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Service providers step up counseling services

By Gabriel Olawale

At the antenatal section of Oak Hospital in Ikorodu area of Lagos state, Mummy Peace, a mother of four, related how her resolve to stop childbearing has been truncated by the COVID-19 pandemic.

As she lamented the hardship of caring for her four children under the current economic situation, she agonised over the ordeal of another pregnancy.

Mummy Peace was quite unhappy as she narrated how the lockdown prevented her from visiting any healthcare facility to access essential family planning service when she needed it most.

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“I have been on contraceptive pills in the last two years but the restriction on movement during the COVID-19 lockdown in Lagos caused me an unintended pregnancy.

“Worse still, my husband’s decision to utilise the withdrawal method of contraception failed because now I’m pregnant,” she stated.

Joke Abikoye, another pregnant woman in her early 20’s who walked into the reception area with an infant in her arms, also expressed her anguish at getting pregnant as a result of the lockdown.

“I will very likely name this unborn child Coro Baby because I didn’t intend to get pregnant now,” she remarked.

Joke stated that both she and her husband did not take pride in the development. “During antenatal, I was counseled on family planning and immediately after delivery I opted for Sayana – a three months injection, but due to the lockdown, I couldn’t come in to renew it, so we opted for withdrawal which failed.”

At Oladapo Medical Centre in Ijede, Rita Nwokejiobi said after her fifth child, she and her husband decided to stop.

“But during the lockdown, he was home throughout and we were having sex to pass the time. Although we made use of condoms occasionally and I took some pills afterward, all I know is that I eventually got pregnant.”

Rita, who regretted the situation said she had already given away all the baby clothes and other baby things.

“My husband is not making money like before and my income also is affected. To feed the five children at home is a very difficult task, yet we are adding another to make it six.”

A family planning provider at the Oak Hospital, Nurse Oluwaseun explained that the emergency of Covid-19 has affected not the only family planning but all services in general, even as she hailed the capacity building efforts by the Post Pregnancy Family Planning, PPFP experts.

“Before COVID 19, on average we usually had about 50 clients but during the lockdown, most of the clients on pills were unable to come here for renewal because of fear of infection. The number of our clients actually dropped to 30.”

She admitted that some patients who attended the antenatal clinic became pregnant during the lockdown.

“I know of two of our patients that said they got pregnant as a result of COVID-19. They were on pills but because of the lockdown were unable to come to the clinic.

“One is 38, with four children, now she is pregnant again; the other one has three children. Both women didn’t plan to have more children, however, there are few women that fall into this category here.”

Oluwaseun said that after the training by PPFP, the hospital upgraded services and they have prioritised family planning counseling during pregnancy, immediately after delivery, and during immunisation.

“Through the capacity building by PPFP we have made progress in dispelling myths and misconceptions about family planning. In an aspect of commodity, with the collaboration between our hospital, PPFP and DKT we are never out of stock.

“Even if the client shows interest but doesn’t have enough money, we assist them in our own little way just to encourage them. The majority of their clients prefer implant of three years and five years.”

Nurse Omowunmi Kanzudeen who is in charge of counseling and sensitizing women on reproductive health and family planning said that majority of the clients didn’t visit the health facility during the lockdown.

“I know three patients that registered with our hospital but they got pregnant due to the lockdown. One is nursing a 4-month-old baby, another has a nine-month-old, while the third has a baby that is just over a year.

“Another woman said she got pregnant because she had no access to family planning services because she feared contracting the coronavirus.

“These women were to obtain the second dose of the method they are using but due to the lockdown they didn’t show up so they got pregnant.”

Omowunmiwho said capacity building by PPFP was very helpful noted that there was a talk to women about family planning on Tuesday and Wednesday previously, but since the sensitisation exercise, the talk is more regular even after delivery, with the women being counseled on different available choices.

In her own views, the Chief Matron of Ikorodu Clinic Hospital, Mrs Grace Jonathan said some of their clients failed to show up not only due to fear of COVID-19 but as a result of a sharp drop in their income.

“Majority of our clients prefer three months preventive methods as they express willingness to get pregnant in a year or two. We don’t limit family planning messages to only antenatal and immunization period, what we do differently now is that even immediately after delivery we counsel people about family planning.

“We have several clients that want to take up family planning but are financially constrained. If I bought an implant at the rate of N800, I would have to put a service charge of maybe N700 making it N1,500.

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Some clients will claim that they heard on the radio that family planning service is free. But if I refer them to the PHC they will say they don’t want.”

Family Planning Consultant and Social Mobilizer, Omojowo Omotola said the PPFP project has helped some private hospitals in Ikorodu to provide comprehensive and qualitative family planning services.

“The PPFP project helps to drive uptake of family planning because in the past some hospitals will just discharge mothers after delivery but now they understand that they need to educate them during pregnancy, immediately after delivery, and even during immunisation. They now understand that at every occasion they are talking to mothers, they need to talk about family planning service.

Corroborating her views, Director, Private Sector Post Pregnancy Family Planning Project, Dr. Taiwo Johnson said that project aimed to ensure that family planning information is provided to post-pregnancy women when they come to health facilities either during antenatal or delivery.

Johnson said that a typical pregnant woman won’t think about family planning during pregnancy, “but it’s important they start thinking about it so that by the time they have baby, they can make a decision on the method of family planning to they want to avoid unplanned pregnancy.

She said that under the PPFP project, they focus more on training healthcare provider on comprehensive family planning services to be able to give adequate information when a woman comes to the facilities, “We also try to improve the environment because we found out that we need to make the environment conducive for family planning. We also realize some gaps in the hospitals in term of equipment they need for family planning in which we provide them with basic equipment to provide family planning services.

She regretted that a lot of women don’t believe they can get pregnant after delivery since they are breastfeeding and mensuration has stopped, “so in the hospital waiting areas, we brand it with family planning information materials so that when they come for antenatal they can ask questions about family planning. During clinic days we are there to talk to them, provide answers to their questions, we also have different video materials for them to watch.

She admitted that the uptake of family planning methods drops during the COVID-19 pandemic lockdown despite the fact that services are available across the state and private facilities, “I will like to encourage women not to be afraid of accessing services once they have their protective measure in a place like a nose mask, hand sanitizer and are obeying social distance rules.

Reproductive Health Coordinator, Lagos State Ministry of Health, Dr. Victoria Omoera said: “COVID-19 has brought about new normal, a lot of patients and clients wanting to access services are expressing fear because they feel exposure to the COVID-19 virus is very high at health facilities.

“But let me assure Lagosians that we are ready to attend to you, we may not take as many patients and clients as we would have at the same time. We know schedule appointments to ensure social and physical distancing. Also, our health workers now have their Personal Protective Equipment, PPE, and ready to work to ensure prevention of infection.

“We are offering stagnated appointment, we don’t have an area where people seat together and have general talk, as people come in we attend to them and they go.

Vanguard News Nigeria