By Marie-Therese Nanlong
30 years old mother of eight, Mrs. Stephen had earlier in the year expressed her ignorance about reproductive health issues to this reporter and was counselled on the need to approach a Primary Health Centre in her native Kwall, Bassa local government area of Plateau State for assistance on such.
The stress of living in a crowded internally displaced person camp in the community hall with seven children and another pregnancy had taken a toll on her as her community was sacked by some gunmen and her property burnt. She only escaped with her family members and the clothes on their back.
Her frail condition evoked sympathy from anyone who saw her while visiting the camp, the goodwill of the people sustained her but almost every visitor who interacted with her, she confessed; advised her to adopt a family planning method and put a stop to having children she did not plan for at least for the sake of her health and wellbeing.
Two months after the delivery of her eighth baby, she took the advice and approached a Health Centre at Tudun Wada area of Jos North local government area of the State where a relative accommodated her. She said she was given orientation on family planning and the different methods available. After some considerations, she opted for the implant which would serve her for five years but to her disappointment, she was told that it was not available at the time.
Apart from her experience, another less privileged mother of four, Mrs. Regina Nanchwat said she has had four children within a space of seven years, those are enough and she wants to access the same implant method for five years. Although it was available at the facility she went to at the Township area of the city, she was asked to pay a token for consumables which she was not comfortable with because, “We were told that family planning in government hospital is free.”
At the time of this report, Mrs. Stephen was the fifth woman in one month to be turned down from her preferred method because of non-availability in that facility. Why would there be unmet needs for women who want to access family planning in Plateau State when there had been a separate budget line to make provision for such? Why would willing rural women be discouraged from such services due to lack of resources?
This budget line was to help ensure that funds are allocated to specific program items that will contribute towards scaling up family planning activities. Parts of what should be done with the fund was to provide commodities, logistics, training for providers, facility improvement and research among others.
The availability and accessibility of family planning commodities will assist women in spacing each pregnancy and there is every need to support women to imbibe family planning to control the already over populated country as it would be recalled that Nigeria remains one of the countries with high Total Fertility Rate, TFR, which is, the total number of children birthed by an average Nigerian woman.
The country’s population is projected to be 206.23 million and the fertility rate according to NDHS is put at 5.3, an average Nigerian woman gives birth to 5.3 children, women in rural areas have an average of 5.9 children compared to 4.5 children among urban women.
World Population Data Sheet states that an average Nigerian woman gives birth to five children as compared with the global figure of 2.3 with a population of 7.8 billion.
Buttressing the point during a five-week long webinar on data journalism on family planning for Nigerian journalists, organized by Pathfinder International, the lead facilitator, OdohOkenyodo explained that the Data Sheet states that, the rising cause of the population is as a result of unintended pregnancies which gives rise to high fertility and subsequent population growth.
Dr. Sekina Bello, Senior Programme Advisor, Reproductive Health, Pathfinder International Nigeria maintained that if births are not adequately spaced, it has negative effects on maternal health as it affects physical, mental and social wellbeing of women and children, “the higher the contraceptive use, the lower the fertility rate. So, to reduce the high fertility in Nigeria, there is a need to increase uptake of family planning services among women of reproductive age.”
The experiences of these women and others prompted Arewa Voice to check the budgetary provision made in the 2020 budget, what was released as well as what was done with the released fund.
Explaining the situation, the State Reproductive Health Coordinator, Mrs. Hannatu Dung said, “For 2020, what was budgeted was N23m but for the first and second quarter of the year, we have not been able to access any fund from that budget item. We have been working with support from partners, commodities are supplied by global health supply chain procurement and supply management which is a USAID project. It takes delivery of family planning commodities to the providers’ doorsteps. That ensures availability.
“The challenge has to do with the long-acting reversible contraceptive where consumables are required to be used and there are not in supply but we have partners like the USAID short support project, the Challenge Initiative programme, Marie Stopes and others that have supported in providing consumables based on need; that has helped to ameliorate the problem of lack of consumables for some of the health facilities.
“This period has been a difficult one for us particular with the incidence of COVID-19 disease, there has been a reduction in the number of those who access family planning services, the lockdown played key role in curtailing movements of client. If we have the release of funds in this quarter, we will look at our work plan and see what essential services we should render. Right now, procurement and provision of consumables are very key because we still find clients being charged one cost or the other because of the consumables that are not available.
“We will also prioritize supportive supervision, there is a light and local approach to this. When we train the Local Government Area coordinators and their assistants, we get those with strong skills and knowledge in these LGAs and pair them to do proficiently well. If fund is made available to us, we will also prioritize job training to strengthen the skills of those with weak skills.”