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AN INVESTIGATION INTO THE ATTITUDES OF FAMILY PLANNING AMONG HEALTH CARE USERS AND MARKET WOMEN

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ABSTRACT

This study examined the influence of attitude on family planning among the health workers and market women in Ikosi/Iheri Local Government Area of Lagos State. The objectives of this research were to find out the influence of family size, socio-economic status of families, marital status and religion on the health care users and market women attitude towards family planning. Four research questions and research hypotheses were stated for the study, the research design was survey in nature. The total number of 90 women of child bearing age were selected using the simple random method. The t-test of significance was employed to test the null hypotheses stated for the study. the of this research include the study revealed that family size will significantly influence health care users’ attitude towards family planning. It also revealed that family socio-economic status will significantly influence couples attitude towards family planning. The study further revealed that marital status will significantly influence couples attitude towards family planning. The study further revealed that religion will not significantly influence couples towards family planning. Recommendations were made on the basis of the findings of this study which include:Education: The government should make it as an educational policy to incorporate sex education and family planning in the post primary school curriculum. Enlightenment: The State and Local Governments should mount intensive enlightenment campaigns on the concept of family planning and its merits. This campaign should take the form of seminars, workshop and symposia. Establishment of Family Planning Clinics: The Government and voluntary organisations should establish family planning clinics in urban and rural areas. They could render such services as advice to couples, processes involved in the practice of family planning, use of contraceptives and other methods of birth control, mobile clinics should be provided also to carry the campaigns to rural areas where family planning clinics do not exist, contraceptives and other control measures and services relating to family planning should be made relatively cheap to enhance acceptance of family planning by people who need it and men should be encouraged to join the women to attend family planning programme and practices as family planning is for both men and women.

CHAPTER ONE

INTRODUCTION

Background of Study

Modern family planning helps women to avoid unwanted pregnancies, illegal abortions and child bearing that will threaten their own personal health and that of the children (Ogunbayo, 2007). Family planning involves two concepts – contraceptive use and family planning services which is used by couples to bring about healthy sexual relationships among them without fears of unwanted pregnancies and sexually transmitted infections (Duzo & Mohammed, 2011).

 Family planning is the planning of when to have and use birth techniques to implement such plans. Other techniques commonly used include sexual education, prevention and management of sexually transmitted diseases, pre-conception counseling, management and infertility management (Derose, Mohammed, Helman

Moronkola & Blumenthal (2010). However, family planning is usually used as a synonym for the use of birth control. It is most adopted by couples who wish to limit the number of children they want to have and control the timing of pregnancy, also known as spacing of children (Derose et al., 2005). Family planning may encompass sterilization, as well as pregnancy termination. It also includes raising a child with methods that require significant amount of resources namely: time, social, financial and environmental. Family planning measures are designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family has access to limited resources (Olaitan, 20012).

The first attempt to offer family planning services began with private groups and often aroused strong opposition. Activists, such as Margaret Sanger in the U.S., Marie Stopes in England and Dhanvanthis Rama Rou in India, eventually succeeded in establishing clinics for family planning and health care. Many countries have established national policies and encouraged the use of public family services (World Health Organization, 2010.).

 The concept of informed choice in family planning can be applied to a wide range of sexual and reproductive health decisions. It focuses on whether to seek, to avoid pregnancy, whether to space and time one’s childbearing, whether to use contraception, what family methods to be used, and whether or when to continue or switch methods. The term family planning choice could also refer to the family decision making; the principles of informed choice focus on the individual; however, it also influences a range of outside factors such as: social, economic and cultural norms, gender roles, social networks, religious and local beliefs. Limited Awareness and Knowledge as a barrier in a variety of cultures with low resource settings, lack of awareness and knowledge has been cited as a significant barrier in the uptake of family planning among couple. Health Belief Model (HBM) is one theoretical framework that has been widely used to understand why an individual chooses to participate in a health-promoting behavior, such as family planning services. There is a need for solid awareness with regards to individual, social and wider contextual determinants of relevant health outcomes. Justification for proposed family planning interventions should be grounded in knowledge about the benefit and gains of practicing it.

Harlap, (2011) described family planning as the arrangement, spacing and initiation of children in a family based upon the wishes and social circumstances of the parents. It could also mean the spacing of birth so as to achieve maximum health and comfort for mother, child, and the entire family. N.P.C. (2011) identified family planning methods to include: total abstinence, withdrawal, methods e.g.            Condom, or Diaphragm, Spermicides, Injectables, Oral Contraceptives, Implant, Intra-Uterine contraceptive device (IUCD), sterilization and Billings method or natural family planning methods.

Individuals are expected to choose any of the enumerated family planning methods depending on the availability of device, facility for medical care, age of applicant, size and body make up. Occasionally individuals pay for family planning care.

The implementation of family planning has been influenced by some factors and Nigeria is not an exception. In Nigeria for example, over 70% of her population live in the rural areas or are peasant communities and one of the characteristics of rural people is that they have limited access to correct information and they find it difficult to accept changes based on ignorance and sometimes fear of the unknown hence family planning though fully embraced by the people.

Various factors have been identified that can influence the choice of  family planning method and these include: Literacy level, socio-economic status of family, availability of family planning service, family size and available medical care.

Efforts have been made by Health professionals to educate mothers and spouses on types and choice of family planning methods through workshops, awareness campaign, health talks and seminars on family planning strategies mounted across the nation. Education programmes on these population control strategies are aimed at the prevention of post abortion complications and promotion of safe motherhood.

Statement of the Problem

Despite various efforts made by health care providers to provide safe family planning and population control methods in the community, there is an observed apathy, poor patronage, non-acceptability of the practice which has led to series of pregnancy related problems such as: unwanted pregnancies, abortions, post abortion complications and deaths resulting from the use of unscientific and crude family planning practices.

Purpose of Study

The purpose of this study is to investigate into the attitudes of family planning among Health care users and market women

Research Questions           

The following research questions will be formulated and answered in this study:

1.         Will family size influence attitude of health care users towards family planning?

2.         Will socio-economic status of a family influence couples attitude towards family planning?

 3.        Will marital status influence the attitude of couples towards family planning?

4.         Will religion influence the attitude of couples towards family planning?

Hypotheses

The following research hypotheses were formulated and tested at 0.05 alpha level of significance:

1.   Family size will not significantly influence health care users’ attitude towards family planning.

2.   Family socio-economic status will not significantly influence couples attitude towards family planning.

3.   Marital status will not significantly influence couples attitude towards family planning.

4.   Religion will not significantly influence couples towards family planning.

Significance of the Study

The findings of this study were useful to the following organizations which include:

§  Mothers of child bearing ages and spouses for the control of family size and improvement of maternal health.

§  Family planning practitioners especially in market women, to ensure part proper utilization of services.

§  The study were immense benefits to health care users and medical centres.

§  The findings may also provide an insight into how family planning programmes can be adequately provided and managed among market women in Nigeria.

Limitation of the Study

The limitations to this study include reluctance of some participants to supply, the observed limitation during this study include the personal information, caused unusual delay. However the participants were assured of confidentiality by researcher hence they were able to participate in the research.

Delimitation

The research was delimited to three small communities namely; Ikosi/Isheri, Ketu and Oworoshoki in kosofe local government area in Lagos State. Thirty (30) respondents were participated from each Local Government Area thereby making up the sample size to be ninety (90).

Operational Definitions of key Terms

Attitude: This is a tendency to hold certain beliefs about and to feel in certain ways towards persons, object or ideas.

Family: Family is a group of people held together by birth, marriage, or adoption or by common residence or close emotional attachment. 

Family Planning: This is the arrangement, spacing and limitation of children in a family, depending upon the wishes and social circumstances of the parents. Family planning is the planning of when to have and use birth techniques to implement such plans.

Health: A state of physical, mental, social and emotional well-being of an individual.

Educator: An   individual that facilitates the acquisition of knowledge.

Contraceptive: An agent used to prevent conception.

Vagina:  This is the canal lined with mucous membrane which leads from the vulva to cervix uteri.

Conception:  The act of becoming pregnant by the fertilization of an ovum.


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