|Year : 2016 | Volume
| Issue : 2 | Page : 60-61
Commentary on barriers to the use of modern contraception among married women of high parity in Northern Nigeria
Anthony Idowu Ajayi
Department of Sociology, Faculty of Social Science and Humanities, University of Fort Hare, East London Campus, South Africa
|Date of Web Publication||20-Apr-2017|
Anthony Idowu Ajayi
Department of Sociology, Faculty of Social Science and Humanities, University of Fort Hare, East London Campus
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ajayi AI. Commentary on barriers to the use of modern contraception among married women of high parity in Northern Nigeria. Arch Med Surg 2016;1:60-1
|How to cite this URL:|
Ajayi AI. Commentary on barriers to the use of modern contraception among married women of high parity in Northern Nigeria. Arch Med Surg [serial online] 2016 [cited 2019 Jan 22];1:60-1. Available from: http://www.archms.org/text.asp?2016/1/2/60/204797
| Introduction|| |
Even though there are many studies on barriers to the use of contraception in Sub-Saharan Africa, there are few studies on this topic in North-Western Nigeria. Barriers to the use of contraception tend to vary by context; thus, this study fills an important gap in the literature. Using a quantitative method, the study explored barriers to the use of contraception among high parity women attending antenatal clinics in a city in Northern Nigeria. The main findings of the study are that awareness of contraception was high, but perceived negative side effects of modern contraception, partners' disapproval, providers' attitude, culture, and religion were the reported barriers to the use of modern contraception. Furthermore, most participants stated that they would start or continue the use of modern contraception. This commentary provides in-depth interpretation of these findings and drew implications for policy formulation.
| Discussion|| |
Studies have shown that knowledge of contraception has significantly improved over the past 2 decades in Sub-Saharan Africa. This is perhaps due to the integration of family planning into child immunization and antenatal care services. Indeed, access to contraception has increased significantly. Nevertheless, the use of contraception remains significantly low in Sub-Saharan Africa and varies by the type of residence and socioeconomic status. Use of any form of contraception is very low in Nigeria, and according to the 2013 National Demographic and Health Survey, the use of any form of contraception is lowest in the northern region of Nigeria. One consequence of low use of contraception is high fertility rate. This is in particular the case in Northern Nigeria where a woman gives birth to an average of 6.7 children. As reported in the study, the average parity was seven deliveries and the highest parity was 15. One of the main reasons for high fertility in Northern Nigeria is low use of contraception and high rate of unplanned pregnancy. This assertion is corroborated in the study, where many women of high parity reported to have experienced unplanned pregnancy. Unplanned pregnancy could jeopardize the health of women and her children and also further impoverish the populace. Thus, it is imperative that women are supported to ensure all pregnancies are planned. Indeed, high parity suggests low use of contraception and high unmet need for contraception.
Even more interesting finding of the study is that many high parity women had previously used modern contraception in their bid to prevent unplanned pregnancy. However, their experience of irregular bleeding and other side effects of modern contraception pose a significant barrier to subsequent use of contraception. Even so, their negative experience could further jeopardize the use of modern contraception among women who are yet to embrace modern contraception. Clearly, there is a need to educate women on the implications of the side effects of modern contraception before administering the methods to them. There is evidence that prior counseling about side effects of modern contraception can promote its use.
Other barriers exist such as religious belief and service provider's attitude as reported in the study. The extent to which culture and religion impede the use of modern contraception is less understood and suggests the need for further studies. Indeed, culture and religion do not expressly forbid the use of contraception. One way in which culture impedes the use of contraception is male hegemony. Culture allows men to control women's body – especially women of low socioeconomic status – by allowing them to make reproductive decisions for women. Perhaps, men refrain their partners from using modern contraception due to concerns about side effects.
In addition, the finding in the study that few women reported that service providers denied them the use of preferred method of contraception is worrisome. Provider's attitude could undermine the efforts to ensure women plan their pregnancies. Consequently, service providers must see beyond their religious values and understand the specific needs of individual client that come to access family planning services in Northern Nigeria. Service providers must understand that reproductive health issues have cultural undertones and require a great deal of trust for women to access services. Clients' right to information on all available contraceptive methods — including their side effects — must be ensured to enable women make informed choice.
As shown in this study, a window of opportunity still exists because many women would like to use or continue the use of contraception. However, aside from improving access to contraception, there is the need to train service providers in providing quality family planning services that are client-centered.
| Conclusion|| |
In the Northern Nigeria context, there is access to contraception and awareness is high, but the use of modern contraception is undermined by perceived negative side effects of modern contraception, partners' disapproval, providers' attitude, culture, and religion. Clients' friendly quality family services are urgently required to address the unmet need for contraception in Northern Nigeria.
| References|| |
Sedgh G, Hussain R. Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries. Stud Fam Plann 2014;45:151-69.
Darroch JE. Trends in contraceptive use. Contraception 2013;87:259-63.
National Population Commission, ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF International; 2014.