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University of Nigeria Virtual Library

Serial No

Author 1 MBAGWU, Felicia

Author 2

Author 3

Title

Family Planning a Planned or Improved

Innovation

Keywords

Description Family Planning a Planned or Improved

Innovation

Category Education

Publisher

Journal of the National Association of Women Academics (JNAWACS) UNN

Chpater

Publication Date

2003

Signature

nal of National Association of Women Academics UNN Chapter

Edited by

\

Professor Uchenna Nzewi

m "" BEL'S BOOKS

LIST 0 1 : ClONTRIBUTORS

I'rofessor Nene Ogugua Obiayo, "Women and Health"

Nkechi Mbancfo, "Women arid Research Priorities"

Professor M. Ikejiani-Clark, "Women and Governance in Nigeria

Iyabo Fcigbolu, "Wonien arid Na tional DevcIopmen t"

Dr. Velonica I. Okckc (Mrs.), "IZolc Strain and Conflict Iniplications for t l l r 1 Icaltli of Working Women"

Stella Chionla Nwim, "Education for Skill Acquisition: A Concept~lal Motlrl For Young Women"

J. 0. R. Uju, "Women's Iiiglits Violation: Aspects of Violence by State Agents"

Dr. Christy Onwurah (Mrs.), "Women anci Administrative Positions in Ed~~cntional Institutions: Problems and Prospects"

Mrs. Antlionia Ogo Uzuegbunnni, "Women and Management of Menopause Crisi.;: Igbo Womcn Exaliiple in Nigeria

Mrs. Chiano Igbodi, "Female Gcnital Mtltilation"

Mrs. F. 0. Mbagwu, "Family Planning, a I'lanncd or Ilnposcd Innovat io~~"

1'. 0. Ubacliukwu, "Fcmalcs, thc Endanga-cd Group in I lIV/AIDS Panclcmic"

Dr. Elsie C. Umcano, "Mccling the Professional Demands, Fulfilling the socio- Cultural Expectations and Satisfying the Lcismc needs: Psychological I-icaltli Implications for the Married Igbo Worncn Acadeniics in University of Nigeria, Nsukka"

F. N. Ibcmcsi, "7'hc C;rctclicn-Tragedy in Gocthc's Faust: A Fcmininc I'erspc~clivc"

Dr. E. A. Ogbonna-Ohuche, "Oratory: An Effective Weapon for tlic Fulfillment of Nigerian Worncn's Political Ambition"

Dr. (Mrs.) C. I. Orch, "The Influence of some faniily and Socio-cultural Motivational Factors - on -- Womcn Academics Carccr Progress"

M. N. Agu, "Computer Literacy: An Aid to Wonien in Academics"

Dr. Koselinc Onah, "Efft>ctive Delegation: A tool for Enhancing the I'crformance of Women in Authority"

M. N. Awachie, "Transmission of I IIV/AIDS to Women and Children: Methods o f Preven tion"

Dr. C. L. Ngoncbu, "Thc Linguistic Implication of the Access of Womcn to Science And Technology courses in Nigcrian Universitics"

9 J ~ ~ I ~ I I ; I ~ ti1'1l1c Nnt~oi~cil Association 01' Wolncn Acxlcn~ics (JNA\VAC'S) LiNN Chapter. Vol. I . NO 1 . 2007

Farniily Planning, a Planned or Imposed Innovation

BY

Mbagwu F. 0. (Mrs.)

Introduction Planning the fiimily is not new. In pre-colonial tjmcts, tlic wcallli, worth and dignity of a typical African man was mcasurcd by tlic numhcr of wives, barns of yalii and herd of sliccp or s o a k lie had. Thcir involvcmcnt in extensive cash crops Iccl them to marry many wives. This was why most men were accorded names like "Ezcji," "(3liaji" and llicir wives wcrc callcci "Oriaku". Most lncn wclr! not privileged hy Wcslcrn cclucation bul rll~>y knew why tlicy practiced and actoptcd m1uraI family planning (abslincwcc) in order not to endangcr thc. lives of tlicir wikv and bab~ l who is hcing breasl-kcd. They L I S I I ~ I I Y resume intimate relationship as soon as the chilcl was of agc and the mother ripe for another pregnancy.

'I'lic issue of population growth did not a r~sc . 1 I ~ c Y . c ~ o ~ c , planning Llic family then was not fc)r population control but mainly for tlie licallh of inotlic~r and child. Wonicn also acloptcyl wli,lt their husbands initiated (abstinence) and i t ncver rcsultcd in any Corm of violence llkc family instabilily, family coiiflict and ctivorce, ~imong ollic~-s.

I h w n t str~ciics h a w slio~vn that in Africa, total fertility rate (TFII) is high in Eastern and Mlcslc~~-n Africa with 6.2% TFIZ, and 17'Y0contrnc~ptivc use. as compared will1 North, Wcstcrn and I'askwi Europe where 27'FIZ is 1.7, 1.5, a n d 1.4, rcyx.ctivcly and coiil~-accptivc use slands a1 68%, 75% and 57%, rcywtivcly (I'RB, World Population Vala Slicct, (1997). In Sub-Saharan Africa, tlie story is the sanic bccausc women start bearing cliildrc~n-ocry early in lifc., as soon as they ale lc3gaIly marricd unlil Iiicnopau.;c sets in. Motherhood is tlic point around wliicli all other 1-71-oblcms of wonicn's history center. Tlic more a woman gels pregnant the more she. is at risk with pregnancy-related ailments wIiicli account for about 600,000 maternal mortality annually from causcs like child birth, abortion, hypertension, pregnancy malnutrition, anaemia, ruptured uterus, Vcsico Vagina Fistula (VVF), nialposition and ninlprcsentation of babies, ccrvical incompetence, prc-cclarnpsin, toxemia, sepsis, among others (UNICEF 1991). Tlicse pregnancy- relaled problcnis can be prevented through adcclualc antenatal hcaltli services. The concern for rural women is very instrilctive as they are seen as the least lileralc and most vulncmblc of the female gender who may wish lo use modern contraceptive devices but must obtain pcrniission from their hushands or mother in-laws. Worse still, their reqwst might reccivc unfavorable response. As Modo (1996) has observed, tlic women who are un-educa~cd and culturally imnicrsccl arc tlie most vulncrablc and so cannot asscrt llicir fundamental liurncin rights wliich

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00 Journal of tllc Na~ion:~l i\:,vrci;~tior~ of' Woriicn Acadc~iiica (JNAWACS) UNN CIi:q)rcr, Vol. I. No 1. 2003

have been eiiiyliasized CIS a critlcal ~ s s u c of concern at tlie Fourth World Conference on Wonien 1,. which the ~ iecd for shared parental rcsponsibilitics planning and making children wa reaffirmed (12eq1ng, 1995). Customary laws and practiccs, as well as colonial and post-colonial indcpcndcnt I(.);islat~on, have focused on women as child-bearers and have also souglit to ' regulate fertility rather than addrcss the entire spcctruni of women reproductive health necds * (ECA, 1997). I

In Afrlca, of ~vhicli Nigeria is inclusive, tlie incidence of maternal mortality is high. Thc lifetlnle risk of death (l ln 23 for Africa as against 1 in 4000 for North America) is due to pregnancy related cause-; (UNO, 1995). Out of 150 million tvomcn who become pregnant each year, al?out 23 million devrlop life-threatening coliiplications; 12.5 million suffer from other scrious diseascs like malaria, t y l h i d fever, anaemia, etc. Mortality and morbidity rates also vary froni country to country. For cxnmple, i t is high in Gabon, Botswana, Libya, Nigeria, among otlicrs and less in Nlger, Algeria, Ethiopia and Chad (UNICEF, 1994). The increase in population is indicative o( 1 higli fertility, whicli is also a contributory factor to matcmal mortality and morbidity. Tl ic~c is \ need to check Ihe present and future burden of higli fertility rate, population growth and malnutrition through the panacea of family planning devices which, in practice, should also involve the men. Almost a11 tlic family planning methods are meant for womcn, for example thc pills (Lo feminal), the injccliblcs (Noristerat, Depo-Provcra), Intra Uterine Device or the loop (IUCD), among others.

Family plaluning has received a lot of criticisni as majority of its nicthods are fraught ivitl~ problems, ~vliicli are dctrinicntal to the uscr's health (Ekweghi, 1989). Some of thcsc problems arc irregular bleeding, ectopic pregnancies, secondary infertility, unwanted pregnancy, sepsis, cervical dysplasia, cervical and uterine cancers, amongst others. The family planning method designcd for ntcn include abstinence, condom and male sterilization. Of these three, the most widcly and fairly used ~nctliod by mcn since the incidence of STD and I-IIV/AlDS is tlic condom, ~vhich attracts about 10% use (UNESCO, 1997). In effect, family planning programme should he assumcd to focus on womcn who arc at risk of all tile known side effects associated ivitli family planning. Although the side effects enumerated above vary froni person to pcrson, it is pertinent to mention that family planning secnis not to yield any dividend in developing countrics like Nigeria ~vliosc current population stands at 120 million (National I'opulation Commission, 2000)

Studics have also revealed that the acceptance of contraceptive use in dcveloped countries is higher than in developing countries and tlie proportion varies from 55% in Asia to 40% in Africa. Contrac-cptivc use in Northern, Eastern and Western Europe is 68%, 75% and 57%, respectively (PIIB, World I'opulation Data Sheet 1997). The most widcly used method, whicli accounts for about one-third contraccptive use worldwide, is female sterilization. The second most common method, which accounts tor about 20% contraceptive use is Intra Uterine Device (IUCD). The pill is the third most commonly used method o! family planning and only about 10% of men use condom.

From the above data, i t is indicative that FAniiIy Planning programme and tlie use of its devices were solely meant for womrn. We can takc the definition of the conccpt 'family planning' as sjgnifying a symbiotic relationship emerging from a legal union of man and jvoman, becorning married as husband and wife, working towards the realization of a particular goal, wliicli includes planning and arranging family birth.

Statement of ProbIent Population explosion secnis to bc a global problem. In 1998, when the Nigeria population was 75 million, the Federal Government of Nigeria formulated a population policy regulating births to four chiidre11 per couple. This policy never took into cognizance men who married more than one wife. It is also worth mentioning that uncontrollable human population growth cannot

0 1 ' Journal of thc Natioiial Associ;ltioll of Woriicn Ac:ldcn~ics (JNAWACS) U N N Cl~nprcr, Vol. I . N o 1 , 2003

cnstire deccnt and better life. Moreover, population policy is not an end but a means to a better life (quality ed~ication, good n~itrition, proper liousing a ~ i d clothing, amongst others.)

F A 0 in 1984 rcportcd that the production of food is on thc dccrcasc to about 15% less agricultural land per head. This had led to population malnutrition, and increased rural-urban drift, which are a common phenomenon in Nigcria today. Several programmes introduced by various government regimes to nllcvintc the ugly economic situation in this co~mlrj7 yielded no dividend. To address this disturbing twnd in tmpulalion crisis, the b i r h of family planning programn~e tlirough primary hcaltli care, has not yielded any satisfactory dividend. A l tho~~gh women bear tlw responsibility of family planning, attitude of many husbands towards tlic programnic may havc posed somc inipcclimcnts tolvards their acceptance of contmccptivc usc.

Tlw problem I l~c~cforc is how to bridge tlic gap Lwtwcen population growth, spncc and pcoplr tlirough family planning methods. Thus, this study sccks to exnminc the altitudes o f womcn (in the conununitics studied) to acccptancc of contraceptive use as n planned or imposed innovation.

Purpose of Stlldy The purpose of this study was to evaluate the attitudcs of women to acccptancc of contraccptivc usc as a planned or imposed innovation. Specifically the ~ L I I ~ ) S ~ S of the sttidy are:

To ascvrtnin tlie clinrnctcristics of tlic womcn who practiced family planning nictliods. To ascertain their lcvcl of ntvarcness to contraceptive use. To find out impcdimcnts to acccptnncc of family planning mcthods. To ascertain the bcnefits of family planning to individuals, Iamilics, communities and society at large.

Methodology Tlic n ~ e a of study is some communities in Nsukkn L.G.A. of Enugu State. Thc rnc.thodology for this study was a cross-sectional survey dcsign. Tlic population consistcd of 1,126 registered i'imily planning clienteles in tlisce health ccmtres at Nsukka, Obukpa, ancl Ib'igwa-A~ii. Stratificd mndom sampling ~ ~ n s ~~t i l ized in obtaining 257 (i.c. 23%) of the total sample size used for thc s t~ idy .

Data Collection, Instrument and Technique Oral interview was used for gatliering information but the major research instrument tvas tlic quc~"ionnnilc devclopcd by tlic rcscnrchcr, ~vl~icl i was vnlicintcd by c.xlm.t\ in Adult I:clucntion/Womcn Studies, rcspcclively. A pilot study carried out to nsccrtnin tlic reliability of tlic instrument using a test-re-test method based on Spearman's Knnk order correlation coefficient s l~owcd a reliability of 0.87. A total ~ ~ u n i b c r oi 257 qucstionnaircs werc administcrccl to the clienteles by hand with the assistance o f two hc,ilth workers in the liealtl~ centers. Thcy also interpreted tlie q~rcstionnairc to the respondents in tlicir dialect.

Methods of Data Analysis In analysing the data collected, the two 11~1nclrcd and fifty-four copics of tlic questionnaire wcrc tallied and responses to tlie research questions obtain through frquency counts ancl pcrccn tagcs.

Presentation of Result and Analysis Research question 1: What are tlic characteristics of womcn in the study area?

02 J o u ~ m I oi'tllc National Associ;ition or' W o ~ n c n Ac;~dcrnics (JNAWACS) U N N Chaptcr, Vol. 1. No 1 , 2003

Table 1 shows tlic characterislics profilc of rcspondenls, ivhich revealed that only females (1001%) seem lo participate rn family planning progl-amnle. Their marital s t ~ t u s revealed that 237 (93.1%) were married women. 186 (73.1%) respondents fell within the agc bracket of 16-37 years while the rest (68) fell within tlic age brackc! o f 37-58 years. Their ecii~c~itional qualification showcd a high level of no school~ng 164 (64.4%), primary education 62 (24.3%); and post primary education sho~ved a total number of 28 (10.8%) respondents. Their distribution by

Table 1. Socio-economic

Comtnunitics E Nsukka Obukpa

Ibagwa-Ani

.

B: -. Nsi~kka --

- O l w k p

Ihnpva-Ani C:

.-

Nwkka

Obukpa

. . ILM~;wJ-AII~

D:

Nsu kkn

O l v k p n

l b a g l - A n i --

E: - Nsukka

O b i l k p

lbagwa-Ani

F : Nsukka

Obukpa

1 l m q ~ A 1 1 i

chnractcristics of Sex

Male Female Male Female Male Fclnale Marital status Single. A~Ixricd Singlc Marricd S i n ~ l c AGE IlISTItII3UTION 37-58 16-36 37-58 16-36 37-58 16-30 EDUCATIONAL QUAI.iFlCA1'IONN No S ~ l ~ o c i l i ~ ~ g Primary Post- l ' r i~n~~rv No Cxhoolin~ l'riniarv Post-l'rimay No Sch~wling I'rimary l'osl-1'. ' x y OC

63 Journal of the Natioi~al Association of Womcn Academics (JNAWACS) UNN Chapter, Vol. 1. No I , 2003

occupation showcd !hat the highest number of respondents was applicants 235 (92.3%), followed by 16 (6.1%) civil servants, and 3 (1.1%) who were students. Their distribution by religion revealed that majority were Protestants 135 (53%) followed by Catholics 89 (22.3%) and trnditionnlists 30 (11.7%).

Research Question 2 What are the levels of awareness of respondents to contraceptive use?

Table 2: Distribution of Respondents Awareness to Contraceptive Use

Contraceptive Number Percentage

Tabic 2 shows that respondents wcrc aware of some family planning mcthods and contl-accptivc use. Iicspondents for abstiiwnce were 107 (42.1%); Oral pills 60 (23.6%), Ii~j~clahlc 13cpo-I'1*)vcra 45 (17.7%), Snfc period 24 (9.4'%), Condom 12 (2.3%.

C;ossypol (Mcn's birth Control pill)

Rcsenrch Question 3 What arc tlic inlpcdinicnts to acccptancc of fan~ily planning methods

23.6 17.7

2.3 - 9.4 42.1 4.7 -

-- 1

Oral Pills 1 60 Injectable ~c.po-~'rovcr{ 45 Irijechblc Nonstcrat I -

Table 3: Respondents distribution of impediments to acceptance of Family Planning mcthods.

L)iaphragm Norplant Withdrawal Snfc I'eriod - Ab5tincnce Condom I~ltmulerinc Dcvice h d y Tcmperatr~rc 'I'ubnl Lirrntion

-

6 24 107 ----- 12

- .

--

12csponses 'I'r~idi~ional belief

Oimosition from hwbsnd 107

...- Tnblc 3 gives details of [he impediments to acccptance of Family Planning methods. Ilislilie by spousc attracted 107 or 42.1% responses, followed by religious belief, 66 or 25.9%1, tlwn fear of side effects, 51 or 20.U0/o and traditional bcliel, 30 or l 1 . W rcspondcnts.

I'cwcnlage 11.8 -- .- -. - -. - . 25.9 -- 42.1

Fear of side effccls - Ollicrs

Research Question 4 What are the benefi~r; of Family Planning to individuals, family, community, and soc:jt>ty at large?

20.0 . ~. - ---I

benefit from family planning Numbcr 14

It:! ~ I J &-65 5.1 -. - - . - - -. - 3

64 Journal ol'tlu: National Associnrio~~ of' Worncn Academics (JNAWACS) U N N Chnpkr, Vol. I . No I , 2003

Assures good hcalth of mother and child Freedom from unwanted pregnancy Improvcd knowledge about some aspccls

/ of human anatutqy and physiology - Relaxed illtimate rclationsllip -

to their children base and gencral

standard of living

C. Benefils of family planning to thc community and sociely Reduccs risk associa~ecl with pregnancy and child +- --

I birth Assures a - more productive labour force

.-

Reduces trnplanncd pregnancies Provides basis for checking and controlling

1 ~nl ianc& economic-stabilitv

Table 4 shows thc bencfits of family planning to individuals, family, co~nmunity or society at large. Benefits to individuals included freedom from unwanted pregnancy, which ranked highcst with a total of 97 or 36.6% respondents, followed by relaxed intimate relationship, among others. 13cnclits to family included elimination of unwantcd pregnancy and assured spacing of children, while benefits to thc community/socicty include reduction of risks associatetl \vith pregnancy, followcd by assurcd productive labour force.

Discussion of resul ts Table 1 revcalcd that only fcinales cmbraccd family planning as a pl(,!;*nin)-ric iocused around the family spcuses. i,4ajdrity of them wcre married and at thcir chilcll-enrilip, age with the most vulnerable cc;.~tliiion of little or no cd~ication or up-to-day skills for pcr5onal dcvclopmcnt and cluldcarc. A 5 .;..;~piiiants they remain at home as homemakers and child bcarcrs

Table 2 revealed that majority knew about traditional (abstinence) method of planning thc family. Their knowlcdgc about it may be from practical personal experience or mere acquired knowledge. It is pcrtinent to notc that with the advent of primary health care so many years ago, respondcnls' knowledge about modern family planning is stilI limited because thcre methods wcre not available.

Table 3 confirmed a lot of constraints &pcrienccd by family planning clienteles. Men's opposition ranked highest which may be true from the way the women involved were of the opinion that the programme was planncd and also focused on them alone. To justify this claim, the entire family planning methods, with the cxception of three, were meant for women and yet men find it very difficult to participate. Such innovation meant for the welfare of the family should not receive a lukewarm response from anybody/group or used as an instrument for women's opprcssion. No wonder every effort made by the government concerning women's emancipation, empowerment or Iiberation is usually thwarted. Religious belief was a constraint, followed by fear of side effects of the methods, among others.

65 Journal vf t l~c National Associalion of Women Academics (JNAWACS) UNN Chaplcr, Vol. 1. No 1 , 2003

Table 4 s~m~mar ized the benefits derived from family planning as i~ldividuals as it affects their hcdth slatus, that of their family, community and society at large. The benefits derived by rer;por~dent!; X-rayed their willingness to practice the use of modern contraceptives, which assure:; Ihtm of timing births i f only they could receive cooperation from their spouses.

*.*. .

Conc.lmion and Recommendation The (Llta derived from this study reveals the real attitudes of women in the studied coniniunities. Most of the respondents who were in thcir child-bearing age eii-tbraced family p l a n n i ~ ~ g in q)itc of opposition from thcir husbands, their religious belief or the method's side effects.

In adclition, they had no knowledge of all the methods but were aware of population growth, the ratlical health issues associated with pregnancy, child bearing, and potential benefits accruing from participating in family planning mcthods. Their responses to some of the variables suggest that they nccd to be emancipated to fully excrci:ie their fundamental human rights (whicll also include reproductivc health issues) a s citizens, and develop self-confidence in their family, community and the society.

In view of the findings of this study thc following recommendations are proffered: first the philosophy anel the entirc orientation about "family planning" should be properly defined so that men would know that i t actually takes two to make a pair and so should see family planning as their own programnw too.

To reverse thc tide of marginalization of women, programme planners should incorporate women into policy formntion, management, monitoring and evaluntion of programmes concerning them. For cxamplc, family planning and other health care delivery services have been controlled, monitored and dominated by men with very few women incorporated but not to important positions. This is one way we can ensure stability, and disposc all forms of opprebsion and discrimination against women.

1icfcrc.rrces A ~ ) p v a , S.E., (1996) "Villagers lack faith in meclicine". Irllmnl ]orrr'rrirl ofl-ic~rrltll Eifrrcntion. Vol. 14 no. 6C

Economic Con~mission for Africa (ECA) (1997LAfrica Centre for Women: Traditional and Cultural_practiccs harmful to the girl-child,Occnsionc~l Iwper 110. 1.

Ekweghi, PEG. (1989) Ccrrric~rl~rr~r/or work~~rs, a rirnl~, rrlotiz~atio~~: Onitsha: Summer Ed Pub. Ltd.

Family Support I'rogramme (1994): Elue I'rint Abuja.

Foocl Agric~~ltural OrgCinization Report (1984) :Spacing your cliildren" Dnil!y 'l'irrrcs August 13, 1984 P.6

Modo, I . V . 0 (1996LCulture clevaluntion of Indigenous women in S(.)l;oto mehmpolis. A cog in hqwl i ec l of sustainabIe development, In Yonni Osuwcri (ed) Worrrpn dC7~~1opr~rc~~t nrld tlrc N i p i n Enz~irorrrrrrvrt, %adan: Vantasc Pub.

National Population Commission (2000): The N i p i n Poprrlntior~

UNESCO, (1997) World Bank, Worrrerr D ~ Z J ~ O ~ U ~ C I I ! Ir~dicntor's. Washington.

66 Journal of the National Association of Women Academics (JNAWACS) UNN Chapter, Vol. I . No 1,2003

UNICEF, (1991) The U.N Report, 'World's Women Trends nnd Slntistics. 1970-1991, p. 60.

UNICEF/UNECA, (1994) Aths of the Africni~ Clrild. Addi. Ababa,

U.N.0, (1995) United Nations, Wornen's irrdicnlors nnd Stnlistics Dntnbnsr. (Wistat) New York.

World Population Data Sheet (1997): Africnit Crnlrefor Wornerr

World Population Data Sheet, (1997). Worncw o f O w World: PRB

World Health Organization, (1999) "Women nnd Hcnltlr". Mnirtstrmning tk~gertdcr persp~lizw into tlie Henlth sector. Report of the expert group meeting, Tunisia.