ABSTRACT
The study
investigated influence of personal variables on knowledge and practice of
family planning methods among married women of reproductive ages in Benin
metropolis. Specifically, the study was undertaken to determine knowledge of
married women on family planning methods and the various family planning
methods they practice. The study examined the influence of personal variables
(age and educational qualifications) on their knowledge and practice of family
planning methods. The descriptive survey
research design was adopted for the study. The population of the study covered
all the married women of reproductive age in Benin metropolis, Edo State
comprising of 16,000 women as obtained from the provisional figure of the National
Population Commission (NPC), Benin City (2014). A sample of 800 married women
comprising market women, civil servants, teachers, female local farmers, women
in religious worship among others. However, seven hundred and seventy two (772)
copies of the questionnaires were recovered and used for the analysis. The instrument used a self-developed
questionnaire with a reliability coefficient (α) of 0.73. Data collected
from the survey were analysed with percentages (%), mean (
)
and standard deviation (S.D) while the hypotheses were tested using t-test
statistic. Results obtained from the analyses showed that married women in
Benin metropolis have good knowledge of family planning methods such as the use
of condoms, use of pills, use of injectable hormones, abstinence from sex,
withdrawal method during sex, isolation of women from husband, use of local
drugs (concortions) and prolonged breast feeding. Consequently, many of them
practice the use of condoms, pills, abstinence from sex, withdrawal method
during sex, isolation of women from husband, use of local drugs and prolonged
breast feeding as their family planning methods. Result further showed that age
has no influence on knowledge and practice of family planning methods among
married women in the metropolis (p>0.05) while educational qualification,
significantly influence knowledge and practice of family planning methods
(p<0.05). It was recommended that counsellors and non-governmental agencies
need to try as much as they can to ensure women are well informed on the
appropriate family planning methods they could practice with their spouse or
partner.
CHAPTER ONE
INTRODUCTIONBackground to the Study
Rapid population growth is a burden on the resources
of many developingcountries. Unregulated fertility, which contributes to such
situation, contributed tothe poor economic developmentand political instability
of these countries. Therefore, many countries consider limiting population growth
as an important component of their overall developmental goal to improve living
standardand the quality of life of the people. This strategy is now enhanced by
the availability of effective modern contraceptives methods. Since 1960s,many
international institutionsand organizations such as: the World Health
Organization (WHO),World Bank (WB), United Nation Population Fund Activities (UNPFA)
and United Nations Children Education Fund (UNICEF), have strongly advocatedfor
family planning as a means of spacing children,having limited family size and
should be one of the essential primary health care services provided
(Rosenfield& Schwartz, 2005).
The International Conference on Population and Development
(ICPD) Cairo, 1994expanded marital healthto a broader scope of reproductivehealth
and endorsed a range of major goals for countries to achieve. Two of the goals
are: a) 75 percent reduction in the maternalmortalityratio by 2015 and b) all
couples and individuals should have the full opportunity to exercise their
right to have children by choice (Rosenfield& Schwartz, 2005).Also, the Millennium
Development Goals (MDGs), adopted by United Nations in 2000 require member
countries to achieve a set of 5 goalsamong which is to improve maternal health
by reducing three quarters ofthe ratio of women dying in childbirth by 2015.In
all these programmes, contraception and family planning play a central role in
the strategies to achieve the set goals.
Encyclopedia (2013) defined family
planning as birth control and other techniques to implement such plans which
include sexuality education, prevention and management of sexually transmitted
infections, pre-conception counselling and management of infertility. It
further conceptualizes that family planning is educational, comprehensive
medical or social activities which enable individuals to determine freely the
number and spacing of their children and to select the means by which this may
be achieved. Hence, it implies the ability of individuals and couples to
anticipate and attain their desired number of children by spacing and timing
their births (Umbeli, Mukhtar&Abusalab,
2005). Usually, family planningpractices are of two categories: the traditional
methods and the modern (orthodox) methods. The traditional methods include
prolonged breast feeding, isolation of women from husband, abstinence from sex,withdrawal
method during sex, use of iron ring, use of local concussions and leather belt
stuffed with charm among others.
The modern methods include: the use of
condom, pills, coils, intra-uterine device (UIDs), and use of injectable
hormones, sterilization, vasectomy and douching among others. There are manyreasons
for family planning which among others include: to prevent pregnancy, to
postpone pregnancies, to space children, for those who have all the children they
want, to prevent future pregnanciesand for health and economic reasons. These
reasons are often related to the stage of every woman’s reproductive life
whether:single, new marriage, before birth, after first childand before last
child. During each stage, contraceptive choices and need vary within this
context. Hence, professional counsellorscan play a vital role in helping women
or couples to choose an appropriate method that matches her or their needs
during her or their current stage of reproductive life.
Globally, family planning is promoted as a mechanism
to address the reproductive health needs of men and women, as well as the
crucial challenge of rapid population increase. Family planning is a practice
by which a couple space the number of years between each child they want to
give birth to, through the use of contraceptive methods. More than 200 million
women in developing countries would like to delay their next pregnancy or even
stop bearing children altogether, but many of them still rely on traditional
and less effective methods of contraception or use no method at all (UNPFA,
2001). Those who do not use any contraceptive method may lack access or face
barriers in using contraceptives. These barriers among others include: lack of
awareness, lack of access, cultural factors, religion, opposition to use by
partners or family members, and fear of health risks and side effects of contraceptives.
However, despite the campaign on the usefulness of
family planning inhaving smaller and healthier family, United Nation Population
Fund Activities (UNPFA) (2001) indicated that contraceptive use is still low in
many developing countries, including Nigeria where 23.7% of currently married
women had never used one. One may ask if majority of Nigerian women are aware
of family planning practices, and also whether very many of them use it for
birth control. Observations have shown that some women in the cities, townsand
villages are aware of the family planning campaign but many are reluctant to
using them. Different factors such as culture, age, education, poverty and poor
access among other numerous factors have been identified by scholars to
militate against the use of family planning methods (UNPFA, 2001;
Rosenfield& Schwartz, 2005).
Traditionally, most Nigerian cultures are highly
patriarchal, having value for high fertility and male child preference. Hence,
this perhaps could have a negative impact on the utilization of family planning
services. A study by Rosenfield& Schwartz (2005) on reproductive motivation
and family size preferences among Nigerian men, revealed that the
characteristic male dominance, patrilineal traditions support for large family
sizes and men’s reproductive motivation to a large extent, affect the
reproductive behaviour of their wives. These cultural values undermine the
utilization of family planning in many communities in Nigeria like the
traditional core areas of Benin, where families still support large family
sizes of more than four children per woman, and where polygamy is commonly
practiced.
The use of
modern contraceptive methods translates into the prevention of unwanted
pregnancy and subsequent abortions. If contraceptive usage increases among
Nigerian men and women who are sexually active, then, there will be a
significant reduction in unwanted pregnancies and abortions leading to reduced
maternal mortality.The importance of considering the well-being of women in
development planning is well supported by the United Nations and many of its
agencies; some of which areUnited Nation Population Fund Activities (UNPFA), United
Nations International Children Educational Fund (UNICEF), and World Health
Organization (WHO) among others. These agencies contribute to the increasing
campaign for women right in family issues mostly as it pertains to their health
and that of their child(ren) (born and yet unborn). Women are both
beneficiaries and potential contributors to the development process and active
efforts to meet their needs, should be considered a national priority, most
especially their reproductive health issues. Despite all this, in most cases
especially in rural areas, women do not have a say when it comes to family
planning issues and reproductive health care. Many married women also, have
been threatened, abused, beaten and sometimes overpowered when it comes to
sexual play and matters that concerns family planning. Some married women
either due to illiteracy or self-beliefs do not adhere or practice family
planning. Many see the use of contraceptives as a portrayal of waywardness
The acceptance of family planning is known to be
influenced by social and cultural factors, among others. Some of these factors
comprise of family income, age, educational status, and occupation of married
couples among others (Shareen, 2011; Ozumba, 2011). Such cultural indolence is
often sustained by religious values even when there are no specific prescriptions
against birth control. The Old Testament injunction to “be fruitful and
multiply” has its counterpart in the teachings of several religions
predominantly throughout Sub-Saharan African Countries, Nigeria inclusive. Although,
family planning is widely promoted in Nigeria, it is not without ethical issues.Unfortunately
in many religions, there is an opposition to human intervention in the
reproductive process. This is as a result of the beliefs that procreation is
sacred and any interference with it would bring down the wrath of God.
Desire by most individuals and couples for a large
family size is as a result of the positive value which the Nigeria society
attached to marriage, family life and procreation.Unexpected or unplanned
pregnancies possess a major public health challenge in women of reproductive
age, especially in developing countries. It has been estimated that of the 210
million pregnancies that occur annually worldwide, about 80 million (38%) are
unplanned, and 46 million (22%) end in abortion. More than 200 million women in
developing countries would like to delay their next pregnancy or even stop
bearing children altogether, but many of them still rely on traditional and
less effective methods of contraception or use no method at all (WHO, 2013).
Those who do not use any contraceptive method may lack access or face barriers
to using contraception. These barriers may include lack of awareness, lack of
access, cultural factors, religion, opposition to use by partners or family
members and fear of health risks and side effects of contraceptives.
In some areas of Nigeria, one in five women report having
experienced an unwanted conception, of these 58% had an abortion and an
additional 9% attempted unsuccessfully to end the pregnancy. It is estimated
that about 25% of women who have abortion in Nigeria experience serious
complications (Ozumba, 2011).Following the health problems inherent in women as
a result of early pregnancies, unwanted pregnancies, complications and other
health related problems, adopting family planning measures may help reduce
unwanted pregnancies and abortions to its barest minimum.
The role of women in child rearing, family care, and
the family formation process as a whole, cannot be overemphasized.
Unfortunately, women in most cases do not have a say when it comes to family
planning issues and reproductive health care. It has been observed that married
ones among them, have been threatened, abused, beaten and sometimes overpowered
when it comes to sexual play and matters that concerns family planning by their
partners. Some married women either due to illiteracy or self-beliefs do not
adhere or practice family planning. Many see the use of contraceptives as a
portrayal of waywardness. Consequently, many of them get unintended pregnancy
that they never planned for.
Birth resulting from unintended pregnancies can have
negative consequences including birth defects and low birth weight. Such
children are more likely to experience poor mental physical health during
childhood, and have lower educational attainment and more behavioural issues in
their teen years (UNPFA, 2001). In many male dominated societies Nigeria
inclusive, women are not empowered to take decisions for family planning for
reasons such as their personal beliefs, tradition, their social attitudes and
literacy level. Consequently, many married women bear the burden of
child-bearing and rearing with the attendant rigorous house chores and probable
break down in health.
Governments have failed to provide basic
infrastructure to run family planning programs in rural areas. In Benin
metropolis, an average Benin man (irrespective of his age or social status)
will want his wife to keep on conceiving until a son is born even if he has
more than four female children. Consequently, many married women face the
consequence of raising many children without proper child spacing. Many of them
even ignore using contraceptives because their husbands do not support the use.
Also, elders are often against family planning due to old age tradition and
superstitions. Hence, youngsters who want to go in for family planning risk the
wrath of elders. This situation poses a question or two on: what is the
awareness level of married women on family planning methods and the methods
they use to control child birth in Benin metropolis? What personal factors
influence the knowledge and practice of family planning methods among married
women of reproductive ages in the metropolis?
Furthermore, several studies have been undertaken on
attitude towards contraceptives among married people with respect to their ages
and religion respectively (Nyawade, 2008;Ugoji, 2008); family planning methods among
married couples in Zululand, South Africa and
Delta State, Nigeria respectively (Makhaza&Ige, 2014; Uwe&Okon, 2011); Knowledge, attitude and practices on contraceptive usage
among undergraduates in Ekpoma-Edo State (Idonije, Oluba&Otamere, 2011) and Enugu (Ikeme, Ezegwui&Uzodimma, 2005). However,
a knowledge gap exists on knowledge and practice of family planning
methods among married women with respect to their reproductive ages and
educational status in Edo State. Consequently, this study is undertaken to
determine the influence of age and educational status on knowledge and practice
of family planning methods among married women in Benin metropolis.
This study examines influence of
personal variables on knowledge and practice of family planning methods among
married women of reproductive ages in Benin metropolis. Specifically, the study
sought to:
1.
determine whether married women in Benin
metropolis have knowledge of family planning methods
2.
examine the family planning methods
practiced among married women in Benin metropolis
3.
find out the influence of age on
knowledge of family planning methods among married women in Benin metropolis
4
find out the influence of age on
practice of family planning methods among married women in Benin metropolis
5
determine the influence of educational
status on knowledge of family planning among married women in Benin metropolis
6
determine the influence of educational
status on practice of family planning methods among married women in Benin
metropolis
This
study was guided by the following research questions:
1.
Do married women in Benin metropolis
have knowledge of family planning methods?
2.
What are the family planning methods
practiced among married women in Benin metropolis?
3.
What is the influence of age on
knowledge of family planning methods among married women in Benin metropolis?
4.
What is the influence of age on practice
of family planning methods among married women in Benin metropolis?
5.
What is the influence of educational
status on knowledge of family planning among married women in Benin metropolis?
6.
What is the influence of educational
status on practice of family planning methods among married women in Benin
metropolis?
The
following research hypotheses were tested in the study:
1.
There is no significant difference
between old and young married women on knowledge of family planning methods.
2.
There is no significant difference
between old and young married women on practice of family planning methods.
3.
There is no significant difference
between well-educated and less-educated married women on knowledge of family
planning methods.
4.
There is no significant difference
between well-educated and less-educated married women on practice of family
planning methods.
The findings of this study will be of immense
benefit to married men and women, guidance counsellors, public health administrators,
the government and prospective researchers. The findings would be of benefit to
them in the following ways:
To married men and women, findings from the study would show them the various family
planning methods used by married women in Benin metropolis. Hence, this could
help to show them the various family planning options available as well as the
one they could adopt for their sex life with their life partner.
Guidance counsellors and public health
Administrators would also benefit from this study in that findings would avail
them with information on the level of awareness and methods of family planning adopted
by married women of reproductive age. Hence, the outcome of the study could
bring about increasing sensitization or awarenesscampaign on the use of safe
family planning methods in the Benin metropolis and beyond.
Findings from this study would help the government
to ascertain the influence of age and educational status on family planning
methods practiced by married women in the metropolis. Hence, this could afford
them the opportunity of determining the age status or class of married educated
women to provide detailed information on birth control methods or family
planning.
Lastly, findings from the study will
contribute to knowledge, provoke further researches on this area and consequently
lead to the production of more empirical data that would be of benefit to
prospective researchers in the future.
The study will cover all married women of
reproductive age in Benin metropolis including market women, civil servants,
teachers, female local farmers, women in religious worship centres, health workers
at the family planning unit, post-natal, and ante-natal unit of the Central
Hospital Benin City, St. Philomena Hospital Benin City, Faith Medical Centre, University
of Benin Teaching Hospital (UBTH), Benin City, Our Medical Centre, Benin City,
Military Hospital, Benin City and RohobotMedical Centre,Benin City. The study
will examine the influence of age and educational status on the knowledge and
practice of family planning methods among married women of reproductive ages in
Benin metropolis
Essentially, this study focused on the influence of
age and educational qualification on knowledge and practice of family planning
methods married women of reproductive ages in Benin metropolis. The population
of the study covered market women, civil servants, teachers, female local
farmers, women in religious worship centres, health workers at the family
planning unit, post-natal, and ante-natal unit of selected hospitals in the
metropolis. Hence, exclusion of other category of women reproductive ages such
as academics, bankers, and public office servants (who usually possess high
educational qualification), shows that generalizations from the study is only
based on facts collected from women who are seemingly of low socio-economic
background. Thus, generalizations from this study may be limited. Furthermore,
the study relied only on questionnaire for collecting data. Recently, there
have been clamour for both qualitative and quantitative methods for data
collection. Hence, the involvement of interview schedule and focused group
discussions (FGDs) with women of various ages and educational status would have
further helped to determine the family planning methods practiced among married
women in the study area.
The following terms are operationally defined for
the study:
Family
planning: This refers to birth spacingor birth control methods used by married
women inpreventing a pregnancy.
Knowledge:This
refers to awareness of married women in Benin metropolis on the various family
planning methods or contraceptive practices.
Family
planning methods:These are devices or practices usedor employed by married
women to prevent pregnancy. Some of the devices include among others:
contraceptive pills, condoms,and hormonal injection,while the practices include
withdrawal methods, calendar estimationand abstinence from sex among others.
Married women of
reproductive age: This refers to women still living with their spouse within
the marriageable and child bearing age of 18-55years.
Ages:
This refers to the oldness or youngness of women of married women of
reproductive age.
Old women:This are
married women that are above the age of 30years.
Young women:This are
married women that are below the age of 30years
Well-educated
women:Thisare married women that are degree holders. They cover married women
with degrees and post-graduate degrees such as bachelor degrees, masters and
doctorate among others from tertiary institutions.
Less-educated
women:Thisare married women that do not hold a bachelor degree as their highest
educational qualification but have lesser qualifications such as: diploma(s)
(ND, OND, HND), secondary education, or primary school certificate.
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