Before 2012 when the Family Planning 2020, FP2020, campaign was launched to expand access to contraceptives globally, common knowledge in Nigeria was that family planning is a ploy by the Western world to reduce the population of Africans and render them permanently infertile.
Ignorantly, many women based on religious and cultural reasons among other myths have shunned modern contraceptives.
To date, these conspiracy theories about family planning continue to limit access to contraceptives and their benefits, resulting in unplanned and unintended pregnancies across the country.
Ruth Adeniyi, 38-year-old mother of five, is among millions of Nigerian women that are not using modern contraceptives and placing a heavy burden on Nigeria’s depleting resources due to overpopulation
At 29, Ruth got married with so much enthusiasm. Her dream was to have a happy marriage and three children. Today, Ruth has five children and is pregnant with the 6th child. No thanks to her husband’s position on family planning.
“It was not part of the plan. I did all I could to prevent this but it keep happening,” these were heart-rending words of Ruth.
Her second child came exactly one year after she had her first child, and since then it has been a cycle of pregnancy and breastfeeding year-in-year-out.
According to Ruth, her husband and the family do not believe in contraceptives and this belief has not only robbed her of her youth, but denied good employment opportunities to work and earn good wages.
“I lost my employment after I got pregnant the second time within one year. I have not been able to work again. Since then, I could not do anything other than to take care of these children,” Ruth told Good Health Weekly.
Like Ruth, Bena Onyeukwu was scared away from contraceptive use following stories her friends told her. According to her, she was told that family planning can cause infertility and uncontrollable bleeding.
Due to these myths, Bena said said she decided to use natural method which has continued to fail her. Today, she has six children.
Bena and many other Nigerian women do not believe in family planning, no thanks to the negative stories that they have heard from friends who also shun the services.
Apparently, these stories have fuelled their fears and doubts. “I have heard so many stories about how family planning can cause cancer and I cannot afford the cost of cancer treatment.
“I have never used any type of family planning method and I don’t want to. Some women in my community who attempted to use contraceptives later stopped because of bleeding.
“Another woman that used one form of contraception for three months could not get pregnant after three years. There are others who have gained too much weight as a result of contraception,” she said.
Sadly, for Nigeria which has an unenviable maternal mortality rate of 512 per 100,000 live births, the unmet need for family planning increased from 16 percent in 2013 to 19 percent in 2018, according to the National Demographic Health Survey, NDHS.
But findings by Good Health Weekly showed that despite the projection that Nigeria’s population may be hitting 400 million by 2050, and the country may be sitting on a keg of gun powder if nothing is done to increase contraceptive rate as well as reduce unmet need for family planning.
Family planning, according to experts, is a major tool in the prevention of child and infant deaths, unintended pregnancies, risky births, unsafe abortions, and maternal mortality deaths.
Experts’ views
In the views of the National Coordinator, National Family Planning Campaign Rotary (RMCH) Nigeria, Professor Emmanuel Adedolapo Lufadeju, family planning is key to improving the chances of child survival and population management.
According to Lufadeju, lack of awareness is one major factor limiting access to family planning services, hence, the need to create access to contraceptives and counselling for women and adolescent girls to make informed choices on the best method to use when they need it.
Today, it is no longer news that many Nigerians do not know when to delay births or stop giving birth and not every woman is ready for a life cycle of childbirth and breastfeeding. Lufadeju said with family planning, women will have time for economic activities, help the family grow, increase their wellbeing and participation in the family development and not only childbearing.
Findings have shown that the contraceptive prevalence rate is over 90 percent in many other countries while Nigeria has continued to struggle with less than 15 percent in the last 10 years.
Unfortunately, while Nigerian’s population continues to grow, resources are being depleted because of the population. Electricity and water is in short supply due to overpopulation.
Findings also show that in countries where contraceptive rate is as high as 90 per cent, the people enjoy a good life with a reduced number of children that they can cater for.
“Nigeria is among 10 countries with the highest fertility rate in the world, and lack of access to contraceptives contributes to this high fertility rate.
A Consultant Obstetrician and Gynaecologist at the College of Medicine, University College Hospital, UCH, Ibadan, Professor Christopher Aimakhu, explained that family planning encompasses the services, policies, information, attitudes, practices, and commodities, including contraceptives, that give women, men, couples, and adolescents the ability to avoid unintended pregnancy and choose whether and/or when to have a child.
In his presentation entitled: “Analysis of Family Planning Budget and State of Contraceptive Distribution Logistics in Nigeria”, delivered at the virtual training for media practitioners organised by Rotary Action Group for Reproductive, Maternal and Child Health, Aimakhu explained that despite a population of about 201,000,000, Nigeria has a Modern Contraceptive Prevalence rate (mCPR) of 12 per cent.
Benefits of family planning
He said data has shown that: “If all unmet need for modern contraception in Nigeria were satisfied, unintended pregnancies would drop by 77 per cent, from 2.5 million to 555,000 per year.
“As a result, the annual number of unplanned births would decrease from 885,000 to 200,000 and the number of abortions would drop from 1.3 million to 287,000.
“If a full provision of modern contraception were combined with adequate care for all pregnant women and their newborns, maternal deaths would drop by 68 percent (from 61,000 to 19,000 per year) and newborn deaths would drop by 85 percent (from 255,000 to 38,000 per year).”
Unfortunately, meeting the need for modern contraception among all women in Nigeria who want to prevent pregnancy would cost $546 million annually, an increase of $478 million over current costs. “This additional investment would provide improved quality of care for current users and coverage for new users. if all need for both contraception and maternal and newborn health care were met, the cost of maternal and newborn care would be reduced to $4.5 billion.
“Because the cost of preventing an unintended pregnancy through the use of modern contraception is far lower than the cost of providing care for unintended pregnancy, for each additional dollar spent on contraception would reduce the cost of maternal and newborn health care in Nigeria by $1.24.”
He decried the poor data management, poor logistics management, lack of trained personnel on Family planning services, inadequate storage system and poor supporting supervision in most Nigerian healthcare facilities, particularly, the primary health facilities which are the closest to the grassroots people and the first place to visit for contraceptive needs.
He said studies have shown the need for interventions actions in improving family planning service in Nigerian health facilities if the country must not fail to achieve the Sustainable Development Goals of ensuring global access to family planning and other sexual and reproductive healthcare services by 2030.
Awareness as panacea
Calling for more awareness on family planning to increase uptake, he said in addition to making contraceptives available, the government must ensure that the services are affordable and accessible at all levels of healthcare facilities.
“This will save the citizens from travelling a long distance to access family planning services, reduce using unskilled and unqualified family planning providers and will help the country to further prevent children’s deaths, unintended pregnancies, risky births, unsafe abortions, and maternal mortality deaths in Nigeria.
“It will also help the country to have strong and healthy families; more adolescents will be able to complete their education which will, in turn, have positive impacts on the country’s economy.”
On his part, Professor Abubakar Panti, who decried Nigeria’s high fertility rate said: “The lifetime risk of a Nigerian woman dying during pregnancy and childbirth is 1 in 22, in contrast to developed countries estimate of 1 in 4900. Nigeria ranks fourth in the world’s highest countries with high maternal mortality. Family planning and use of contraceptives prevent pregnancy, thereby preventing maternal death.”
Stakeholders opine that government and donor agencies must carry out urgent interventions such as a regular supply of contraceptives, regular training of family planning service providers, provide sufficient manpower, carry out regular monitoring and evaluation of services as well as create awareness on the need to use family planning services among grassroots citizens.
