TABLE OF CONTENTS
ABSTRACT. ii
TABLE OF CONTENTS……………………………………………………….iii
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study. 1
1.2 Statement of the Problem.. 3
1.3 Objectives of the Study. 4
1.4 Research Questions. 5
1.5 Research Hypothesis. 5
1.6 Significance of the Study. 6
1.7 Scope of the Study. 6
1.8 Limitations of the Study. 7
1.9 Organization of the Study. 7
1.10 Definition of Terms. 8
CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1 Introduction. 11
2.2 Theoretical Review.. 11
2.2.1 Health Belief Model (HBM) Theory. 11
2.2.2 Social Cognitive Theory (SCT) 12
2.2.3. Theory of Planned Behavior (TPB) 12
2.2.4 Ecological Model of Health Promotion. 12
2.3 Conceptual Review.. 13
2.3.1 Overview.. 13
2.3.2 Health Education Initiatives. 13
2.3.3 Family Planning Services Overview.. 13
2.3.4 Community Engagement 14
2.3.5 Challenges in Service Delivery. 14
2.3.6 Socio-Cultural Factors. 14
2.3.7 Government and Policy Support 15
2.3.8 Integration of Services. 15
2.3.9 Educational Campaigns and Media. 16
2.3.10 Impact on Health Outcomes. 16
2.4 Empirical Review.. 16
2.5 Summary of Literature Review.. 19
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction. 20
3.2 Research Design. 20
3.3 Study Area. 21
3.4 Population of the Study. 21
3.5 Sample Size Determination. 22
3.6 Sampling Technique. 22
3.7 Data Collection Instruments. 23
3.8 Validity of the Instruments. 23
3.9 Reliability of the Instruments. 24
3.10 Procedure for Data Collection. 24
3.11 Method of Data Analysis. 25
3.12 Ethical Considerations. 25
3.13 Conclusion. 26
CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
4.1 Preamble. 27
4.2 Socio-Demographic Characteristics of Respondents. 27
4.3 Analysis of the Respondents’ Views on Research Question one: 32
4.4 Testing Hypothesis. 43
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
5.1 Summary of Findings. 47
5.2 Conclusion. 48
5.3 Recommendations. 49
REFERENCES. 52
APPENDICES. 58
Appendix I: Research Questionnaire: Health Education and Family Planning Services in Calabar Municipality, Cross River State. 58
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
The World Health Organization (WHO) estimates that one in every six individuals worldwide is an adolescent, defined as those aged 10 to 19. With over 1.3 billion adolescents alive now, we are seeing the greatest adolescent population in history (WHO, 2024). Notably, around 85% of these young people, or four out of every five, live in underdeveloped nations. Furthermore, over half of the global population is under the age of 25 (Mahamed et al., 2012).
Nigeria, being one of the largest and most rapidly growing economies in Africa, appears to be experiencing a surge in its youth population –specifically, the “youth bulge.” Mainly, 43% of the country’s population is under 14 years and 33% between ages 15 and 24. This trend is projected to remain consistent until around 2050 (UNDESA, 2022). This high population growth rate is alarming as it presents obstacles to growth and in turns the socio-economic development, given that it places severe stress on resources, infrastructure and society. planning thus becomes a vital strategy in managing this population growth.
Family planning is an evidence-based practice to achieve Sustainable Development Goals (SDGs) targets which advocate universal access to sexual and reproductive health services and reproductive rights (Dwomoh et al., 2022). Family planning services are essential to improve reproductive health and manage population growth. They enable populations to access contraceptives, support them in reproductive health, and inform them about different family planning options (Umo et al., 2021). Effective family planning has been shown to significantly reduce maternal and neonatal mortality rates and promote women’s economic empowerment (Eze et al., 2020). To achieve these advantages, family planning services must be incorporated into regional health initiatives.
Even while the number of people using contraceptives has increased over time, there is still a significant knowledge and implementation gap. Religious convictions, worries about adverse effects, and—above all—a lack of awareness and education about family planning techniques are some of the causes of this disparity.
Health education is extremely important because it provides people with the essential information and skills they need to make informed health decisions. According to Akinyele et al. (2023), health education initiatives aim to increase public knowledge on various health-related topics, such as nutrition, preventive health measures, and communicable diseases. These initiatives help communities adopt healthier lifestyles and reduce the prevalence of preventable diseases by improving health education (Ogu et al., 2022). Therefore, health education can be a very effective strategy to encourage couples to use family planning services more often (Ajmal et al., 2011; Golbasi et al., 2012; Cadmus and Owoaje, 2009; Nishtar et al., 2013).
Notwithstanding the advantages, little research has been done to examine how well these educational initiatives have improved the uptake of family planning (Akinyele et al., 2023). Therefore, it is crucial to comprehend the connection between health education and the adoption of family planning services in order to improve reproductive health outcomes in Calabar municipality and make sure that these services are accessible to those who need them the most.
1.2 Statement of the Problem
Experts believe that individuals with accurate knowledge that goes beyond knowing a few contraceptive methods, such as knowledge of fertility, benefits, and contraceptive side effects, are more likely to use and less likely to discontinue using family planning to fulfill their fertility intentions necessitating family planning educational intervention so that couples satisfy their need for fertility and desirable practice (Olusegun, 2022; Gayathry et al., 2018; Semachew Kasa et al., 2018)
Although women use family planning, some have little or no information about family planning. Some women had a negative attitude toward family planning, while others had heard of false and misleading information (Kasa et al., 2018)
According to a study conducted to determine the effectiveness of an educational program in increasing women’s knowledge and awareness of contraceptive methods in Egypt, the mean scores of women’s knowledge of family planning methods showed an improvement in the posttest score compared to the pre-test (Sayied & Ahmed, 2017).
Another quasi-experimental study on the knowledge of family planning methods among married women in Khartoum showed that the post-intervention knowledge score increased from 84.7% to 40.1% (Sagiron, 2022).
A study among university students in Turkey revealed that students’ knowledge of FP improved after attending health education sessions. The study also highlighted that health education on FP can significantly change students’ behaviour regarding contraceptives (Golbasi, Tugut, & Erenel, 2012). In Nigeria, health education enhanced female students’ knowledge and use of contraceptives Cadmus & Owoaje, 2009).
Despite the critical need for family planning awareness, there is a significant lack of research in Calabar Municipality regarding the effectiveness of health education on family planning services.
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1.3 Objectives of the Study
The main objective of the study is to examine Health Education and Family planning services in Calabar municipality of cross river state. Specific objectives of the study are:
- Assess the level of knowledge and awareness of health education and family planning services among residents in Calabar Municipality.
- Evaluate the accessibility and availability of health education and family planning services in Calabar Municipality.
- Examine the effectiveness of health education and family planning programs in Calabar Municipality.
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- What is the level of awareness of health education and family planning services among residents in Calabar Municipality?
- Are health education and family planning services adequately accessible and available to residents in Calabar Municipality, especially those in marginalized communities?
- What are the key factors influencing the effectiveness of health education and family planning programs in Calabar Municipality?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: Health education programs have no significant effect on the utilization of family planning services in Calabar Municipality, Cross River State.
1.6 Significance of the Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the Social Works sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analysed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organisations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of the Study
The study is delimited to Calabar Municipality, Cross River State, Nigeria. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of the Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of the Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
1.10 Definition of Terms
1. Health Education
Health Education refers to the process of imparting knowledge and skills to individuals and communities to promote healthy lifestyles, prevent diseases, and improve overall well-being. In Calabar Municipality, it involves programs and activities designed to educate residents about health issues such as nutrition, hygiene, disease prevention, and healthy living practices.
2. Family Planning
Family Planning encompasses a range of practices and services that enable individuals and couples to control the number and timing of their children. This includes the use of contraceptives, reproductive health counseling, and education to help people make informed decisions about their reproductive health. In Calabar Municipality, family planning services aim to provide access to contraceptives and guidance to support responsible family planning choices.
3. Contraceptive Methods
Contraceptive Methods are various tools and techniques used to prevent pregnancy. These include hormonal methods (like pills and injections), barrier methods (such as condoms), intrauterine devices (IUDs), and permanent solutions (like sterilization). In Calabar Municipality, providing access to a range of contraceptive methods is crucial for effective family planning.
4. Reproductive Health Services
Reproductive Health Services encompass a broad spectrum of medical and educational services related to sexual and reproductive health. These services include prenatal and postnatal care, family planning, screening for sexually transmitted infections (STIs), and education on sexual health. In Calabar Municipality, these services are essential for supporting the health and well-being of individuals and families.
5. Awareness Campaigns
Awareness Campaigns are organized efforts to increase public knowledge and understanding of specific health issues or services. In the context of Calabar Municipality, these campaigns might focus on promoting the benefits of family planning, educating the community about sexually transmitted infections, or encouraging healthy lifestyle choices.
6. Maternal Health
Maternal Health refers to the health care and services provided to women during pregnancy, childbirth, and the postpartum period. In Calabar Municipality, improving maternal health involves ensuring that pregnant women receive appropriate medical care, nutrition, and support to reduce the risk of complications and enhance overall maternal and infant health outcomes.
7. Community Health Workers (CHWs)
Community Health Workers are trained individuals who provide essential health services and education within their communities. They act as a bridge between healthcare providers and the community, offering support in areas such as family planning, disease prevention, and health education. In Calabar Municipality, CHWs play a vital role in delivering health education and family planning services directly to residents.
