FACTORS MITIGATING AGAINST FAMILY PLANNING AMONGST WOMEN IN RURAL COMMUNITIES A CASE STUDY OF OBIBE EZENA COMMUNITY, OWERRI, NORTH, IMO STATE
1.1 Background to Study
Family planning is one of the most ―health-promoting‖ and cost-effective activities in public health promotion and has the potential to avert approximately 30% of maternal and 10% of child deaths.1 Thus, FP contributes to achieving the Millennium Development Goals (MDGs) through healthier birth spacing and by reducing mortality and morbidity associated with pregnancy.2 Decades of research and investment in family planning programmes have resulted in dramatically improved programme coverage and biomedical technologies as well as significant (although uneven) increases in contraceptive uptake throughout most of the developing world.3 Contraceptive options—not all of which are available in many developing countries—include a variety of hormonal regimens and modes of delivery for women (e.g., pills, injectables, implants, patches, vaginal rings, medicated intrauterine devices) as well as improved male and female condoms, spermicides, cervical caps and other vaginal barriers, post-coital (emergency) contraception, improved fertility awareness-based methods, and simpler and more effective surgical techniques for tubal ligations and vasectomies.
Nevertheless, Demographic and Health Surveys (DHS) reveal that in many countries- including some with quite high rates of contraceptive prevalence -40% or more of women who recently gave birth reported that the pregnancy was wanted later or not at all.5 Proportions of married women with an unmet need for contraception also range up to 30 to 40% or more in a number of countries.6 Both of these situations reflect, to variable degrees, programme- and method-related inadequacies, including contraceptive failures due to a variety of reasons, as well as personal and situational factors such as partner’s opposition or women’s experiences or fears of side-effects that need to be addressed.7 Contraceptive information, needs and motivations evolve through the life course as male and female adolescents become sexually active before marriage or cohabitation (perhaps with several partners) or at the time of their marriage, and as couples decide if and when to begin childbearing (if they have not already accidentally done so); accumulate experiences with contraception (or its absence) and with pregnancy and childbearing; think about spacing and stopping; and are potentially faced with 10 or 20 more reproductive years at risk.
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