ATTITUDES OF WOMEN TOWARDS UTILIZATION OF MODERN CONTRACEPTIVES IN URUAN LOCAL GOVERNMENT AREA
CHAPTER ONE
Introduction
1.1 Background to the Study
In 2011, World population stood at 7 billion. Population Reference Bureau: World Population data sheet (2011). Nigeria accounts more than 180 million of world population of which, Akwa Ibom State, is the seventh populous state in Nigeria contributes 4.5 million people (Oni (2006). The average total fertility rate worldwide ranges from 1.7 children per woman in more develop states to 4.6 in the least developed states.
Total fertility rate in Akwa Ibom State is 5.3 children per woman. Epidemiology and Ecology of Health and Disease in Akwa Ibom State Edited by Berhane-Shama books (2006). This puts Akwa Ibom State among states with high total fertility rates in Nigeria. For fertilities to fall to those low levels, increase the use of family planning methods plays a significant contribution especially in less developed states including Akwa Ibom State (Planned Parenthood Federation of Nigeria 2010).
If the current population estimate is something to go by, much population analysis already regards Nigeria as being over populated. Based on the contest, the Federal Government recently formulated a policy on the nations population. These include management and control of our human population with guided skills, goals, policies, plans, programmes and projects for the improvement of human quality (Planned Parenthood Federation of Nigeria 2010).
We cannot dismiss as presumptuous the adverse effects of uncontrolled reproduction on women and such risk factors as childbirth before 18 years or after 35 years of age where as in the rich developed nations of the world, population growth rate has diminished as women and men have chosen to have fewer children, in developing nations like Nigeria, the growth rate remains high as only few couples limit the number of their children. Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in (2000) WHO (2004). This is probably because children are seen as the most valuable assets from God as such they are accepted whenever they come.
There is the concern that Natural resources are not unlimited and uncontrolled therefore, population growth may result in crisis, statistics which statistics central statistical Agency: ICF International (2006). Shows that majority of the world’s people are neither adequately fed nor housed. The sad reality is that people that are less able to care for their children are having more children than those who have the means to support them (Shuaib & Oghdoh 2010).
There is a growing concern among individuals and nations alike, to limit their family size and population respectively. (Timothy, Nelson & Tom. Soc. Sc. 2011). There is the need for adequate nutrition, housing and better quality of life. Health policy and the strategic framework and plan in 2012 was a major step by the Federal Government to reduced the unacceptable high levels of maternal and neonatal morbidity and mortality and to ensure the necessary improvement in access to quality reproductive health services at all levels. One of the major steps to achieve the declared objectives of reproductive health policy is to promote access to information on family planning, encourage wider choices of contraceptives methods and to encourage the development of new initiatives that would support availability of commodities and supplies at the service delivery points. All the stakeholders believed that availability of commodities (contraceptives and condoms for (HIV/AIDS) is critical to the success of the reproductive health, population and HIV/AIDS programmes.
Therefore, in creating the necessary awareness for family planning, it is equally very vital to ensure a regular supply of the commodities at all levels.
Family Planning emerged as a population control measure. The services were initially provided by independent agencies and private individuals provide the services in Nigeria. There is growing acceptance of the fact that men and women need so that they can protect themselves and make informed decisions regarding their reproductive health. Inspite of the advantages of family planning, rumours and misinformation about family planning are widespread. Despite the awareness resistance persists, some people fear that when young people are educated about sexuality, providing them with family planning information will lead to irresponsibility and promiscuity on the other hand. Women of child bearing age are reluctant to seek information or help from their family or professional settings. They therefore do not got the information they need. Olugbenga-Bello, Abodunrin & Adeomi (2011).
Planned Parenthood Federation of Nigeria (2001) stated that experience of Planned Parenthood Federation of Nigeria in 34 states out of the 36 states of Nigeria shows that women are very poorly informed about reproductive health and family planning.
For centuries, family planning has been a thing of concern as people tried to find ways to prevent unwanted pregnancies. Attempts to prevent these pregnancies have met oppositions both in the ancient and modern times Ali, Rozi & Mahmood (2004). However, several researchers had been carried out resulting in the emergence of different methods of family planning to meet the varying needs of individual users.
Until, recently many people were opposed to birth control for moral reasons. Even today some groups frown upon any form of birth control, which, is not natural. But the problem of over-population has become so pronounced that almost all-social groups recognized the necessity of controlling births, Ibnouf, Van Den, Born & Maarse (2007). They considered it an unavoidable necessity to continue living on this planet with a minimum level of dignity.
Over-population is no longer a question which will have to be addressed in the distant future, it is happening now. It is also true that in the most developed countries lower birth rates are causing serious difficulties, and a birth rate which is too low can be as problematic as one which is too high. For this reason, we are concerned with family planning within the framework of responsible parenthood.
The woman’s reproductive organs are designed only to be fertilized a few days every month, Stephenson & Hennink (2004). This shows that the creator also thought about the need for the couple to freely plan the children they wished to have without having to stop enjoying sexual relations that are satisfactory for both of them.
In industrial society great urban conglomerations, where the problem of housing is acute, it seems that limiting the number of children is the right thing to do. Abraham, Adamu & Deresse (2013). This along with the fact that sexual practice is not longer considered to be only reproductive in nature but also means of mutual satisfactions ensures that family planning has become a primary need within marriage. If this is the case in countries with a high standard of living, it is even more so in the underdeveloped or developing countries.
The demerits of over population faced by Nigeria now include over crowding, depletion of available resources, chronic malnutrition’s, starvation, lack of adequate education, unemployment, lack of social facilities to mention just a few. (Kasonia & Maliro, 2011). To improve the quality of life for individuals and communities, family planning becomes an essential component of any broad based development strategy for a nation. The World Health Organization (WHO) in declaration in Alma-ata an essential component of the Primary Health Care (PHC).
To achieve this objective, this objective, therefore, the women must be assisted through counseling, persuasion, health education and family life education which includes family planning. This is not a job that government alone can do, it requires joint efforts of all in the society.
The use of contraceptives is one way of checking population explosion through family planning, contraceptive devices addresses important health problems especially in developing countries where maternal and infact death rates are extremely high. According to population reports (December 1989) maternal death rates are possible as much as 400 times greater in developing countries than in developed countries and complications of pregnancy account for between 10 and 30 percent of death among women of reproductive age in parts of Africa. Apart from the control of fertility, some other importance of contraceptives includes prevention of the spread of sexually transmitted diseases (STDS). The pills reduce some inenstrcial problems and help to protect against pelvic inflammatory diseases (PID), cancer of the uterine lining, cancer of the ovaries, decrease in ovarian cysts, reduction in endometriosis, prevention of anemia and rheumatoid arthritis (World Health Organ. (WHO) Global and Regional Estimates of the Incidence of Unsafe Abortion & Associated Mortality in 2000 (WHO 2004).
According to National reproductive Health strategic frame work and plan (2004-2008). The fertility level in Nigeria remains persistently high at a national average of about 5.2 children per woman due mostly to:
- Negative socio-cultural beliefs and norms.
- Negative impact of myths and rumours about family planning methods.
- Poor access to services especially in rural areas and for specific target groups such as adolescents, women and men.
- Low quality of services due to inadequate skills providers and inadequate and irregular supply of commodities.
- Low status of women.
- Increasing teenage pregnancy and
- Lack of male involvement.
These factors have resulted in a low contraceptive prevalence rate of 9% and a large pool of people whose needs are unmet.
The level of unmet need for family planning in 2010 was 18 percent (NDHS, 2010). Among adolescents and young persons, contraceptive use is very low, resulting in high prevalence of undesired pregnancies, unsafe abortion and hence, high abortion-related morbidity and mortality.
Before the return of democratic governance in Nigeria 1999, family planning services had become fragmented due in part to low stocks of commodities as a result of withdrawal of donor support and poor public sector funding. Previously, family planning activities were intense and broad-based through the use of diversified approaches including community-based distribution, social marketing, pharmacies and patent medicine stores, in addition to facility-based and outreach services.
As at 2009, Nigeria was said to be the most populous country in Africa and the tenth most populous country in the world (Federal Ministry of health 2005) United Nations Demographic Survey estimated in current population to be 180 million people with the growth rate of 7.9 percent per annum and the total rate of 13.5% and contraceptive prevalence rate of 8%. The high population and growth rate is due to decreasing mortality and sustained high fertility.
Ironically, while the rich and developed nations are reducing their population growth by choosing to have few children and by using birth control. The most and hungry nations are having more children with only few limiting their family size. Family planning and population control can benefit not only the individual but their entire nation or community. Mekonnen & Worku. Repro Health (2011).
Limiting family sizes means better nutrition comfortable houses, good education for the children and improved quality of life for the family and nation at large. Too many people means excessive competition for the unlimited natural resources and social facilities such as housing health services, water, electricity and other utilities. With family planning the fear of unwanted pregnancy and the associated psychological stress is reduced. Family planning eliminates the need for abortions and its complications.
Family planning helps to increase the mother’s health, the family’s standard of living and stability of the home.
It promotes general well being for all members of the family although the major beneficiaries are the children.
Infant mortality and illness rates depend primarily on the health and nutrition of the pregnant mother and secondly on the nutrition and hygienic care given to each child. We must therefore make sure that both the quantity and the quality of life increase at the same rate as technological and scientific advances. Because of this, we consider family planning to be preventive measure. Kebede-Ethiop Health Dev. (2006). The purpose of which is to increase the well being of the family and to decrease risk of illness and death, both for mothers and for children. It is also the aim of family planning to give parents the chance to delicate more time and resources towards the education of their children Pall (2010).
The birth of a wanted child is a great family event and can encourage family stability. It is also a positive factor in the child’s own development. The unwelcome child, however, can be the cause of major physical and psychological difficulties for the parents and the siblings and if he is a drain on the finances of the family, he will be the first to suffer. Women are likely to be healthier if they plan to have their children when they are between 18 and 35 years of age. The mother also protects her health by allowing minimal interval of two years between each birth. High risk pregnancies should be avoided if the mother’s health is poor Lucas & Gilles (2011).
A family should consider its abilities and needs when they plan for the important process of child bearing. And advanced and just society will try to make sure that they young and defenseless receive the best – possible quality of life. This requires an understanding of how many children can be cared for and educated properly.
Birth control should have as its principal goal the achievement of a better life for all people today and tomorrow. In advanced countries, governments usually guide families and young couples in order to guarantee that they are conscious of the responsibility they have taken upon themselves, people need to understand their responsibilities to their future descendants and to society in general when they decide to bring children into the world. Pandey, Karki & Pradhan (2009).
All couples before having children should study and decide how many children they can maintain and educate properly. If they have the opportunity to attend a centre for family planning, they should do so. In such an important life step, the advice of the experts (gynecologist, nurse, social workers, family counsellor can be of great help.
Adequate family planning also includes the acquisition of some minimum knowledge of birth control methods even as we can see non is perfect or has universal application. Finally, the health benefits of family planning can be translated into healthy people, hence more productive labour force of able men and women. Contraceptives, especially among women meet individual needs and enhance the health of women. It also offers the women the opportunity of having the number of children they will be able to cater for and help to achieve the goal of “Health for all by the year 2015” For this submission, it then becomes necessary to encourage its usage.
1.2 Statement of the Problem
At present, family planning service which is free of cost is provided in both governmental and NGO health facilities in Akwa Ibom State including hospitals, clinics, health centres and health stations. Akwa Ibom State is among states with low contraceptive prevalence rate with only 14% and 16% national and local government, Akwa Ibom State Demographic & Health Survey (2011).
During my interactions with women of child bearing age (18 – 49 years) in Uruan Local Government Area, about poor usage of modern contraceptives methods, I found that educated women and married women readily utilized modern method of contraceptives while the un-educated and un-married women were not making use of modern method of contraceptives as do the married and the educated women. As such I feel it necessary to research on the above topic, Attitude of women towards utilization of modern contraceptives in Uruan Local Government Area.
1.3 Purpose of the Study
The purpose of this study therefore was to assess the attitudes of women towards utilization of modern contraceptives in Uruan Local Government Area.
The study will also highlight women acceptance to modern contraceptives and investigate on factors that will influence their attitude towards modern contraceptives and make useful recommendations that will assist in the achievement of the objective of this study.
1.4 Objectives of the Study
In order to realize the purpose of this study, the following specific objectives have been designed.
- To assess the attitudes of women towards utilization of modern contraceptives in Uruan Local Government Area.
- To determine the influence of education on women on the attitudes towards utilization of modern contraceptives in Uruan Local Government Area.
- To examine the awareness of women on the attitudes towards utilization of modern contraceptives in Uruan Local Government Area.
1.5 Research Questions
The following research questions were raised for this study:
- Do educated and non educated women generally exhibit different attitudes towards utilization of modern contraceptive?
- Do married and unmarried women have equal attitudes towards utilization of modern contraceptives?
- Do urban and rural women differ in their attitude towards utilization of modern contraceptive method?
- Do younger and older women differ in their attitude towards utilization of modern contraceptives?
1.6 Research Hypothesis
The following Hypotheses were formulated to assist in this study.
- There is no significant difference in attitude between educated and non educated women towards utilization of modern contraceptives.
- There is no significant difference in the attitude between married and unmarried women towards utilization of modern contraceptives.
- There is no significant different between urban and rural women towards utilization of modern contraceptives.
- There is no significance difference in attitude between younger and older women in Uruan Local Government Area toward utilization of modern contraceptives.
1.7 Significance of the Study
The problem associated with unwanted pregnancy, which has become an eyesore in Nigeria today has claimed one life or the other and has also led to over population in Nigeria and also abandoned baby cases. The illegality of abortion has further worsen the case. But in recent times, discoveries have been made in preventing these occurrences and this is through the use of modern method of contraceptive. Devices, and also a lot of misconceptions about modern contraception. Based on the foregoing this research work has focused its attention on attitude of women towards utilization of modern contraceptives in Uruan Local Government Area. Information and suggestion derived from this study will provide administrative and policy guidelines for further development and education on contraceptive devices as part of solution to women’s problem.
The study will help the Planned Parenthood Federation of Nigeria (PPFN), the Federal Ministry of Health, Abuja, Society for Family health, Abuja, Ministry of Health, Akwa Ibom State and even clinical family planning providers know where to focus her attention in order to disseminate good information on effective use of modern contraceptives among women in order to:
- Prevent unwanted pregnancies with its complications.
- Prevent the spread of sexually transmitted diseases, including HIV/AIDS.
- Improve the living standards of the populace.
- Reduced the rate of maternal mortality.
- Control the nations population.
- Ruled out misconceptions on family planning.
1.8 Delimitation of the Study
This study is delimited to the Attitude of women towards utilization of modern contraceptives in Uruan Local Government Area of Akwa Ibom State of Nigeria . thus the research is delimited to women in Uruan Local Government Area within the age bracket of eighteen to forty – nine years (18 – 49) being the marital age in Uruan Local Government Area.
1.9 Limitations of the Study
The researcher encountered some constrains, one of which was inadequate record keeping both in the records office of the hospital and Health clinics and also in family planning units of both the hospitals and health facilities in Uruan Local Government Area.
Another problem encountered was some of the respondents (women) were shy to open up in giving correct information about themselves though with much persuasions and explanations on the purpose of the study, they were able to co-operate and appropriate information given thus making the research work successfully.
1.10 Operational Definition of Terms
In this section, the following concepts were defined as they are used in this work.
Attitude: According to Achalu (2001) Attitude can be viewed as a psychological state of readiness or predisposition to react to some object or situation. Also attitudes can be inferred from reactions of people to things or situations. Attitude can vary in intensity or how deeply the attitude is held.
Also there is always an underlying belief associated with attitude. Attitude is complex and can take different forms depending on the situations.
Abortion: This is the termination of pregnancy before the 28 weeks of gestation.
Abstinence: Total avoidance of sexual intercourse.
Conception: Fertilization of the ovum by the sperm resulting in pregnancy or beginning of pregnancy.
Condom: Condoms are stretchable rubber sheaths or material that fit over the penis, condoms work by catching and holding the sperm or semen following ejaculation.
Contraception: The prevention of conception through the use of contraceptives which might be mechanical, chemical or surgical in nature or the regulation of intercourse to avoid the ovulation stages of the menstrual cycle.
Contraceptive: Any method that a woman or man uses to prevent pregnancy. It is also called birth control.
Cultures: According to Ibia (2003) culture means the total shared way of life of a given people which comprise the mode of thinking, action and feeling and which is expressed for instance, in religion, law, language, art and custom as well as material products such as houses, clothing and tools. This total way of life is evolved by men living together as a unit.
Coon in Ibia (2003) stressed the learned quality of culture, he stated that culture is “the sum total of the way in which human beings like, transmitted from generation by learning” he also sees culture to mean the relationship between people in group and in pairs. Rodney in Merris (2010) stated that culture is the acquired or cultivated behavior and thought of the individuals within a society. But parsons (2011) views culture as emergence of social interactions.
Family Planning: According to world Health Organization ( WHO) (2010) family planning is defined as “A way of thinking and living that is adopted voluntary upon the basis of knowledge, attitude and responsible decision making by the individuals and couple in order to promote health and welfare of the family group and thus contribute effectively to the socio-development of the country. In 1912 Margaret Sanga founded the family planning.
Fertility: Being able to become pregnant or becoming mother or father.
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