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CONTRACEPTION: It’s your life and responsibility

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By Sola Ogundipe

The World Contraception Day (WCD) on September 26, is an annual worldwide campaign that centres around a vision where every pregnancy is wanted.

The global campaign is specifically to improve awareness of contraception, and to allow women make informed choices about their reproductive health, in the hope that every pregnancy is planned and intentional and that every life is by choice and not by chance.

Adequate access to contraceptives could reduce unsafe abortions by over 70 percent.

With the theme: “Contraception: it’s your life, it’s your responsibility,” the World Contraception Day is strictly to promote contraception. One of the benefits of contraception is that it allows women to put off having children until their bodies are fully able to support a pregnancy. Contraceptive use reduces the need for abortion by preventing unwanted pregnancies.

An effective contraception helps to optimize the health of a woman prior to pregnancy by stabilizing any medical condition or getting the medical condition under better control. It also helps to avoid complications in pregnancy by enabling women to enter pregnancy in the best state of health.

Common family planning options include injectable contraceptives, oral contraceptive pills, male and female condoms, implants, IUDs, sterilization and natural or traditional family planning methods among others.

There is no gainsaying that some barrier family planning methods, such as condoms, help prevent the transmission of HIV and other sexually transmitted infections. It has been proven over many decades that family planning / contraception reduces the need for abortion, especially unsafe abortion.

Through contraception, couples can practice family planning to prevent closely spaced and ill-timed pregnancies and births, which contribute to some of the worlds highest infant mortality rates. Family planning enables couples and women in particular, to have informed choices about their sexual and reproductive health. However, there is a global unmet need for contraception.

In Nigeria and in many developing countries, many women of reproductive age that want to avoid pregnancy are not using a modern contraceptive method. Reasons include limited choice of methods; limited access to contraception, particularly among young people, poorer segments of populations, or unmarried people; fear or experience of side-effects; cultural or religious opposition; poor quality of available services; users and providers bias, gender-based barriers, etc.

Ensuring uninterrupted availability of high-quality family planning commodities and consumables is a current challenge. There is a low knowledge of contraceptives, especially Long-Acting Reversible Contraceptives (LARCs), across the country. The LARCs are methods of birth control that provide effective contraception for an extended period without need for action.

According to the NDHS (2013), 84.6 percent of married women of reproductive age have heard of at least one method of contraception. However, this average masks critical differences related to method, type, age, wealth, and other factors.

It is also of interest to observe that only 25.9 percent of women have heard of implants in Nigeria. This is a much lower rate of knowledge than in other countries. From a geographical perspective, knowledge is significantly lower in the Northern parts of the country, just as contraceptive prevalence is low.

The 5th round Multiple Indicator Cluster Survey (MICS 5) was recently carried out in 2016/2017 by the National Bureau of Statistics (NBS) in collaboration with other partners as part of the global MICS programme, reported that the Total Fertility Rate (TFR) for Nigerian women of child bearing age (15-49) is 5.8. Under the indicator for early childbearing in the report, 30.8 percent of women aged 20-24 years had had at least one live birth before age 18.

The MICS reported a relatively low Contraceptive Prevalence Rate (CPR) for the country as just 13.4 percent of women aged 15-49 years are either currently married or in union who are using (or whose partner is using) a (modern or traditional) contraceptive.

Also from the MICS, the unmet need for contraceptive usage among women aged 15-49 years, that is, women who are currently married or in union who are productive and want to space their births or limit the number of children they have and who are not currently using contraception is 27.6 percent.

From the perspective of the Network of Reproductive Health Journalists of Nigeria, NRHJN, every pregnancy in Nigeria must be intentional and no pregnancy must be allowed to just happen by any form of accident.

The Network is saying there is no better time to discuss contraception than now. As a key advocacy stakeholder the Network on government and other stakeholders to join hands in closing the wide gap of access to all forms of modern methods of contraception.

The promotion of safe, accessible modern family planning methods to the last mile at this point in time in Nigeria is crucial towards achieving the global goal of Family Planning by 2020 (FP2020) and the 17 Sustainable Development Goals (SDGs).

In the view of the Director of The Change Initiative in Nigeria (TCI) Dr. Victor Igharo: Making access to quality contraceptive services and information should be treated as a human right because it changes and even saves lives of women and girls. The government has the responsibility to make modern contraceptives accessible to women and girls most especially in urban poor communities in Low- and Middle-income Countries.

“Just as the government has a major role to ensure uninterrupted provision of quality contraceptive services to its citizens, the women also have the right to demand for these services as part of their fundamental human right.

In her own view, the Country Director of Ipas Nigeria, Barrister Hauwa Shekarau, states: The World Contraception Day 2018 more than ever before provides another golden opportunity to create awareness on the different contraceptive methods as well as reinforce the need for Nigeria to up her game with a view to ensuring adequate allocation of resources to engender availability and access to contraceptive commodities to women in all communities in Nigeria.

“Every pregnancy should be one that is planned, wanted, loved and cherished. That way, we engender a happy and prosperous society. This has been the cornerstone of our work at Ipas.

The bottom line is that family planning strengthens the rights of all women of reproductive ages to determine the number and spacing of children in their lives. Access to modern contraception options can help prevent unwanted or unintended pregnancies, which, in turn, can help reduce maternal deaths by delaying motherhood, spacing births and avoiding unsafe abortions.

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