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Abstract

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Introduction

INTRODUCTION



Background to the study



Family Planning is the purposeful regulation of conception or childbirth or the use of devices, chemicals, abortion or other techniques to prevent or terminate pregnancy or voluntary avoidance or delay of pregnancy (Wikipedia, 2010; Caufield, 1998). Family planning techniques commonly used include sexual education, prevention and management of sexually transmitted infections, pre-conception counseling and management and infertility management (Wikipedia, 2010). These services are defined as “educational, comprehensive medical or social activities which enable couples, individuals including sexually active adolescents and minors, to determine freely the number and spacing of their children, avoid getting pregnant and/or even avoid sexually transmitted diseases, to select the means by which this may be achieved” (Wikipedia, 2010; Plata, 1996). Family planning is sometimes used as a synonym for birth control or child spacing, though it often includes more.



The use of family planning implies that the users make concerted efforts to deal with procreation within the context of a sexual relationship. This covers things as varied as when to get pregnant, the number of children that are wanted, how to deal with fertility issues, how to avoid getting pregnant, whether to consider an abortion if an unwanted pregnancy occurs, or adoption etc. to say nothing of working out parental strategies with one’s partner. Family Planning was listed as one of the twelve pillars of Reproductive Health. Among the objectives of Family Planning is to help women to protect themselves from unwanted pregnancies (FMHN, 2005). In Nigeria, before the introduction of modern family planning by Babangida administration in 1989 there were traditional methods of birth control (Odimegwu, 1999). These traditional methods which still exist and are convenient for users (Encyclopedia Americana, 2001) are natural while the modern types which are new in Nigeria are both natural and artificial. In Nigeria like in most developing countries, the story of family planning services is not successful because of a number of factors, such as culture of the people and low status of women (Coleman, 2004). Other factors include lack of education and understanding about health related issues, the ability of women to command resources and make independent decisions about their fertility, birth control knowledge, (Nwakeze, 2003). Location, religion and social class, lack of cooperation from spouse, cost, perceived difficulty with the method and lack of knowledge about contraceptive methods etc. (World Bank, 2004; IPPF, 1993). Moreover in Nigeria, the provision of health services is more in the urban areas than in the rural areas (Dobie, et al 1998). Where family planning services are located in rural areas, access is low due to lack of proximity, bad road network and the nearest urban center, where such clinic is available, it may not provide adequate care because of lack of proper trained staff and equipment (Wikipedia, 2009; Quedraogo, 2005; NISER, 2001). Other factors include lack of proper family planning function dissemination; inadequate motivation to seek actively, access and regularly use contraceptives (Odimegwu, 1999).



Lack of use of family planning services is enormous as it affects the individual, the family, the community and nation at large. Empirical findings have shown that it leads to increase in maternal illness, such as multiple pregnancies, hemorrhage, etc. (Ikpeze, 2010; Wikipedia, 2009; Wikipedia, 2008). It sometimes leads to social problems in the family and community such as violence, desertion, accusation of infidelity, fear of violence on the part of the woman, mistrust. On the part of the man, it could lead to having multiple sexual partners with its attendant contraction of STIs and HIV/AIDS, affecting sexual and reproductive lives of women (Ezumah, 2003; Pop Report, 1999) and sometimes it leads to maternal death. These have socio- economic consequences on the immediate family as the resources meant for the up- keep of the family are diverted to the health care of the parent(s) as the case may be, time wasted and the future and the life of the children truncated. Family planning services have the function of preventing most maternal illnesses and deaths (Wikipedia, 2008), yet it has been recorded that the rate of maternal morbidity and mortality is high in developing countries compared to developed countries (Ikpeze, 2010; FMHN, 2005). UNICEF (2008) estimate shows that maternal mortality in Nigeria is high about 800/100,000 live births yet attitude of members of the developing countries to family planning services is low and this attitude is attributed to socio-cultural and economic reasons (Engender Health, 2009; Galadanci, 2009; Agujiobi, 2003; Ezumah, 2004; Onyeneho and Okeibunor, 2003; Nwakeze, 2003). With the adverse consequences of non-consent and non-use, and the inappropriate understanding of the importance of family planning services on the reproductive health of women, concerted efforts must be made economically, socially, politically and otherwise towards ensuring that the negative consequences of lack of use of family planning services are controlled to the barest minimum. This study therefore will examine the socio-economic and cultural barriers to access and use of family planning services by women of reproductive age in Nkanu area of Enugu State and suggest measures that could enhance effective use of family planning services for both genders in the research area.