Family Planning – Determining the Level of Awareness of Women to the Available Family Planning Services



Family Planning  – Determining the Level of Awareness of Women to the Available Family Planning Services

Family Planning – Limiting the would population through fertility control has become a political as well as religions and personal issue the implications of overpopulation have usually been stated in terms of developing nations but have to – on a global context (Bailliere Findall, 2002)

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In the olden days, a man’s wealth in most part of Africa was judged by the size of his family i.e the number of wives who bear the more and consequently large families. This was common in Igbo land where women are judged by their fertility

WHO (2002) stated that family planning is a way of thinking and living that is adopted voluntarily upon the basis of knowledge. Attitude and responsible decision by individual and couples in order to promote the health and welfare of the family groups and this contribute effectively to the social development of a country. It can also be defined as the arrangement spacing and limitation of children in a family. Family Planning is the planning of when to have children and the use of birth control and other techniques to implement such plans. It is also know as fertility awareness, periodic abstinence and the rhythm method, this approach entails not having sexual intercourse on the days of a woman’s menstrual cycle when she could be become pregnant or using a barrier method for birth control on those days.

The scope of family planning goes beyond just limiting the family size as many think but include the following the proper child spacing limitation, sex education, advice of sterility education for parenthood, sex education. Genetic counseling etc. (Vasundhra. 2008).

In recent times, a lot of studies have been made of improving contraceptives and making them available affordable and accessible. Yet an estimate of 123 million couples mainly in developing countries do not use contraceptives despite wanting to space or limit their child bearing. In addition, there are up to 27 million unintended pregnancies each year among proole who use contraceptives and some 300 million couples are dissatisfied with the methods they use (WHO, 2004).

I are veat more than hall of pregnancy in United State is unitended (Centres for disease control and prevention, 1999). Although, unintended pregnancy occur in women of all ages, income, racial and African – American women (US Surgeon General, 2000). Fewer unwanted pregnancies may reduce the number of abortions, abused children stressed families and infants mortality and morbidity (Brunners et 2004).

Despite the popular attention family planning has gained and it’s importance to the society. Its practice in Ebonyi State particularly Abakaliki and environ is still backward.

Many women who are aware of family planning don’t practice it because some of them see it as sin for God has said “ go and multiply and till the earth” Genesis 1: 28 Other believer that is causes infertility and not culturally or religiously acceptable. Hence this study is to determine the knowledge and attitude of the women towards I family planning. The researcher has decided to carry out the study among women attending antenatal clinic in “Mile Four Hospital because most of the populace in Abakaliki prefer this hospital because is a mission hospital which makes its services cost cheaper. This  will help the researcher to discover ways of improving Family planning practices among them.

Family planning is a good measure to check population growth. There are several method that are available for couples but despite that there is high party among the women, child abuse (where most of the children begin quarry work at a tender age), teenage pregnancies, malnutrition, maternal mortality due to inadequate spacing, early co-habitation among the dweller’s of Abakaliki of which women attending antenatal clinic in Mile Four Hospital is a part.

(WHO, 2004) studies have shown that about 123 million couples do not use contraceptives. In developing countries of which Nigeria is one Ebonyi State been one of is states.

In spite of the Family planning methods/services that are available how many women are aware, known the importance of these services and use them. Hence, this study in order to promote awareness. Knowledge and usage among women attending antenatal clinic in Mile Four Hospital Abakaliki.

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The purpose of this study is to identify the knowledge, attitude and use of the available services in Mile Four Hospital, in order to device other strategies of promoting knowledge positive attitude and use of Family Planning services

Based on this purpose, the following objectives are stated

1. Determination of level of awareness and knowledge of the women to the available Family Planning services

2. Identification of how the women’s cultural and religious beliefs influence their attitudes towards family planning practices.

3. Determination of how the women attitude is influence by Health Care provider in hospital

The presence of this research is the applicability of findings to both theoretical and practical problems.

Practically, it will help to determine the knowledge and attitude of women this instituting ways of promoting usage of available family planning services, which will in turn reduce parity, overpopulation and its consequences.

The effective use of family planning materials will encourage couples to take responsible decisions about pregnancy. Child spacing and also serve as a basis for health workers and to intensity their efforts in promoting family planning practices among the women it will help to determine areas of needed support from the government and non governmental organization

Research Questions

1) What is the level of awareness and knowledge of women to the available family planning services?

2) Do their cultural and religious beliefs support family planning?

3) How does the healthcare providers attitude influence the women’s attitude toward family planning

The study is Family to women attending antenatal clinic in Mile Four Hospital, their knowledge and attitude towards family planning in the first two week of October, 2009.

Operational Definition of Terms

1. Family Planning: It is the decision made by a couple to bear the number of children they will be able to care for and to have them.

2. Practices these are steps taken by the women to avoid unwanted pregnancy.

3. Knowledge: It refers to the degree of awareness and understanding of family planning and available family planning services.

4. Attitude: This refers to the behaviour of women towards Family planning neither positive or negative which influence their usage the available services.

  Definition of Family Planning

Dechemey and Nathan (2003) defined Family Planning as the use of contraception to limit or space out the number of children born to a couple Obionu (1999) also defined family planning as the services, which enable couples to take responsible decision about pregnancy and to enable them achieve their wishes with regard to preventing unwanted pregnancy securing desired pregnancy. Spacing pregnancies and limiting family size.

Earlier Tin dall (2000) define family planning as the arrangement, spacing and limitation of the children in a family depending upon the wishes and social circumstances of the parents. It can also be defined as the decision made by a couple to bear the number of children, they will be able to care for and have them when want them

  Scope of Family Planning

Many people view Family Planning as only preventing unwanted pregnancy but it goes bond that, it includes the following

i. Birth Control: This term involves guidance about timing, child spacing and number of children education regarding contraceptive methods and the provision of facilities for birth control. The aim is to produce children by choice and not by chance.

ii. Timing of Birth: It implies the age at which women should conceive, maternal morbidly and maternal complications of pregnancy and delivery are highest when mother age is below 20 and over 35 years. Neonatal and foetal death are lowest for mothers in their twenties. Congenital anomalies are common in children born to elderly mothers. Thus the safest time for conception is when the women is in her twenties.

iii. Number of deliveries: Maternal mortality risk is less with few deliveries

iv. Management of Sterility and low fertility

v. Education about Sexuality: This includes educating the couples persons of both sexes at different ages as regard anatomical, physiological psychological hygiene, social and ethical aspect of sexuality.

vi. Advice on wise Parenthood: This consists of educating the couples and unmarried young persons, the future parents about relationships between their reproductive behaviour and their own health and welfare, as also that of their children, community and country.

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Other aspects include premarital advice, examination, early diagnosis of gynecological troubles such as cancer of cervix, service to the unmarried mothers, termination of pregnancy if indicated etc.

History of Family Planning

Family Planning activities started about 1850BC in Egypt where the Egyptians had a method of preventing pregnancy i.e by pouring gummy substance into the vagina including bicarbonate as vaginal paste which they do before intercourse, it is believed to kill the spermatozoan thereby preventing fertilization.

The development of family planning in United State of America (USA) can be attributed to the works of Dr. Marie Stopes (1880 – 1950) and her husband who opened the first birth control unit in Britain on March 17th 1921. Also in USA in the works of Abraham Jacob (1921). President of American Association on birth control, John Stuart, Margaret Sanger (a nurse) must be remember for their selfless effort in introducing family planning for general use. (Live and Berry 1995).

Margaret Sanger became the international pioneer of birth control in 1942: the Planned Parenthood Federation of America was formed due to rapid growth of contraceptive practice.

Ten years later i.e (1952), the birth control pioneer of different countries joined and formed the international parenthood federation (IFPT, 1999).

In Traditional Africa, separation of wives from their husbands (abstinences) during breastfeeding coitus interruptus and waistbands were also used.

In Nigeria, the effort to get family planning introduced in the country began in 1950 and first Family planning clinic in Lagos in1958 although it was short-lived. In 1962, pathfinder Fund held consultations with the members of national Council of Women Society on setting up Family planning Services.

The pathfinder Fund, Population Council and International Planned Parenthood Federation together gave financial assistance which led to reestablishment of family planning Clinic in the country (PPFN, 1995).

Qualities of a Contraceptive 

1. Reliability: It must be 100% effective.

2. Safety: It should be free from associated side effect or complications.

3. Reversibility: There should be complete return of fertility when the method is discontinued.

4. It should be affordability (low cost).

5. Convenience: long acting method are usual convenient for users.

6. Consumer Control: Most present day contraceptives are meant for use by women, only temporary male contraceptives are in use today, over which users full control. Development of female contraceptive, which they can use, safely themselves will go a long way in promoting family planning.

7. Cultural Acceptability: It should be culturally acceptable.

Methods of Family Planning

They are various classification of Family Planning Method e.g. Traditional or Folk method, Modern method, Natural method and artificial method. Temporary and permanent method etc. but this study will classify family planning base on the temporary and permanent method.

Temporary Family Planning Method Constitutes the Following:

(i) Natural Method of Fertility Awareness Method.

(ii) Traditional method

(iii) Barrier method

(iv) Vaginal method

(v) Hormonal method

(vi) Long term method

Natural Method of Fertility Awareness Method.

This includes all Family Planning Methods based on the identification of fertile periods. The effectiveness of this method depends on the ability of the women to identify her fertile time and prevent pregnancy either by abstinence or barrier method.

The successful use of fertility Awareness Method (FAM) to avoid pregnancy depends on adequate teaching by qualified FAM teacher (Knight Pyper 1999), FAM include the following:

a. Total Abstinence: This is a method of Family Planning that cost the couple nothing except self-denial i.e avoidance of sexual intercourse.

Advantage of Abstinence (FAM)

1. It is reliable (absolutely).

Disadvantages of Abstinence

2. It is very difficult to practice

Periodic Abstinence: This implies the avoidance of sex during the time the women is deem fertile i.e during her ovulation period which is 2 – days before and after ovulation. The practical is based on the knowledge the physiology of the female reproductive system including menstruation, conception and changes in the quality of vaginal secretions. They include the following

(b) Calendar (Rhythm) method: this method is based on the record be calculated on basis of the number of days in the shortest and longest cycle. The women then calculate first unsafe day by subtracting 18 days from the shortest cycle and last unsafe day is determined by subtracting 11days from the longest cycle. This method is practicable in women who have regular menstrual cycle.

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(c) Temperature Method: this involves the use of the body temperature to detect ovulation period. The women usually takes her temperature every morning before any physical or emotional activity occurs each day. A rise in temperature (usually about 0.50C – 10C) indicate ovulation.

This method is not practicable where there is high level of illiteracy because the women will not be able to read the thermometer or chart the even if they know the end of the thermometer to put in the month.

(d) Billings Ovulation Method (Cervical Mucus): This relies on the changes in cervical mucus secretion, it is base on the women’s ability to observe sequence of changes in the consistency or quality or cervical mucus. Shortly before ovulation, the mucus is sticky and moist, but post ovulation days of fertile period, there is scanty or no mucus in which the women feels dry. Ideally abstinence should extend through the early ovulatory (sticky moist mucus) to the ovulatory period of clear wet stretchy mucus, whereas intercourse can be permitted beginning on the fourth day after the last day of wet stretchy mucus.

(e) Symtothermic method: It combines the use of basal body temperature ad analysis of cervical mucus changes affected by illness, stress or activity level.

(f) Coitus inferruptus: Coitus interruptus involes the male withdrawing his penis from vigina immediately before ejaculation of semen during intercourse. It does not involve cost, chemical devices and it is always available but requires a great deal of self-control.

(g) Coilus Reservatus: In this method, penetration of the vagina take place but there is little or no motion and the man does not ejaculate into the vagina.

(h) Coilus interfermorrs: The erect penis is placed between the thighs of the female, so ejaculation, if it occurs does so outside the vagina.

(i) Lactation Amenorroca (LAM): This method is utilized by women breastfeeding, when a baby is feeding at the mother’s breast, there is reflex release of protactin from pituitary which prevents ovulation, but the life time of protactin is very short so requires repeated sucking to maintain a high level of it in the blood but it is only effective during 6 months post partum.

Advantages of Fertility Awareness Method

1.            It has no physical side effects.

2.            It has little or no cost

3.            It has no effect on breastfeeding

4.            It gives men the opportunity to be involved in family planning.

5.            Once it is learned, it requires no further help from a healthcare provider.

Disadvantages and Side Effects of Fertility Awareness Method

1.            It does not work well as modern family planning methods.

2.            It may be difficult to use if the woman have a fever or a vagina infection.

Chemical Method

There are chemical substances inserted into the vagina before intercourse inserted to inactivate spermatozoa and also prevent them from entering the uterus. They include creams, foaming tablets, aerosol, foams etc.

Precaution When Chemical Method is Used


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This article was extracted from a Project Research Work/Material Topic “DETERMINATION OF THE KNOWDEGE,ATTITUDE AND FACTORS CONSTITUTING  BARRIERS TO NON- COMPLIANCE OF FAMILY PLANNING PRACTICE AMONG WOMEN  ATTENDING ANTENATAL  CLINIC IN MILE FOUR HOSPITAL ABAKALIKI, EBONYI STATE”

 


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Comments

  1. that a very good article
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  2. maryjane says:

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  3. Amos Katin Ibrahim says:

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