Knowledge, attitude and practice of family planning among Igbo women of south-eastern Nigeria

The role of partners, parents and friends in shaping young women's reproductive choices in Peri-urban Nairobi: a qualitative study

BACKGROUND

Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning (FP) methods. This paper draws on social norms theory to explore the role of key influencers (partners, parents and friends) in women's FP use and how women anticipate normative reactions or sanctions.

METHODS

A qualitative study with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya. Interviews were conducted during the COVID-19 pandemic in 2020 by phone. A thematic analysis was conducted.

RESULTS

Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as key influencers on FP. Their interactions with these key influencers varied based on trust, the information they needed about FP, and whether they perceived a key influencer to perpetuate or challenge existing social norms on FP. Mothers were perceived to understand the social risks of using FP and thus could advise on discreet FP use, and aunts were trusted and approachable sources to impartially describe the benefits and drawbacks of FP. Although women identified partners as key FP decision makers, they were cognisant of possible power imbalances affecting a final FP choice.

CONCLUSIONS

FP interventions should consider the normative influence key actors have on women's FP choices. Opportunities to design and deliver network-level interventions which seek to engage with social norms surrounding FP in order to challenge misconceptions and misinformation among key influencers should be explored. Intervention design should consider dynamics of secrecy, trust and emotional closeness that mediate discussions of FP to address changing norms. Further training to change norms held by healthcare providers about why women, in particular unmarried young women, access FP should be provided to reduce barriers for FP access.

Exploring Readiness for Birth Control in Improving Women Health Status: Factors Influencing the Adoption of Modern Contraceptives Methods for Family Planning Practices

Background: Pakistan is the world’s sixth most populated country, with a population of approximately 208 million people. Despite this, just 25% of legitimate couples say they have used modern contraceptive methods. A large body of literature has indicated that sexual satisfaction is a complex and multifaceted concept, since it involves physical and cultural components. The purpose of this study is to investigate the impact of influencing factors in terms of contraceptive self-efficacy (CSE), contraceptive knowledge, and spousal communication on the adoption of modern contraceptive methods for family planning (FP) under the moderating role of perceived barriers. Methods: Data were collected using an adopted questionnaire issued to married women of reproductive age belonging to the Rawalpindi and Neelum Valley regions in Pakistan. The sample consisted of 250 married women of reproductive age. SPSS was used to analyze the respondents’ feedback. Results: The findings draw public attention towards CSE, contraceptive knowledge, and spousal communication, because these factors can increase the usage of modern methods for FP among couples, leading to a reduction in unwanted pregnancies and associated risks. Regarding the significant moderation effect of perceived barriers, if individuals (women) are highly motivated (CSE) to overcome perceived barriers by convincing their husbands to use contraceptives, the probability to adopt modern contraceptive methods for FP practices is increased. Conclusions: Policymakers should formulate strategies for the involvement of males by designing male-oriented FP program interventions and incorporating male FP workers to reduce communication barriers between couples. Future research should address several other important variables, such as the desire for additional child, myths/misconceptions, fear of side effects, and partner/friend discouragement, which also affect the adoption of modern contraceptive methods for FP practices.

Awareness and practice of family planning among women residing in two rural communities in Ogun State, South West Nigeria

Background:

Family planning helps individuals and couples to avoid unwanted pregnancies, regulate interval between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors.

Aim:

This study was conducted to assess the rural women's awareness and practice of family planning in two communities in Ogun State.

Materials and Methods:

This was a cross-sectional study conducted among 561 women of reproductive age. Data collection was done using interviewer administered questionnaire. Data were analyzed using IBM SPSS version 20. Frequencies were generated and Chi-square test was used to explore associations. Binary logistic regression was used to determine predictors of ever-used family planning.

Results:

Majority were aware of family planning (410, 73.1%). The method most commonly known was male condom (348, 84.9%), pills (276, 67.3%), and injectables (231, 56.3%). Respondents who had ever-used family planning were (265, 47.2%). The methods commonly used were injectables (104, 39.2%) and pills (85, 32.1%). Reasons for not using family planning include the desire for more children (78, 26.3%), lack of spousal support (56, 18.9%), and fear of undesirable effects (44, 14.9%). Determinants of ever-used family planning after logistic regression were age and occupation. Women between 31 and 40 years of age were two times more likely than women <20 years to have used family planning (adjusted odds ratio [AOR] 2.17, 95% confidence interval [CI] 2.17–1.23). Farmers were 53% less likely than traders to have ever-used family planning (AOR: 0.47, 95% CI: 0.29–0.78).

Conclusion:

Although the awareness of family planning was high in this study, it did not correspond to practice. Campaigns promoting the use of family planning for child spacing, male involvement in family planning and dispelling of fears is recommended to improve practice of family planning.

Does community mobilisation improve awareness, approval and uptake of family planning methods among women of reproductive age in Ebonyi State? Experience from a quasi-experimental study

Introduction

family planning programmes have helped in increasing the prevalence of contraceptive use and reducing total fertility rate in developing countries from six to three births per woman. However, its uptake is lower in the rural areas compared to urban areas. This study seeks to elucidate the effect of community mobilisation on awareness, approval and use of family planning among women of reproductive age in the rural areas of Ebonyi state, Nigeria.

Methods

we conducted a quasi-experimental study among women aged 15 to 49 years in two rural communities in Ebonyi state. Using simple random method, we recruited 484 women for the study. We used pre-tested interviewer-administered questionnaire to collect information from the participants. Community awareness and distribution of information, education and communication materials were carried out within one month. We estimated the effect of the intervention on the level of awareness, approval and uptake of family planning methods.

Results

level of awareness increased by 19% (p<0.001) while uptake of family planning increased by 16.7% (p<0.001) in the intervention group. The approval rate was higher in the intervention group compared to the control group (p=0.008). The most commonly used method of family planning was the natural method in intervention and control arms.

Conclusion

although uptake of family planning increased significantly in the study population, the rate is generally low. Given the critical role of the community in family planning programmes, community mobilisation may be deployed to increase uptake of family planning in similar rural communities.

Role of community resource persons in improving use of modern family planning methods among women of reproductive age in a rural area in Ebonyi State, Nigeria

BACKGROUND

The study set out to determine the role of community resource persons in improving uptake of modern family planning methods among women of reproductive age in Ebonyi State.

METHODS

A non-randomized intervention study with control was done. A multistage sampling technique was used to select a sample of 484 in union women of reproductive age. Data were collected using a pretested structured questionnaire. Community resource persons were trained to provide culturally appropriate information on family planning to men and women in the community. Postintervention data were collected after a waiting period of 3 months.

RESULT

In the intervention arm, use of modern methods of family planning increased significantly by 7.4% at 3 months postintervention (P = 0.01) compared with the control arm. The most commonly used modern methods of family planning were pills, injectables, and barrier methods in the intervention arm and implant in the control arm. The major source of modern methods of family planning was health facility both before and after the intervention in both arms. Number of living children, increasing age and husband's education were predictors of current use of modern family planning methods.

CONCLUSION

Community-driven strategies are useful for increasing uptake of modern methods of family planning and are recommended.

Access to Information on Family Planning and Use of Modern Contraceptives Among Married Igbo Women in Southeast, Nigeria

This study was conducted among married Igbo women in Nigeria who have the lowest median birth interval coupled with a culture of sex preference and low use of modern contraceptives. We examined the relationship between access to information on family planning and sex preference on the use of modern contraceptive (MC). The 2013 Nigeria Demographic and Health Survey data were used. The data of 1,661 women of reproductive age were analyzed in this study. Access to information on family planning was low, and almost half (48.6%) of the women had a score of zero. Controlling for possible confounding variables, the data show that women who have good (odds ratio [ OR]= 3.92; CI [2.28, 6.75], p < .001) and poor ( OR = 2.56; CI [1.85, 3.56], p < .001) access to information on family planning were more likely to use MC than those with no access to information on family planning. Sex preference showed no relationship with the use of MC. Families where husbands want more children than their wives inhibit ( OR = 0.62, CI [0.42, 0.90], p < .05) the use of MC compared with those families where husbands and wives fertility desire is the same. Public health programs by government and donors should intensify interventions to increase access to family planning information to promote the use of MC among married Igbo women.

Contraceptive prevalence and preference in a cohort of south-east Nigerian women

BACKGROUND

Rates of fertility, population growth, and maternal deaths in Nigeria are among the highest in the world, with an estimated 4% of all births being unwanted and 7% mistimed. These are caused mainly by nonuse, inappropriate choice, and difficulty in accessing contraceptive commodities. The purpose of this study was to determine the prevalence and factors influencing the choice and sources of contraceptive options among market women in Ebonyi State, Nigeria.

METHODS

This was a questionnaire-based, cross-sectional, descriptive study involving 330 market women of reproductive age in Abakaliki, Ebonyi State, Nigeria. A survey was carried out to identify their knowledge, use, and sources of contraception and the factors that influence their contraceptive practices.

RESULTS

Knowledge of contraception was high (275 [83.3%]), and 229 (69.4%) of the study population approved of contraceptive use. However, only 93 (28.3%) of the respondents were currently using any form of contraception. Fifty-four women (16.3%) were using modern methods. The commonly used forms of modern contraception were the barrier method (male condoms, 27 [8.2%]), the oral contraceptive pill (10 [3.0%]), injectables (8 [2.5%]), and the intrauterine contraceptive device (7 [2.0%]). The most common source of contraceptive products was patent medicine dealers (58 [51%]). The main barriers to use of contraception were desire for more children (86 [26.1%]), religious prohibition (62 [18.8%]), spousal disapproval (32 [9.7%]), and the perceived side effects of modern contraceptives (25 [7.6%]). There was a significant association for approval of contraception when the model was adjusted for religion (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.18-0.84; P=0.02); educational status (OR 2.84, 95% CI 0.96-8.40; P=0.04); parity (OR 1.78, 95% CI 1.09-2.85; P=0.03); and social class (OR 2.54, 95% CI 1.26-5.11; P=0.01).

CONCLUSION

There is good knowledge about contraception among Nigerian women, but use of these products is low. The main barriers to use of contraception are the desire for more children, religious prohibition, and spousal disapproval.

Awareness of family planning amongst antenatal patients in a nigerian community: an exploratory study

AIM

This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria.

METHODOLOGY

The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical Review Committee of the hospital prior to commencement of the study. The information was obtained from the respondents with the aid of a pre-tested semi-structured questionnaire which included their bio-data, awareness and the sources of awareness about family planning .Other information obtained were reasons for family planning as well as knowledge about the different methods of family planning. The information obtained with the study instrument (questionnaire) was collated and analyzed with SPSS statistical software version 12.0.1.

RESULTS

Most respondents (89%) were aware of family planning. The majority of the respondents:42 (47.2%) received information about family planning from health workers while 21(23.6%) received the information through the media. Most of the respondents (74%) knew about condom. The level of education significantly affected the awareness about family planning with a p value of 0.017.

CONCLUSION

Most respondents were aware of family planning. The media should play a more prominent role in creating awareness amongst the populace about family panning.

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study

BACKGROUND

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.

METHODS

A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted.

RESULTS

Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.

CONCLUSION

While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Contraception among bankers in an urban community in Lagos State, Nigeria

Introduction

Contraception means procedures employed to interfere at one stage or the other with the normal sequence of events in the process of reproduction leading to a failure in conception. It means voluntary techniques adopted to achieve birth control. Its use remains sensitive worldwide. Within the same society, contraception varies amongst people of different socio-cultural, educational, religious, or occupational affiliations. It also varies between urban and rural settlements. Some contraceptive techniques also prevent sexually transmitted infections (STIs). The prevalence of STIs also varies with these same factors. There is very limited literature on contraception exclusively amongst bankers. We sought to investigate the level of awareness and practice of contraception amongst bankers in an urban society in Lagos State, Nigeria.

Methods

In this descriptive cross-sectional study, 200 self-administered structured questionnaires were retrieved from bankers from 5 banks selected by simple random sampling in Surulere Local Government Area of Lagos State, Nigeria. Data was subsequently statistically analyzed using SPSS.

Results

The age range was 21-45 years, mean28.8±1.4 years, 51.7% were males (72% single, 27% married, 1% separated) and 48.3% were females (52.4% single, 47.6% married). All (100%) respondents were aware of contraception, 93.3% males and 91.7% females were sexually active, 88.9% males and 84.5% females believe contraception is useful. Most (71.4%) respondents practice contraception, males (81%) being more than females (61.1%), p < 0.05. More (71.4%) females and fewer (37.8%) males believe that contraception prevents pregnancy but not STIs, 28.6% of females and 46.6% of males believe it prevents both pregnancy and STIs, whereas 14% of males and no female believe contraception prevents STIs but not pregnancy.

Conclusion

The awareness of and practice of contraception was very high among the bankers but more male bankers practice contraception whereas more female bankers perceive contraceptives to be for the married only.

Factors associated with induced abortion in women prostitutes in Asturias (Spain)

Background

The aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain).

Methodology/Principal Findings

Cross-sectional descriptive study by self-completion questionnaire of 212 women prostitutes who attended the three Sexually Transmitted Disease Clinics in Asturias, between January–December 2003. The questionnaire was designed to investigate the women's perceived knowledge (what they claimed to know), their real knowledge (what they really knew), the use of contraceptive methods and socio-demographic variables. Multivariate analysis was carried out. 92% of the participants were immigrants. 76% were practising at brothel. 37.6% (95%CI:30.7–44.4%) reported to have undergone at least one IA during their life. According to the logistic regression the “presence of IA” was directly associated with the variables “number of pregnancies”(OR:65.82;95%IC:7.73–560.14) and “years of practising prostitution”(OR:1.13;95%CI:0.99–1.29); and inversely associated with “children”(0 = no children;1 = one or more children; OR:0.005;95%CI:0.000–0.057), “women's age”(OR:0.89;95%CI:0.82–0.97) and “real contraceptive knowledge”(OR:0.50; 95%CI:0.34–0.75). Married women were more likely to have undergone an IA (OR:2.74;95%IC:1.05–7.13). No association with “perceived contraceptive knowledge” was found.

Conclusions/Significance

The characteristics more closely linked to the reproductive history of the women (such as “pregnancies”, “children”), together with the “real contraceptive knowledge” and the “time practising prostitution” explain the presence of IA better than factors more closely linked to the conditions in which the women practise prostitution (“place of activity”, “other activities compatible with prostitution”, “use of safe method in commercial relation”). It is possible that IA is being used as a birth control method, hypothesis suggested by the inverse association observed between the variable “children” and the “presence of IA”. Therefore, the promotion of the use of safe contraceptive methods should be a high-priority. If the real contraceptive knowledge was measured correctly, all strategies to increase it would be justified because it was inversely associated with the presence of IA.