Evaluation Of Health Concerns And Attitude Of Women Towards Utilization Of Modern Contraceptive

Project and Seminar Material for Nursing (Science)

Abstract

This study focused on the evaluation of health concerns and attitude of women towards utilization of modern contraceptive using Lagos State as case study. The study specifically was aimed at determining the extent of contraceptive use amongst women in Yaba LGA of Lagos state, examine the level of knowledge about contraceptives available to women in Yaba LGA of Lagos state, investigate the ways in which prevailing level of knowledge about contraceptives affect its use among women in Yaba LGA of Lagos state, determine the socio-cultural factors influencing contraceptive use among women in Yaba LGA of Lagos state, examine the consequences of the current level of contraceptive use among women in Yaba LGA of Lagos state and determine how the safe reproductive health and contraceptive use among women in Yaba LGA of Lagos state be enhanced. The study adopted the survey research design and randomly enrolled participants in the study. A total of 433 responses were validated from the enrolled participants where all respondent are active students of the selected institution.

Table of Content

Title Page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
Abstract

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Limitation of the Study
1.9 Definition of Terms
1.10 Organisations of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
References
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

Globally, unintended pregnancies resulting in abortions and myriad abortion-related complications is now a major reproductive and public health challenge. This problem affects millions of women worldwide and has been identified as one of the leading causes of maternal morbidities and mortalities. According to World Health Organization (WHO), about 16 million girls aged 15-28 and about one million girls less than 15 years of age give birth every year while about three million girls aged 18- 26 undergo unsafe abortion yearly (WHO 2007). Moreover, about 75 million of the estimated 180-200 million pregnancies that occur annually in the world are unintended and most of these pregnancies occur in students (WHO 2010). On the average 56 million induced abortions occur worldwide each year (Wang, Z. L. & Chou, L. 1999). Regrettably, an estimated 2.2 million unintended pregnancies occur annually among students in sub-Saharan Africa and almost 60 percent of unsafe abortions in Africa are among women aged 18-26 years (United Nations Development Programme 2004). In a study among in-school female youths in eight African countries by Peltzer K, not less than 27.3% of the respondents had experienced sexual debut before age 15. In Nigeria, not less than 60% of the 600,000 induced abortions occurring annually are found among female youths while 250 out of 1000 female students pregnancies end in unsafe abortion (Sigman-Grant, M. (2002).

Reproductive health indices for Nigeria are still staggering in spite of several efforts from governmental and non-governmental agencies. The 2013 Demographic and Health Survey for Nigeria revealed that only 10% of the currently married women were using modern contraceptive methods. This could partly explain the high maternal mortality rate of 576 deaths/100,000 live births recorded in the survey and could be part of the reasons while Nigeria was among the countries that failed to meet the Millennium development goals.

The rapid growth of world population in recent times has received widespread attention especially in Africa where the highest crude-birth rates are found. The present population of Nigeria is between 90 and 100 million persons or perhaps even larger with the annual growth rate of 3.3 percent (Oni, 2006).

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. (Nelson, Tom & Timothy,. 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 Dwger J. C. (2002). 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.

1.2 Statement of the Problem

It have been observed that most in-school female students have been engaged in unsafe sex practices thereby increasing their vulnerability to unwanted pregnancies and unsafe abortion (Osakinle, E.O. 2013). Every year throughout the world, the rate of unplanned pregnancies amongst students continues to increase due to lack of use of contraceptives.

Lack of awareness and knowledge on the availability and use of contraceptives is associated with the failure of their utilisation (MacPhail et al. 2007). The high rate of unplanned pregnancies caused multiple challenges for academic institutions across the world and Nigeria inclusive.

In a context where maternal and infant mortality rates are high, poverty is rampant, and malnutrition is common, empowering women with the knowledge and resources to plan their own families is vital. The ability of women to freely determine the timing and number of births may be limited partly due to unmet needs. Willingness to control fertility and ability to access and use contraception must also exist for a change in fertility to occur (Kathryn, 2009).

According to the most recent data available reported by the United Nations in 2011, contraceptive prevalence among women of reproductive age who are married or in a union varies between 3 per cent in Chad and 88 per cent in Norway. Globally, contraceptive prevalence is estimated at 63 per cent and it is some what higher in more developed regions (72 per cent) than in the less developed regions (61 per cent), but in both a high proportion of women of reproductive age who are married or in a union are using contraception. In the majority of the less developed regions contraceptive prevalence is 50 per cent or more. The major exceptions are sub-Saharan Africa, Melanesia, Micronesia and Polynesia, where the estimated levels of contraceptive prevalence are still below 40 per cent. As a region, sub-Saharan Africa has the lowest level of contraceptive prevalence, with only 22 per cent of women of reproductive age who are married or in a union using some method of contraception. Over half of the 48 countries in sub-Saharan Africa with data available have a level of contraceptive prevalence below 20 per cent (United Nations, 2011).

In Nigeria, the total fertility rate has been consistently high and stands at 5.4 children per woman (URT, 2010). Contraceptive Prevalence Rate stands at 29% among all women of 15-49 years old and 34% of married women age 15-49 years with 27% using modern methods (URT, 2010). However, little is known about the attitude of women in using modern contraceptives in Nigeria. This is why this study was done to fill the gap

1.3 Objectives of the Study

The general aim of this study is to evaluate the health concerns and attitude of women towards utilization of modern contraceptive. To achieve this, the following specific objectives emerged;

Determine the extent of contraceptive use amongst women in Yaba LGA of Lagos state
Examine the level of knowledge about contraceptives available to women in Yaba LGA of Lagos state
Investigate the ways in which prevailing level of knowledge about contraceptives affect its use among women in Yaba LGA of Lagos state
Determine the socio-cultural factors influencing contraceptive use among women in Yaba LGA of Lagos state
Examine the consequences of the current level of contraceptive use among women in Yaba LGA of Lagos state of River State
Determine how the safe reproductive health and contraceptive use among women in Yaba LGA of Lagos state of River State be enhanced

1.4 Research Questions

The following research questions were put forward to guide the study;

What is the extent of contraceptive use amongst women in Yaba LGA of Lagos state?
What is the level of knowledge about contraceptives available to women in Yaba LGA of Lagos state?
In what ways do prevailing level of knowledge about contraceptives affect its use among women in Yaba LGA of Lagos state?
What are the socio-cultural factors influencing contraceptive use among women in Yaba LGA of Lagos state?
What are the consequences of the current level of contraceptive use among women in Yaba LGA of Lagos state of River State?
In what ways could safe reproductive health and contraceptive use among women in Yaba LGA of Lagos state of River State be enhanced?

1.5 Significance of the Study

The result of this study will be beneficial to:

The health educators in planning awareness program for the client, thereby creating enlighten to the client in making decision that are related to family planning methods.
Findings of this study will enable the client to benefit from the awareness programs that are provided by the health educators in areas that are related to utilization of contraceptive.
Findings of this study will sensitize the policy makers in creating policies that would support family planning practices.
Findings of this study will help tremendously in reducing mortality and morbidity through the awareness program on issues or family planning and unwanted pregnancies.
Findings of this study would contribute to the body of knowledge for Researchers and other educational purposes.

This study will provide useful information that would help policy makers to revamp family planning services for in-school students in Nigeria. Theoretically, this study will assist the students in understanding the extent and consequences of ineffective use of contraceptives.
Practically, the data generated from the study will be used by future researchers to explore other ways of reducing unwanted pregnancy, maternal mortality and morbidity and sexually transmitted diseases. The knowledge that will be obtained from this study is intended to create public awareness on the importance and proper use of contraceptive method. However, feasible policy strategies that are going to enhance or address students sexual and reproductive health are likely to emanate from the study and will aid the young people and society at large, on the use of effective family planning methods.

1.6 Scope of the Study

The scope of this study is on evaluation of health concerns and attitude of women towards utilization of modern contraceptive, specifically focused on the “attitude of women towards the utilization of modern contraceptive in Nigeria” of reproductive age 15-49, and was carried out in Lagos State, Nigeria..

1.7 Limitation of Study

Financial constraint: Insufficient funds tend to impede the efficiency of the researcher in sourcing the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint: The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted to research work.

1.8 Definition of Terms

Contraception:

It refers to artificial methods/techniques for prevent pregnancy through temporal or permanent means. Pernoll (1994) stated that contraception is practiced for many reasons, such as pregnancy planning, limiting the number of children, avoiding medical risks of pregnancy and controlling of world population.

Contraceptive Methods:

It refers to artificial device use for prevention of individual from both pregnancy and HIV/STIs.

Unsafe Sex:

This is the practice of sexual activities that carry a higher risk of negative consequences. In this work, it is activities that involve exchange or contact with semen, vaginal fluids, penile or vaginal discharges, or bloods at high risk.

1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusions and Recommendations

5.1 Introduction

This chapter summarizes the findings into the evaluation of health concerns and attitude of women towards utilization of modern contraceptive using Lagos State as case study. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was the evaluation of health concerns and attitude of women towards utilization of modern contraceptive using Lagos State as case study. The study specifically was aimed at determining the extent of contraceptive use amongst women in Yaba LGA of Lagos state, examine the level of knowledge about contraceptives available to women in Yaba LGA of Lagos state, investigate the ways in which prevailing level of knowledge about contraceptives affect its use among women in Yaba LGA of Lagos state, determine the socio-cultural factors influencing contraceptive use among women in Yaba LGA of Lagos state, examine the consequences of the current level of contraceptive use among women in Yaba LGA of Lagos state and determine how the safe reproductive health and contraceptive use among women in Yaba LGA of Lagos state be enhanced.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 433 responses were validated from the enrolled participants where all respondent are active students of the selected institution.

5.3 Conclusions

This study has confirmed that use of contraceptives by women in Yaba Local Government Area is stimulated, shaped or predicated upon level of knowledge possessed on the subject by the women and socio-cultural norms of the area. Knowledge about contraceptives is not widespread in the area among adolescents. There is also poor knowledge of benefits, the patriarchal social system and poverty, all of which were found to have tremendous influences on contraceptive use in the area. Parents’ denial of sex education to adolescents has done more harm to the adolescents and the society at large.

There is immense need for inculcation of sound morals, proper orientation of adolescents about sex, provision of counseling services and contraceptive education to them. This is with a view to ensure that reproductive health behaviour of the adolescents and their contraceptive use culture can be positively influenced..

5.4 Recommendation

The following recommendations are based on the findings of this study,

Family life education should be introduced in families and religious groups for younger children. Such programs help adolescents develop the skills to make informed decisions about engaging in sexual intercourse and contraceptive use.
Parents should educate their daughters at home on safe sex and contraceptive use. Such education is to counter false information and fantasies created around sexual intercourse by friends and peers at school.
The media should regularly educate adolescents through programs and advertisements which promote knowledge and use of contraceptives.
Adolescents should be accorded basic reproductive health service irrespective of their age and marital status. Their tender age should place them on priority list for accessing health care and family planning information as a right.
The government, non-governmental organizations (NGOs) and private sector should provide social support like bursary and unemployment stipend to adolescents in and out of school. This will reduce the harsh effects of poverty on them and the tendency to indulge in sex to make money.
The federal government should also enforce the policy on girl-child education to a certain level before marriage so as to empower them.