By Chioma Obinna
Family planning enables couples delay early child-bearing and to avoid unplanned pregnancy. It is estimated that up to one-third of childbirth-related deaths and injuries could be prevented if women had good access to contraception. Family planning also has the potential to reduce infant mortality, prevent HIV, empower people, enhance education, reduce adolescent pregnancies and slow population growth.
Family planning also allows women to recover from traumatic physical and psychological experience, without the additional worry of becoming pregnant again before they are ready.
However, Nigeria has a young population compared to the advanced countries of the world even as experts say more use of contraceptives by women of child-bearing age would reduce increasing population of the country amid a high fertility rate of over 5 percent.
Findings show that, amongst other factors, rapid population growth has affected the quality of life and made achievement of socio-economic development goals difficult in the country. Worse still, many Nigerian women are opposed to family planning. Sunday Vanguard reports that despite efforts in the last four decades to achieve rapid economic development and the fact that knowledge of Nigerians and attitude towards family planning has improved in the last two decades, contraceptive use in the country remains generally poor.
In 2012, Nigerian leaders and leaders from 192 other countries gathered in London and made the famous Family Planning 2020 Commitment. The commitment was that by 2020, 120 million more women and girls in 69 of the least developed countries would have voluntary access to contraceptives and information about planning their families. However, since the London conference, spearheaded by the Bill & Melinda Gates Foundation, UNFPA and partners, several countries have increased their commitment to family planning including Nigeria which has resulted to significant improved funding.
However, today, thousands of Nigerian women are yet to buy into it. Further investigations show that the fear of the unknown, culture, religion, myths and misconceptions are plaguing family planning across communities in Nigeria.
Many Nigerian women like 39-year-old Sarah still have doubts about family planning. Sarah and others revealed their fears.
They claimed that contraceptives like implants disappear inside the woman’s body. A contraceptive implant is a long-acting reversible contraception for women. According to them, the implants walk round the woman’s body while some argued that it migrates from the hand to the brain. They also narrated how friends made them to believe that family planning causes cancer and infertility.
Sarah, a mother of three, narrated: “I grew up in a family of seven even though it was not easy bringing us up. I cannot use contraceptive due to the stories l hear. The stories are scary.”
Pregnant for the fourth time, she told Sunday Vanguard that she was an eye witness to the trauma of infertility her neighbour suffered after using 3-year contraceptive injectables and could not get pregnant five years later.
“My neigbour had to go through another round of treatment before she could get pregnant again. I don’t want to experience that,” she said.
“I and my husband decided to stay away from man-made trouble because of the stories about its side effects.”
On the part of Mrs. Doris Ukadike, although she believes in child spacing, her faith does not support family planning.
“I am a Catholic and we don’t believe in it (family planning) but we are taught how to prevent pregnancy. We enjoy sex like every other couple.”
Another woman, Onyinyechi Nzekwu, said whereas she was not comfortable having babies almost every year, she was not ready to risk her life due the numerous complaints about contraceptives. “Some of the women who use contraceptive told me they experience excessive bleeding, while some said it made them add extra weight. Some even told me that sometimes the implant moves from the hand into the stomach”, she stated.
“The fear of the side effects of contraceptives has kept me away from embracing family planning. The experiences of some women that I have heard discouraged me and many other women in this community from embracing family planning.”
While Sarah, Doris, Onyinechi, among other Nigerian women, continued to shun family planning, experts say family planning will help to achieve demographic dividend in the country and it is fundamental to the realisation of the 2030 agenda for sustainable development and strategic for national progress.
They claimed that family planning offers enormous economic and health returns. According to the Chairman of the National Population Commission, NPopC, Chief Eze Duruiheoma, who spoke at an event to mark the 2018 World Population Day in Abuja, “Family planning and birth spacing is the first and right step to population management, central in saving the lives of women and adolescent girls, enhances women’s empowerment and key to poverty reduction”.
A reproductive health expert, Dr Mercy Panyi, spoke in the same vein when she blamed the rapid population growth in the country on low family planning uptake by Nigerian women.
Noting that it has also affected the quality of life and made achievement of socio-economic development goals difficult, Panyi, who is also the Head, Reproductive Health Division of the Federal Ministry of Health, in a lecture entitled: ‘Family Planning situation in Nigeria, lamented: “Knowledge of Nigerians and attitude towards family planning has improved in the last two decades but the use of contraceptive remains generally poor.
“There is a wide gap between the North and the South, accessibility to family planning services is very poor. In the rural areas, only 15.1 percent of reproductive aged women use contraceptive. Only 10 percent of married women use modern methods
“Nigeria’s population was equivalent to 2.55 per cent of the total world population of 7.6 billion, and ranks the country number seven in the list of countries and dependencies by population”
Throwing light on how fertility affects development, she said that fertility decline helps many families out of poverty, adding that, at the family level, having fewer mouths to feed could help to reduce poverty and free more money to educate or help each child.
“In economic terms, fertility decline and thus slower population growth creates the potential to increase the rate of economic growth, a path out of poverty for many families”, the reproductive health expert said.
“In the education sector, if Nigeria continues on its current path of high fertility, the number of students that will enter primary schools will increase – more than double by 2040. How shall the nation take care of these students?
“If the country takes the path of low fertility, the nation has fewer students; there will be less pressure to build new schools”.
Panyi noted that in Nigeria, more than 6 in 10 births fall in at least one of the high risk categories and that means more than half the children born have elevated risk of dying before their 5th birthday
On agriculture, she said: “Nigeria strives for a productive agricultural sector and wants to conserve natural resources for sustainable development. In the agricultural sector, as in other sectors, there are lower fertility yields for Nigeria. At the current rate of population increase, can the country feed the number of people it has?”
Nigeria at the London Summit had pledged to achieve 36.6 per cent Contraceptive Prevalence Rate, CPR, by 2020 and an annual CPR growth rate of 2 per cent. Meanwhile, statistics show that the country’s CPR hovers around 24.2 percent for all women and 27.6 percent for married women in 2018 while its unmet contraceptive need was at 16.6 percent. However, should the country attain the commitment of 36 per cent CPR, not less than 20,000 lives of mothers and over 100, 000 of children would be saved by 2020. Additionally, by 2050, it would save about $2.2 billion in social costs if it achieves annual CPR reduction of 2 per cent.
Health watchers say that at the current CPR of 24.2 per cent, there is a wide gap in knowledge of contraceptives. Currently, only15 per cent of women, between 15 and 49, use contraception to limit and space births. As the year 2020 draws near, experts are of the view that there is need to increase awareness, education and campaign on the use of modern contraceptive methods like the intrauterine device (IUD), injectables, implants, male condoms, female condoms, diaphragm among others. There is also need for aggressive awareness to dispel the myths and misconception around family planning services across the country.