CHAPTER ONE
1.1 Background of the Study
The escalating population growth has sparked concerns about its impact on humans. Currently, the world’s population is approximately eight billion people, with a high likelihood of further increase (Population Reference Bureau, 2015). Most of this growth is taking place in developing nations, where fertility rates are still relatively high, despite the fact that millions of women express a desire for smaller families (Sippel et al., 2011). In response, family planning has become a critical element of a global strategy to curb population growth.
The concept of family planning refers to the ability of couples and individuals to control and achieve their desired number of children by controlling the timing and spacing of their births. This can be divided into two main types: natural and artificial methods. The natural methods include safe period, abstinence, coitus interruptus, and lactational amenorrhea. Common artificial methods include injectables, pills, condoms, and Intra Uterine Contraceptive Devices (IUCD) (World Health Organization (WHO), 2020).
The provision of family planning has benefits beyond limiting family size. It also protects individual health and rights, and enhances the quality of life for couples and their children. Family planning is a crucial strategy for promoting maternal and child health (Umbeli et al., 2005; Omolase et al., 2009). Adequate spacing of births and avoiding pregnancy at high-risk maternal ages and parities are among the benefits of family planning, which can improve health. The most crucial factor that affects fertility is the utilization of family planning methods. In places where contraceptive use is widespread, fertility rates tend to be low. Rajaretnam, as cited in Omolase et al. (2019), has illustrated that even if individual couples do not reduce their family size, delaying childbearing can decrease fertility and the population growth rate.
The regulation of human reproduction is not a new practice, as individuals have employed various traditional methods throughout history, such as prolonged lactation, periodic abstinence, barrier methods, the withdrawal technique, and self-induced abortions, to control fertility, with varying degrees of effectiveness and risks to maternal health (Potts and Campbell, 2009). The advancement in scientific knowledge and technology has transformed the methods of regulating human reproduction, leading to safe and effective contraceptive options that enhance the well-being of mothers and infants (Mansour et al., 2010; Mafiayai et al., 2014)
However, despite the availability of modern contraceptive methods, more than 200 million women of reproductive age in developing nations who wish to prevent pregnancy do not use them due to various reasons (WHO, 2020; Pack et al., 2014). The reason for this is a variety of factors such as limited options for contraception, restricted access to contraception, particularly among young individuals, those living in poverty, or unmarried individuals, fear of or negative past experiences with side-effects, opposition based on cultural or religious beliefs, insufficient quality of available services, preconceived notions or preferences of both users and providers, and barriers based on gender. (WHO, 2020).
Worldwide, out of the 1.9 billion women worldwide who fall under the reproductive age group (15-49 years) in 2019, approximately 1.1 billion women require access to family planning. Among this group, 842 million women (44%) utilize artificial methods of contraception, while 80 million use traditional family planning methods, and 190 million women (10%) lack access to any form of contraception, as per the United Nations Population Division (2019) report. In Nigeria, the prevalence of contraceptive use among women was 17% in 2018, with a higher usage rate among sexually active single women at 28% compared to currently married women at 12%. Despite the fact that currently married women may have more sexual exposure, the overall contraceptive use has only increased marginally from 15% in 2013 to 17% in 2018, while the use of any modern method of contraception also slightly increased from 10 to 12%. Additionally, there has been a slight increase in the usage of implants since 2008, from barriers 0% to 3%. (National Population Commission- NPC/Nigeria and ICF, 2019).
Although Nigeria has implemented policies and initiatives to increase the use of contraceptives, the rate of uptake remains low (Apanga and Adam, 2015). The Nigerian government provides family planning commodities at no cost, but the end-users face bureaucratic barriers and an inefficient supply chain, particularly at the state and local government levels, which affects access. Additionally, various consumer-level factors also impact family planning uptake.
The year 2021 marked the launch of Nigeria's family planning 2030 commitments, which aimed to provide quality family planning to all at a reasonable cost. The objective is to increase the current contraceptive prevalence rate (CPR) of 12% to a minimum of 27% by 2030. This increase is to be achieved through evidence-based practices that align with personal preferences and family requirements (Apanga and Adam, 2015; Uthman et al., 2022).
In spite of the government's and various development partners' initiatives and policies, the adoption of contemporary family planning techniques has remained low. According to a national survey conducted in 2018, only 10.5% of women who are of childbearing age use current family planning methods (Amuka et al., 2021). Earlier research on this topic in Nasarawa State indicated contraceptive utilization of 32.6% among women in 2014 and 22.7% in a more recent (2020) study, respectively (Ogbe et al., 2014; OlaOlorun et al., 2020).
Therefore, this study seeks to understand the perception of women of child bearing age towards family planning in Nasarawa state.
1.2 Statement of the Problem
Nigeria is experiencing a speedy surge in its population, with present approximations exceeding 200 million, of which approximately 46 million comprise women of childbearing age (WRA). Given Nigeria's total fertility rate (TFR) of 5.3, its population is anticipated to climb to 401 million by 2050, placing it as the fourth most heavily populated nation in the world. The low level of adoption of family planning is a major contributor to Nigeria's fertility pattern and population growth rate. Despite numerous efforts over the past few decades, the current prevalence rate of modern contraceptives (mCPR) is a mere 12% (Federal Ministry of Health, 2020).
To the best of the researcher’s knowledge, no research has been conducted in Nasarawa state that investigates women's attitudes and beliefs about family planning. This study, therefore, aimed to delve into the perspectives of women of reproductive age regarding family planning in Nasarawa state. The findings of this research will offer valuable insights to researchers, policymakers, and reproductive health program developers, which can aid in developing effective strategies to meet the unfulfilled demand and boost the adoption of family planning methods.
1.3 Aim of the Study
The study aims to investigate the perception of women of child bearing age towards family planning in Nasarawa state.
1.4 Objectives of the Study
The study had the following specific objectives:
- To determine the perceptions of women of child bearing age on the use of family planning methods in Nasarawa state.
- To understand the barriers that prevent women of child bearing age in Nasarawa state from accessing family planning services.
- To explore effective strategies for promoting positive perceptions towards family planning among women of child bearing age in Nasarawa state.
1.5 Research Questions
- What are the perceptions of women of child bearing age on the use of family planning methods in Nasarawa state?
- What are the factors that prevent women of child bearing age in Nasarawa state from accessing family planning services?
- What are the effective strategies for promoting positive perceptions towards family planning among women of child bearing age in Nasarawa state?
1.6 Research Hypothesis
H0: There is no statistically significant difference in the perceptions of women of child bearing age towards family planning in Nasarawa state.
Ha: There is a statistically significant difference in the perceptions of women of child bearing age towards family planning in Nasarawa state.
1.7 Justification of the Study
The findings of this study will help to understand the perceptions that women of child bearing age have towards family planning methods. This knowledge can be used by health care providers, government, and other stake holders to develop effective strategies to promote family planning and increase contraceptive use.
Moreso, by identifying factors that prevent women from accessing family planning services, targeted interventions that address these factors and improve access to services, can be developed. Overall, the study will provide valuable insights into how best to promote positive perceptions towards family planning as well as serve as a borderline for future research.
1.8 Scope of the Study
The study focuses on investigating the perceptions of women of child bearing age towards family planning in Nasarawa. Data for The study will be obtained from two selected local government areas in Nasarawa state.
