BY PATIENCE IHEJIRIKA, Abuja, RALIYAT HARUNA, Kano, AISHA ABUBAKAR, Kaduna, UMMA AHMAD, Kano
The campaign for families to adopt family planning methods is facing challenges in Nigeria due to religious beliefs, misconceptions and other factors.
Aisha, 28, strapped her 12-month-old baby, Ahmed, to her back as she leaned against the wall near the entrance to the Kafin Sule Community Primary Health Care (PHC) center in the Misau Local Government Area of Bauchi State.
Kafin Sule is about two hours from Bauchi town with a single PHC serving 30 villages including Aisha village.
Like Aisha, many other women, some of them pregnant, have to travel a long way from their villages to access health care in Kafin Sule.
Aisha, looking exhausted, then sat down in front of the PHC to breastfeed her crying son.
Aisha has eight children, the youngest of whom is Ahmed. She said she had all seven of Ahmed’s siblings at home, adding that Ahmed was lucky because when she was pregnant with him she learned that an international organization offered women N1,000 per hospital visit for antenatal care or infant vaccination. , a lot of money for a woman who had never earned her own money because she is completely dependent on her husband who is a farmer with four wives and 30 children.
The mother-of-eight, who would have loved to stop having children after her fifth child, said being a woman she had no power to make such a decision.
With tears in her eyes, Aisha said she was told about family planning when she had Ahmed at the facility, but she didn’t even have the courage to discuss it with her husband because in her village, it is believed that having many children is a blessing from God.
Additionally, Zainab, 26, who came to the hospital for antenatal care, was pregnant with her sixth child. Unlike Aisha, Zainab’s husband approved of the family planning that Zainab started after her fifth child. However, Zainab started experiencing unusual symptoms so she had to stop.
Three months after quitting, Zainab became pregnant with her sixth child. Now she is ready to try another method of family planning because she does not want to have another pregnancy.
Unfortunately, Aisha is just one of many women in Nigeria who would like to use contraceptives but cannot due to religious/cultural beliefs, while Zainab is among many women who have children by chance due to pregnancy. discontinuation of contraceptives due to side effects, myths and misconceptions. .
Reproductive health experts have identified these factors as major setbacks in the country’s drive to meet modern contraceptive prevalence goals and control its population growth.
The current population of Nigeria is over 200 million according to the Worldometer elaboration of the latest United Nations data. The UN predicts that Nigeria’s population will double by the end of 2050.
LEADERSHIP recalls that the federal government set itself the goal in 2012 of increasing the modern contraceptive prevalence rate (mCPR) to 36% by 2018.
However, on July 11, 2017, at the Family Planning Summit in London, this target was rebased to 27% by 2020. Two years later, the mCPR remained at 12% while the prevalence of traditional contraception was 5%, for a total of 17%. hundred.
Factors Discouraging Use of Contraceptives in Nigeria
Although family planning has been identified as essential to address Nigeria’s impending demographic crisis, many women do not use contraceptives for several reasons including religious/cultural beliefs, the quest to have more children , fear of side effects, myths and misconceptions.
According to research conducted by the LEADERSHIP data mining department, 35% of women stopped using modern contraceptives due to the desire to get pregnant, 14% due to health problems and side effects, while 11% were due to infrequent sex or a husband. to be far.
On the perceptions and knowledge of the couple, the study found that 98% of single women in the northern part of the country were informed about modern contraceptive methods compared to the statistics of married women at 94%.
Regarding family planning methods, it was found that the majority of contraceptive users in the country use modern methods (10% of currently married women), 5% use traditional methods, 3% use injectables and 2% use male condoms or the pill for contraception.
The study also showed that fear of side effects is among the reasons some women stop using contraceptives, with injectables having the highest discontinuation rate due to side effects at 22.7%. while the male condom had the least at 0.9% within 12 months of initiation. use of the method.
Misconceptions and negative perceptions about the use of family planning, such as beliefs that contraceptives are dangerous to a woman’s health, that they can harm a woman’s uterus, inhibit later fertility or that they can cause cancer, also affect the high fertility rates in the country.
LEADERSHIP data reveals that 46% of women believe contraception makes single people “loose”, 33% believe it causes infertility, 15.2% believe it causes cancer and other diseases while 39.3% think it encourages female promiscuity, according to the data.
Regarding the availability of family planning commodities, data show that approximately 15% of married women report using contraceptives and 16% report an unmet need for family planning services.
In northwestern Nigeria, high parity norms determine fertility, with 61.6% of women with six or more children wanting more children and 89.1% of men in this category.
This is prevalent in the northern part of the country, where the majority of the population is Muslim as many women believe that high fertility honors Allah.
Specifically, one way “to serve God with fertility is to give birth to many children who will worship him and secure the future of Islam,” they say.
Likewise, the cultural belief is that God places children in the womb and “until they are born, you don’t stop”. It is also believed that to some extent it is considered haram (illegal) to have family planning due to fear of sustenance and ability to care for children.
However, there are other groups of people who still believe that having modern family planning is permissible in Islam. The positive impact of Islam on the use of contraception cannot be ruled out, as the reasons behind justifying the use of contraceptives include preservation of family quality, health, economy and even help the woman to preserve her beauty.
Kafin Sule Community Neighborhood Development Committee (WDC) Vice Chairman Baidu Liman said all his wives have access to family planning services.
He said, “Many people now understand the importance of family planning. Before now, if you talked about family planning, people would just think you don’t want them to give birth, but with explanations, men and women now understand that family planning is just about spacing their children, not about them. prevent childbirth. .”
Sharing his personal experience, he said, “Before knowing family planning, I had two children in two years, but since I had this enlightenment, my children are now six years apart. Our religion allows family planning, only those who don’t know the religion misinterpret it. We continue to preach and tell them about family planning during weddings and Islamic gatherings. »
Additionally, “facility manager” Amina Abdulahi said, “We write down the days we give them health talks. Some of them start accessing family planning immediately after birth. About 60% of them have access to family planning, but the remaining 40% said their husbands would not allow them.
“We also advise them to breastfeed optimally as it serves as a form of family planning.”
She said, however, that for some reason some women are unwilling to admit in public that they have access to family planning.
“Some of them don’t like to come to the establishment, but they confide in me; they even change their name and address when they come for family planning,” she said.
This is an indication that religious and cultural factors have the potential to influence the acceptance and use of contraception by couples of different religions in very distinct ways.
Within religions, different sects may interpret religious teachings on this subject in different ways, and women and their partners may choose to ignore religious teachings and follow their personal interests.
Along with culture and religion, the desire for large families is also driving fertility in the northwest region of the country. According to the Nigeria Demographic and Health Survey (NDHS) 2018, 61.6% of women with six or more children in this region wanted to have more children. Among men with six or more children, this percentage was even higher; 89.1% wanted more.
The LEADERSHIP study found that social norms driving high fertility in the North West are linked in part to perceptions of its social benefits, such as signaling higher wealth and status. , ensuring the survival of surnames and expanding social networks and influence. Large family size is believed to represent and engender both wealth, influence, respect and fame.
In addition, large families are seen to have economic benefits, such as serving as social insurance for parents as they age and contributing to domestic work or earnings from market-based employment. .
However, the perception that men are more opposed to family planning (FP) in northern Nigeria is gradually changing, as a man from Gombe shared how he managed to persuade his wife to adopt birth spacing.
A high school teacher and father of eight in the state, Usman Ibrahim, said he tried every means available to convince his wife to opt for family planning, including asking her parents for help. . “Yet she refused and accused me of planning to marry a second wife.”
He continued to persuade her and promised to send her to school, but she refused until he threatened to take a second wife if she continued to give birth to children every year, before she does not accept.