… As ignorance of family planning fuels unplanned pregnancy
By Marie-Therese Nanlong
It is no longer news that teenage pregnancies or unintended or unplanned pregnancies are commonplace in many part of Plateau State, Nigeria.
Several homes are affected. The sight of a pregnant teenager in the urban and rural areas is no longer taboo.
Society has become used to such incidences that the frequency erodes the shame that was once the burden.
Many of the girls that engage in premarital sex are often unprepared for the consequences of unplanned pregnancy and even though some survive the stress, pains and ignominy, quite a few others secretly escape all this by resorting to unsafe abortion.
Some narrowly escape death by the skin of their teeth, probably ending up with damaged wombs or other permanent injuries, and, at worst, lose their lives in the process.
In many of the Local Government Areas of Plateau State, the sad tales of pregnant teenage girls abandoned by their relatives and erstwhile lovers abound especially in the rural areas.
Tackling this abnormality is a big challenge in an environment that forbids open discussion about sex education, family planning and contraception.
The 2018 Nigeria Demographic Health Survey, NDHS, confirms that in Nigeria, the proportion of teenagers who have begun childbearing rises rapidly with age, from 2 percent at age 15 to 37 percent at age 19.
The NDHS also found that rural teenagers tend to start childbearing earlier than urban teenagers (27 percent versus 8 percent).
Further, the NDHS statistics revealed that while 29 percent of teenagers in the North West had begun childbearing, only 6 percent in the South West and 9 percent in the South East had begun to give birth.
Bauchi State with 41 per cent has the highest proportion of teenagers who have begun childbearing, while Lagos with 1.0 percent has the lowest proportion.
According to the Survey, teenagers with more than secondary education and those in the highest wealth quintile tend to start childbearing later than those with no education and those in the lowest quintiles.
Good Health Weekly, spoke with at least 20 pregnant teenage girls and teen mothers in Ban, Barkin Ladi Local Government Area; Lo-Gwom in Riyom LGA; Tudun Wada in Jos North LGA, Lalin and Garkawa communities in Mikang LGA show that they have no basic ideas on family planning nor how to access its services. This ignorance is their bane ultimately costing them their good health and future.
The thought of discussing family planning and accessing its services is still an embarrassment in the public space hence the need for relevant stakeholders’ intervention to create more awareness among the rural populace and mitigate the harm unwanted pregnancies is causing in the society.
The girls have no idea about methods such as oral contraceptive, vaginal ring, female condom, male condom, contraceptive patch, natural family planning, injectables, intrauterine devices, IUD, implant, among others could save them from all the stress they go through.
Narrating her own story in tears, 16-year-old Esther, in Ban community, confessed she knows nothing about family planning methods except the use of condom by men while having sex.
However, her runaway boyfriend – a man in his 20s, did not want to use the only method she knows.
Esther, who had to drop out of SS1 as the result of pregnancy stated: “When he (the boyfriend) started coming to me in November, 2017, I was afraid because before then, I had no boyfriend. When he showed interest in me and wanted us to start having sex, I was afraid of AIDS and pregnancy but he promised that nothing would happen. Truly, we met for over six months, nothing happened but when I got pregnant and informed him, he suggested abortion but I was afraid of death so I declined. He said if I will not abort, he will deny me and he did.
“He ran away when my parents knew I was pregnant, I don’t know where he is now and I am not sure if he is from the village he told me he came from, since my parents are not happy with me and do not even want to hear from me, there is no way I can trace him.
“I don’t have the money and the time; his phone number is switched off but I know one day, he will look for me.”
Esther noted that the suffering she is undergoing is a lesson. “My parents only allow me and the baby to stay in the house but I try to fend for myself and my baby. This is a big lesson, I hope other girls learn. I don’t know anything about family planning; it is only condom I know because of AIDS.”
Apart from Esther, other teen girls including Dorathy in Tudun Wada, Na’ankus in Lalin, Ladi in Garkawa, Yeipieng in Lo-Gwom, among many others spoke. Good Health Weekly, gathered from them recurring claims of “ignorance of family planning methods/services, fear of openly accessing the services as unmarried people and lack of people to talk to.”
These are the very concerns of family planning experts who raised alarm about the level of uncontrolled births and population explosion especially in the north without concurrent resources.
Confirming the level of ignorance, Dr. Josiah Mutihir, the Chairman, Voice for Family Planning and Reproductive Health Centre, a Technical Team on reproductive health in the State Ministry of Health said, statistics has shown the true situation on ground hence the need to tackle the issue.
Mutihir stressed, the population is growing faster than its resources and this poses a great danger to the country’s future and if the trend is not checked, it would result in the total collapse of the country’s economy as well as bring more insecurity and warned against political and socio-cultural practices encouraging overpopulation.
“Ideally, population should only grow according to resources but in our country, the reverse is the case and this poses a great challenge to socioeconomic development. Aside from voting for politicians with our numbers (large population), I don’t know what else we get from having large families that we can’t cater for. We seek to outnumber one another for religious and cultural supremacy but what other than enmity do we get?
“Despite the belief that it is in the public space, many people especially in the rural areas do not have the right information about family planning, neither do they know where to go to access family planning services. The half truth or broken truth they have about family planning is dangerous as they tend to believe what it is not.
“Family planning is responsible parenthood, responsible child spacing which help families to have the number of children they can cater for at a particular time and at the particular age. Unfortunately in Plateau State, 23 percent of married women do not want to have a child, but are not using family planning.
“Eighty three percent of women have not heard or seen family planning messages on the radio or through any other media source in the past few months. Would be clients have no idea where to go and some end up with patent medicine stores who know nothing about such services.
“We are calling on government at the State and local government levels to support in areas of supplies of commodity and consumables as well engage quality service providers to attend those in need because population needs to grow alongside development so that there will not be problem. By addressing barriers to family planning access, the State could save more mothers’ lives and reduce additional cost that unintended pregnancies bring.”
Also speaking, the State Reproductive Health Coordinator, Mrs. Hannatu Dung lamented the lack of qualified medical personnel and facilities to provide family planning services.
She called for urgent employment and deployment of skilled health workers to the field to provide family planning service, domestication of existing reproductive health and family planning policies and capacity development for health workers for effective service delivery.
Confirming the dearth of health workers, particularlty, medical doctors in the State employment, the Director, Medical Service in the State Ministry of Health, Dr. Samuel Audu said: “We have 17 local government areas in the State but we have 14 functional General Hospitals and the Plateau Hospital under Hospital Management Board. Right now we have a total of 75 doctors, 29 in the General Hospitals, two in the Ministry excluding the Permanent Secretary and 44 in Plateau hospital including the CMD. Some General hospitals have one doctor each and some have two, some have three depending on the influx of patients and the location.
“The number is grossly inadequate and doctors over-worked; some health workers like Nurses, Pharmacists, Community Health etc and cleaners, security are volunteers offering their services free. This is not good enough but the good thing is there is an opening for employment but how many would be employed seeing there were no employment in the State for many years.
Many graduates are roaming the streets without employment and the corps doctors prefer to serve in faith-based and private facilities where they will be paid.”
The situation of ignorance of family planning, lack of availability of commodities resulting in unmet needs and lack of professional service providers is a cause for concern and relevant authority must sit up to safeguard lives of young mothers.