DETERMINANTS OF UTILIZATION OF FAMILY PLANNING SERVICES AMONG WOMEN (A CASE STUDY OF GAMBARI WARD IN ILORIN, KWARA STATE)
ABSTRACT
This study was conducted on the determinants of utilization of family planning services among women of Gambari ward in Ilorin, Kwara State.
The specific objectives were to determine the level of utilization of family planning services, to assess the level of knowledge of family planning among women of reproductive age group in Gambari Ward, to determine the proportion of women currently using family planning methods and to determine the proportion of women who wish to use family planning services but cannot access the services.
The study was a descriptive cross-sectional study. A Cluster random sampling method was used. Our study populations were female residents of Gambariward within the reproductive age group. Relevant information was obtained through a 5-section structural questionnaire that assessed areas of interest with both open and closed-ended questions. Data analysis was done using SPSS version 20.0 and results were presented by means of tables, charts and graphs.
Majority of the respondents were aware of family planning services. However,the level of utilization was low due to religious beliefs, spouse refusal, cost and other misconceptions on family planning use.
Appropriate recommendations were made to the government and the community as a whole, on how to improve the overall utilization of family planning services.
TABLE OF CONTENTS
Title Page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract v
Table of Contents vi
CHAPTER ONE
1.1 Background information 1
1.2 Problem statement 2
1.3 Justification for the Study 3
1.4 Objectives of the Research 4
1.41 General objectives
1.42 Specific Objectives
1.5 Conceptual framework 5
CHAPTER TWO
2.0 Literature Review 6
CHAPTER THREE: METHODOLOGY
3.1 Description of study area 22
3.2 Study Design 23
3.3 Study population 24
3.4 Sampling technique and method 24
3.5 Minimum sample size determination 25
3.6 Research instrument 26
3.7 Data Collection, Analysis and Presentation 26
3.8 Ethical consideration 27
3.9 Method of data dissemination 27
3.10 Limitations of the study 28
CHAPTER FOUR: RESULTS
4.1 Socio-demographic characteristics 29
4.2 Gynecologic and reproductive history 35
4.3 Level of awareness of family planning 35
4.4 Level and determinants of utilization of family planning 39
4.5 Perception on family planning 40
4.6 Cross-tabulations. 43
CHAPTER FIVE
Discussion 47
CHAPTER SIX
Conclusion 50
Recommendations 51
References 53
Sample Questionnaires
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND INFORMATION
Family planning, as explained by World Health Organization (WHO), allows individuals and couples anticipate and attain their desired number of children and the spacing and timing of their birth. It is achieved through the use of contraceptive methods. A woman’s ability to space and limit her pregnancies has a direct impact on her health and wellbeing as well as outcome of each pregnancy.
Uptake of family planning methods remains low in Sub-Saharan Africa including Nigeria. This may be associated with high incidence of unintended pregnancies, unsafe abortions and maternal death [1, 2]. The United Nations Sustainable Development Goal (SDG) 5 aims at improving maternal health and reducing maternal mortality by three quarters between 1990 and 2015. An important intervention towards achieving this target is the promotion of family planning among women of Sub-Saharan Africa [1, 3].
Several studies have been conducted on determinants of family planning use. In some cases strong associations have been established between family planning and some socio-demographic, socio-cultural and socio-economic characteristics of women. Studies have revealed that use of family planning methods was found more in women of older age group [4, 5]. Education has also been observed in many other studies to be associated with contraceptive use [4, 6, 7].
1.2 PROBLEM STATEMENT
United Nations MDG5 aims at improving maternal health and reducing maternal mortality by 75% between 1990 and 2015. An important tool towards achieving this target is the promotion of family planning among women. Unfortunately, uptake of family planning methods remains low in Sub-Saharan Africa.
In a study conducted in Ghana, it was estimated that about 17% of married women use modern contraceptive method [8]. This suggests that the use of contraceptive methods, especially modern ones, still remains low among women in Ghana. In the same study, it was estimated that unmet need increased from 30% to 34% in 2008. It is therefore imperative to establish and understand the factors that serve as barrier to the use of contraceptives and available family planning services.
1.3 RATIONALE AND JUSTIFICATION
The world’s population is increasing rapidly and increasing birth rate contributesimmensely to this rapid growth. Family planning has been shown to have control over population growth, therefore knowing the determinants of utilization of the available modern family planning methods will go a long way in encouraging family planning and population control. Evidence also exists that if couples can space their pregnancies by at least 2years through the use of family planning, up to 35% of maternal death and up to 13% of child mortality could be averted [9-11], whilst 25% of under-five mortalities could be averted if birth intervals were at least 3years [10].
The cost effectiveness of family planning in poverty reduction and socio-economic development due to population control in the developing world cannot be disputed [12, 13]. If individuals and couples plan their pregnancies and family with improved use of contraception, they are more likely to have fewer and healthier children.
Hence, having known the benefits of familyplanning, this study is carried out to know the factors that determine the level of utilization of family planning among women of Gambari ward in Ilorin, Kwara state.
1.4 OBJECTIVES
1.4.1 GENERAL OBJECTIVES
1. To identify the determinants of utilization of family planning among women in Gambari Ward.
1.4.2 SPECIFIC OBJECTIVE
1. To identify the determinants of utilization of modern family planning methods.
2. To assess the level of knowledge of family planning among women of reproductive age group in Gambari Ward.
3. To determine the proportion of women currently using family planning methodsinGambari Ward.
4. To determine the proportion of women who wish to use family planning services but cannot access the services.
5. To make recommendations based on findings in the study.
1.5 CONCEPTUAL FRAMEWORK
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CHAPTER 2
LITERATURE REVIEW ON FAMILY PLANNING
2.1 INTRODUCTION
Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births.This is achieved via contraceptive methods which have been found to be an essential tool in this regard and consequently in controlling/reducing the ever growing population size.A woman’s ability to space and limit her pregnancy has a direct impact on her health and wellbeing as well as on the outcome of each pregnancy(WHO).
In enabling women to exercise their reproductive rights, family planning program can also improve the social and economic circumstances of women and their families. Realizing the importance of family planning, the International Conferences on Population and Development(ICPD) held in Cairo, Egypt in 1994 in corporate this as one of important component of overall Reproductive Health. The ICPD rejected a narrow focus on population issues in favor of a broad development approach based on realizing women’s reproductive right and gender equity; calling for family planning to be provided as an integral part of wide ranging reproductive health services. According to ICPD plan of action, Reproductive Health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition is the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice.
Similarly, reproductive rights rest on the recognition of the basic right of all couples to decide freely and responsibility the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.
So, family planning information and services are therefore a critical means for the articulation and attainment of reproductive rights and reproductive health and a central component of reproductive health program.
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