Poverty as impediment to contraceptives use among women
By Abiemwense Moru, News Agency of Nigeria (NAN)
According to the UNPFA access to safe voluntary family planning is a human right. Family planning is central to gender equality and women’s empowerment, and it is a key factor in reducing poverty.
“Yet in developing regions, an estimated 257 million women who want to avoid pregnancy are not using safe and effective family planning methods, for reasons ranging from lack of access to information or services to lack of support from their partners or communities,“ said a UNFP report.
The agency highlights the impact of this on global poverty alleviation saying it “threatens their ability to build a better future for themselves, their families and their communities”.
Experts say poverty is negatively associated with family planning utilisation. This claim is reflected in the low level of contraceptive use in societies with low socioeconomic conditions compared to the high-income countries.
This is contained in a study by Akinyemi and other scholars on Socio-economic inequalities and family planning utilization among female adolescents in urban slums in Nigeria.
In many Nigerian families spouses desire to undertake family planning options but are hindered by the cost of managing them.
To address this, Association for the Advancement of Family Planning (AAFP) in an interview with the News Agency of Nigeria (NAN) urged stakeholders to produce a legislation that would support family planning.
Dr Ejike Orji, Chairman, Technical Management Committee, AAFP, described family planning as critical in reversing maternal mortality and achieving demographic dividends.
He said making family planning budget to pass through the annual legislation and appropriation would give it constitutional backing and ensure that through oversight functions legislators would ensure that funds allocated to it were utilised.
Oji, therefore, recommends that “about one per cent of the annual budget for health should be set aside for family planning.
“There have been inconsistencies in the budget for family planning in the past, we need to make the funding a legislative affair for it to be sustained.”
He urged government at all levels to as a matter of necessity, prioritise family planning in their policies for a guaranteed health and wealth.
NAN reports that some countries such as the U.S. have legislations that aimed at expanding access to family planning.
Women are critical partners in any family planning effort and they expressed diverse views on the use of contraceptives.
Some women told NAN that family planning was a necessity yet a hectic journey which requires money to undertake and maintain, adding that they consider pregnancy prevention methods safe, while others said they are worried by its side effects.
Mrs Benita Sampson, a civil servant, said that her family planning method had been helpful because she does not entertain any fears of unplanned pregnancy.
“I use Nexplanon which is the arm birth control implant. I replace the implant every three years which is convenient for me.
“I sometimes forget I’m wearing it; it has been good because, unlike some other women, I usually see my menstrual cycle without hitches.
“It is, however, not a bed of roses. In September 2022, I went to replace my old implant and experienced bleeding for a month.
“The gynaecologist, however, told me that my body was just adjusting to the implant since I just finished a dose and was starting another.
“My menstrual cycle normalised after two months of that experience and I’ve been fine since then,” she said.
Mrs Chinonye Nwokenna, a mother of four, said she had an implant placed under her armpit for five years but had to remove it because she was gaining so much weight.
Nwokenna said she opted for the injection contraceptive, which was taken every three months but said that it had its side effects.
“I had to remove the implant in my arm because I was gaining so much weight. I take the injection once in every three months, but I usually come down with headache.
“I prefer the injection; the headache is not serious and is better than gaining weight,” she said.
But sometimes, it is not all good news as in the case of Mrs Joy Omoyeni, who said she was on the implant contraceptive for three years but still conceived her last child.
While some women have embraced contraceptives, others have rejected it, arguing that it is not necessary as far as the woman is married. Yet to some others, their faith forbids it.
Mrs Esther Ojukwu, a civil servant and mother of seven, said she would not go for any kind of family planning as it is against her religious belief and faith.
“I am a Catholic and the Catholic faith does not encourage family planning. I try in my own possible way to avoid getting pregnant, but if it happens, I have no choice,” she said.
On his part, Mr Joseph Malaki, a public servant, said he had a nasty experience with the use of contraceptive which was implanted on his wife.
He alleged that it caused his wife to suffer from fibroid which was later removed through surgery.
Mrs Jane Nnoli, a mother of three, said she would not undergo any family procedure due to fear of after effects.
Nnoli said she would rather abstain or use the withdrawal method as her husband does not enjoy the use of condom.
“I am afraid of family planning be it the implant, injection or any other form of family planning that has the ability to alter the way our my functions.
“I believe these contraceptives have long term effects on the user which the health care providers would not want to disclose,” she said.
Meanwhile, a Senior Community Health Officer, Mr Sabo Sunday, advised women to use the Long Acting Reversible Contraceptives (LARC), which is considered the most effective method of family planning.
“We advise women to use the Long Acting Reversible Contraceptive Method. Although it is a hormonal contraceptive, it is reversible and it has a better advantage in women.
“The implants are the most effective forms of reversible birth control available. They are more effective than birth control pills, the patch or the ring.
“The benefits include cost effectiveness, few contraindications, few side effects and privacy; they are also rapidly reversible,” he said.
Mrs Roseline Egudu, a nurse, told NAN that family planning helps women to alter their regular reproductive system, adding that some tests are carried out before placing them on their preferred choice.
“Tests are usually carried out before starting women on their preferred method.
“Some women experience memory loss, nausea, breast tenderness, heavy bleeding, headaches, weight gain, mood changes, prolong or irregular menstrual flow, among other side effects while others experience none.
“Family planning has helped a lot of families in spacing their children and also in avoiding unwanted pregnancies but in some cases it fails and some women get pregnant,” Egudu said.
She said some birth control pills stop ovulation and change the lining of the womb, which makes it difficult for fertilised eggs to be implanted.
Meanwhile, the Society for Family Health (SFH) has called for the expansion and funding of the provision of family planning services in Nigeria and other West African countries through the private sector.
The Non-Governmental Organisation (NGO) made the call in a statement by Dr Jennifer Anyanti, Deputy Medical Director, Strategy and Technical, to commemorate the World Population Day 2023, celebrated every July 11.
Anyanti commended the Federal and state Governments’ commitment to scaling family planning services, adding that the organisation supports quality service provision and products through its network of primary care providers.
“Women, regardless of age or financial status should have access to the information they need to make informed decisions about their family planning options.
“The need for them to receive any service if needed pushes us to continue to advocate service provision in the private sector.
“This we do through community pharmacies, private clinics and hospitals, and Patent and Proprietary Medicine Vendors (PPMVs), also known as chemists,” she said.
According to her, the private sector plays a critical role in family planning and contributes to a total market approach to providing services for women.
“In Nigeria over 60 per cent of women obtain their contraceptive supplies from the private sector. We call on government to continuously create the enabling environment for the private sector to thrive.
“The government should ensure that regulation supporting private sector provision of contraceptives is supportive of growth, development and supplies through the private sector.
“This has a core role in addressing access to Family planning, one of the high impact interventions to address maternal and child mortality,” she said.
Speaking about the organisation’s interventions in family planning over the years, she said it had implemented programmes towards strengthening private sector capabilities in service delivery, demands generation, data quality and reporting.
Others are supply chain management including last mile delivery and building resilient health systems to improve access to sustainable markets for contraceptive services.
“We advocate that governments should continue to engage the private sector partners in developing policies and programmes that expand access to family planning information,” she said. (NANFeatures)
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