, it could be rightly said that there was no conscious effort on the part of the couple above to use family planning. It should be highlighted here that this desire to keep having more children is an obstacle to accessing family planning services.
The births of their children were left to chance, which is contrary to modern-day advocacy on using family planning to advance the health of women and their families; childbearing should be by choice, not by chance. This underscores the UNFPA Family Planning Strategy 2012-2020, which is ‘Choices not Chance’.
The whole idea of delivering this strategy is to ensure a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled.
On the impact of religion, it has been shown that religious leaders can be a positive influence in their communities to advance family planning practices when they have sound information and assistance in overcoming common misconceptions and misunderstandings about contraception.
Similarly, the study in southwest Nigeria, showed that awareness of how family planning commodities work effectively would better serve the needs of clients and their families.
According experts, this awareness about family planning could dispel numerous myths and misconceptions. For instance, it is common to hear that people who use contraceptives end up with health problems; contraception results in infertility, using family planning leads to a bloated stomach, among others. Medical experts said these are not based on scientific evidence.
The Guttmacher Institute, one of the leading research and policy organisation advancing sexual and reproductive health rights (SRHR), stated that negative myths about family planning are a barrier to modern contraceptive use.
On the issue of awareness, the UNFPA at various fora has stressed the importance of community members becoming involved in building awareness about family planning. The world body has also called for sustainable male involvement to improve family planning uptake.