Factor That Influence The Choice Of Contraceptive Methods By Women Of Child Bearing Age Attending Family Planning Clinic

Factor That Influence The Choice Of Contraceptive Methods By Women Of Child Bearing Age Attending Family Planning Clinic

Abstract

This study was carried out to examine the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic using primary healthcare in Owerri North Local Government of Imo State as a case study. The study was carried out to find out to determine the modern methods of contraception used in Nigeria, determine the socioeconomic factors which influences the choice of contraceptive methods by women of child bearing age attending family planning clinic, and determine the healthcare factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of women of child bearing age attending family planning at primary healthcare in Owerri North Local Government of Imo State. In determining the sample size, the researcher conveniently selected 41 respondents and 35 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using mean scores. While the hypotheses were tested using chi-square statistical tool. The result of the findings reveals that the modern methods of contraception used in Nigeria includes: male and female condoms, oral pills, injectable contraceptives, intrauterine contraceptive device (IUCD), implants. The study also revealed that the socioeconomic factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic includes: education level, religion, cultural norms, income level, and number of children. Therefore, it is recommended that the Ministry of Health should encourage the uptake of contraceptives at household level by enhancing continuous promotion of family planning services. This could be realized by supporting family planning outreach activities by the health workers. This is expected to contribute positively towards enhancing awareness of family planning services and the benefits and side effects. To mention but a few.

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
• 4.5 Findings

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

The choice of contraception by a woman of reproductive age has been considered as a human rights issue (UNFPA, 2002). Women of reproductive age therefore have a right to access safe, effective, affordable, and acceptable methods of contraception. The gains made in including reproductive health issues as an essential component of human rights was largely the result of the International Conference on Population and Development (ICPD UN, 2000).

It is universally accepted that contraceptives would reduce maternal and infant mortality (MoH, 2007). Moreover, the fifth millennium development goal aims at reducing the maternal mortality rate by two thirds by the year 2015 (UN, 2000). It is estimated that maternal mortality rates range from 300 to 800 per 100,000 live births in developing countries (WHO, 2000). In Nigeria, maternal mortality rate stands at 512 deaths per 100,000 live births, which is nowhere near the SDGs target of 70 per 100,000 live births.(NDHS, 2018). Despite reproductive health being an important issue, low use of contraceptives has been observed among women of reproductive age in Nigeria, especially poor women.

Low contraceptive use accounts for 45% of all reproductive health needs (APHR, 2021). It has been estimated that if contraceptives were more widely available, up to 42% of maternal deaths could be averted. In an effort to improve the level of access to appropriate contraceptives the government of Nigeria has invested in information, education and counselling (lEe) on contraceptives as a major strategy in the intervention (MoH, 2007). The efforts by the Government of Nigeria notwithstanding, there still remain great variations in the use of the various contraceptives.

The uptake of choices of contraception may greatly vary with such characteristics as age, income, users’ desires to prevent or delay pregnancy and culture. Methods that depend on consistent and correct use have a wide range of effectiveness. However, most women tend to be more effective users as they become more experienced with a contraceptive method (WHO, 2007).

1.2 Statement of the Problem

Family planning allows individuals and couples to achieve their desired number of children and determine the spacing of pregnancies through the use of contraceptives and infertility treatment (WHO, 2021). Increased access to contraceptives is key in improving maternal health outcomes. Therefore, contraception is an excellent method for reducing maternal mortality and morbidity (Adeyemi, and Adekanle, 2009). Despite the benefits of contraception, women of reproductive age in Nigeria still have a limited range of methods to choose from and this has forestalled the ability to meet the reproductive health rights of women (NPC, 2013). Nigeria remains as one of the most populous countries in the Sub-Saharan Africa with a high total fertility rate of 5.5-5.7 for women of reproductive age (15–49 years). Meanwhile, 16% of the women in the country reported of unmet need for family planning service (NPC, 2013). A low rate of contraceptive use (17%) has also been recorded among married women (aged 15 to 49 years) in Nigeria. In addition, only 12% of women were reported to use modern contraceptive methods (NPC, 2018).

As in other parts of the world, the modern methods of contraception used in Nigeria include male and female condoms, oral pills, injectable contraceptives, intrauterine contraceptive device (IUCD), implants and male and female sterilization methods (Ijarotimi, 2015). However, the preferred method of contraception may vary depending on the level of the healthcare facility, education level, geopolitical zone and place of residence (Babalola, 2015) Healthcare facilities in Nigeria are still not able to offer all types of contraceptives, which implies that clients have a limited range to choose from. This in turn decreases the likelihood for individuals to choose the method they truly desire (Ibisomi, 2014). Previous studies reported that choosing the method of contraception relies on availability, affordability and accessibility of the methods as well as couples’ education level, traditions, religion, culture, health status, number of children and socio-economic status (Lamina, et al. 2015). In Nigeria, women’s choice of contraceptives is hindered by traditional and cultural beliefs (Akinyemi, 2018). A study conducted in the Niger Republic also stated that cultural norms directly impact contraceptive choice among women (Kouabean, 2016).

Given the significant effect of method of contraception on fertility and national health, this study seek to examine the examine the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic.

1.3 Objectives of the Study

The main objective of this study is to investigate the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic.

Other specific objectives are to:

1. Determine the modern methods of contraception used in Nigeria.
2. Determine the socioeconomic factors which influences the choice of contraceptive methods by women of child bearing age attending family planning clinic.
3. Determine the healthcare factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic.

1.4 Research Questions

The research will seek to answer the following questions:

1. What are the modern methods of contraception used in Nigeria?
   1. Male and female condoms,
   2. Oral pills,
   3. Injectable contraceptives,
   4. Intrauterine contraceptive device (IUCD),
   5. Implants
2. What are the socioeconomic factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic?
   1. Education level,
   2. Religion,
   3. Cultural norms,
   4. Income level,
   5. Number of children
3. What are the healthcare factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic?
   1. Availability of contraceptive methods,
   2. Affordability of contraceptive method,
   3. Accessibility to of healthcare services,
   4. Knowledge of healthcare workers.
   5. Health workers friendliness when offering contraceptive method health education and counselling

1.5 Research Hypotheses

• Ho: There are no significant factors influencing the choice of contraceptive methods by women of child bearing age attending family planning clinic.
• Ha: There are significant factors which influencing the choice of contraceptive methods by women of child bearing age attending family planning clinic.

1.6 Significance of the Study

The findings of this study will assist program managers to formulate effective strategies towards addressing the problem of family planning non-users and help to develop programs aimed at meeting the demand of family planning through the provisions of appropriate method mix to meet the need of current users depending on their characteristics.

The findings and recommendations of this study will help to design messages on family planning targeting the rural community. The findings will also serve to enrich the literature especially on the positive influence of service providers in FP uptake and issues of contraceptive preference and choice. The study is therefore expected to form a basis for further research in the area in relation to other regions in the country.

1.7 Scope of the Study

This study focuses on the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic. The study will be delimited to some primary healthcare in Owerri North Local Government of Imo State.

1.8 Limitations of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

1.9 Definition of Terms

Contraceptive Prevalence:

This is the proportions of WRA or their partners who are using a contraceptive method at a given point in time.

Contraceptive Method Choice:

Choice among an array of contraceptives methods including the option of not using any method (Entwisle, 2008).

Family Planning:

A reproductive strategy that individual and/or couples employ to meet their reproductive goals and to prevent unwanted pregnancies.

Unmet Family Planning:

Percentage of women who do not want to get pregnant but are not using any method of modern family planning. They want to wait two or more years for their next birth.

Women of Reproductive Age (WRA):

This is an indicator of reproductive health. Refers to women aged 15- 49 years; they are women of child bearing age.

1.10 Organization of the Studies

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic using primary healthcare in Owerri North Local Government of Imo State as a 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 to examine the factor that influence the choice of contraceptive methods by women of child bearing age attending family planning clinic using primary healthcare in Owerri North Local Government of Imo State as a case study. The study was specifically carried out to determine the modern methods of contraception used in Nigeria, determine the socioeconomic factors which influences the choice of contraceptive methods by women of child bearing age attending family planning clinic, and determine the healthcare factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 35 responses were validated from the enrolled participants where all respondent were women of child bearing age attending family planning at primary healthcare in Owerri North Local Government of Imo State.

5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

1. The modern methods of contraception used in Nigeria includes: male and female condoms, oral pills, injectable contraceptives, intrauterine contraceptive device (IUCD), implants.
2. The socioeconomic factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic includes: education level, religion, cultural norms, income level, and number of children.
3. The healthcare factors which influence the choice of contraceptive methods by women of child bearing age attending family planning clinic Includes: availability of contraceptive methods, affordability of contraceptive method, accessibility to of healthcare services, knowledge of healthcare workers, and health workers friendliness when offering contraceptive method health education and counselling.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

1. The government through the Ministry of Health should revive and support family planning education at both household and community level that targets the women of reproductive age This could be undertaken through print and other mass media.
2. The Ministry of Health should encourage the uptake of contraceptives at household level by enhancing continuous promotion of family planning services. This could be realized by supporting family planning outreach activities by the health workers. This is expected to contribute positively towards enhancing awareness of family planning services and the benefits and side effects.
3. The Ministry of Health in collaboration with other development partners involved in the provision of family planning services need to enhance large scale training of service providers in quality care, client follow up, communication skills,counselling, referral and feedback and provision of a wide choice of methods. With good customer care, clients who seek contraceptives will have confidence in the staff which in the process will attract more users while at the same time encouraging further usage on those currently using them.
4. Creation of advocacy groups at community level is highly recommended. This will not only articulate the rights of the clients, in this case the woman who seek contraceptives, but will lead to cultural and attitude change towards the services thereby encouraging their uptake. In the end, this is expected to contribute positively towards a reduction in the total fertility rate as well as decline in population growth rate. NGOs, CBOs, and other institutions involved in family planning need to initiate and promote targeting programmes for the uptake of the services in the rural areas.

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