Accessibility, Use, Misuse and Effects of Combined Oral Contraceptives Among Women of Child Bearing Age
Chapter One
Objective of the study
General objective
To assess accessibility, attitude and use of oral contraceptive among women of reproductive age group in Eri ile LGA, Kwara state.
Specific objectives
- To assess accessibility of contraceptive utilization of women at reproductive age group in a study
- To assess attitude towards contraceptive utilization of women at reproductive age group in a study
- To assess practice of contraceptive utilization of women at reproductive age group in a study
- To assess the association of socio-demographic characteristics with KAP of women’s of reproductive age group in this study.
CHAPTER TWO
LITERATURE REVIEW
Global situation of Family planning
In more developed country, the recent study examines recent levels and trends of contraception practice throughout the world. It is estimated that 57% of couples with the wife of reproductive age were currently using some form of contraception on average. Therefore, in more developed region the average level of use at the most recent measurement was 72% and in less developed region is 53%. The level of current use or contraceptive prevalence varies greatly among the less developed region from an estimated 18% of couples using contraception in Africa and only 12% in sub Saharan Africa, to 79% in eastern Asia. For all individual developing countries, in Asia, the level of use is 58%, the same as in Latin America and Caribbean
As the study done on family planning among mothers of Mexico shows the use of family planning among women’s of reproductive age group, was high, overall 47% of women use family planning method. Among current users majority relay on IUCDs, pills and injectable are most widely used 8% and 6% respectively.
Study done in Brazil peasant association shows that 59.6% of women were with panned pregnancy, literacy status of women was statistically, significantly associated with type of pregnancy that is planned or unplanned, and also 80% of mothers use injectable followed by pills(76%).( Samuel G.Shiferaw, Mandeferew Gebrehiwot.T 1996. Pp.27)
The finding in Nigeria shows that accessibility of mothers of reproductive age group on oral contraceptive is high , 22% of women even using family planning and 13% of them are not using, 43% do not know any family planning method and 22% were afraid of side effects and did not know where to obtain.( Friedman, Herbert, L. 1993, pp. 22-23 ).
A study done in developing countries over one million who are married have unmet need for spacing or limiting births. Other suggested countries were large number of women have unmet need are Pakistan at 7.5 million, Brazil at 3 million, Mexico at 3.1 million and Philippines at 2.5 million. Among the most common reason for unmet need are unsatisfactory service, lack of information, fear of side and opposition from husband, relative or others.’
Nigeria situation of Family planning
A survey conducted in Nigeria showed that 30% of all pregnancies were unplanned. This indicates an enormous unmet need for family planning will be about 800,000 unwanted pregnancies every year (Ethiop. J. Health Dev. 2009;23(2))
A study done on family planning practice and related factors of married women in Nigeria, show that almost 67% of women were currently using at least on family planning method and most common obtained family planning method from the public health sectors. Short-term methods such as pills and injections were most commonly used. Family planning practice was significantly associated with willingness to use long-term permanent family planning method in future and spousal discussion about family planning method.
Among those who have discontinued contraceptive usage women, the reason for discontinuation of contraceptive use were, 55% of women were to have children and 34.7% of women reported discontinuation due to fear of side effects and the rest 10.3%, have the discontinued using contraceptive by social, family influence. (Federal democratic republic of Nigeria ministry of health 2007 report, page 29.)
A survey conducted by MSIE on KAP of family planning method from January-February 2009 in five regions :- Oromia, Amhara,Tigrai, southern people nation, afar and two city administrative areas of Addis Ababa and Dire dawa on 1200 female of reproductive age group show that 51% of the respondent use modern family planning method like IUCDs, implants, male; female sterilization were mentioned by only 3% of respondents, and unmet need for family planning is 25%, (17% for spacing, 8% for limiting). (Belay T. 1999., Nigerian journal of health science 9(1) pp1-8.)
A cross-sectional survey was conducted in Addis Ababa February. 1-5, 2005, a total of 361 study subjects were interviewed making the coverage of study 99.7%, 183(50.7%) were married, 186(51.5%) illiterate and 352(97.5) were got less 100 birr per month, 266(73.54%) had good accessibility about modern contraception and 279(77.3) had favourable attitude towards modern contraception. (Samuel g.shiferaw mand gebrehiwot.t 1996. Pp.32).
CHAPTER THREE
RESEARCH DESIGN AND METHODOLOGY
Study design
The paradigm of this study was quantitative and it utilised a descriptive, cross-sectional survey design. It was referred to as such because it was centred on numerical data, dedicated to describing a particular phenomenon and data was collected during a single, relatively brief time period. By using the cross-sectional design, this study gives a snap- shot impression of the Accessibility, Attitude and Use of oral contraceptive among women of reproductive age group in Eri ile LGA.
Source population
Women of reproductive age group (15-49) that included 211 women in Eri ile health centre who are coming for the health care seek.
Study population
Women of reproductive age group will be selected from 211 source population by systematic random sampling technique.
CHAPTER FOUR
MAJOR FINDINGS AND DISCUSSION
Socio-demographic characteristics
A total of 75 women of reproductive age group (15-49) were participated in the study accounting for a response rate of 97.33%. Majority 27 (36%) of the respondents were in the age range of 20-24 years and 36(48%) of the respondents were Muslims by religion. In case of ethnicity Oromo covers 39(53.33%) of the respondents. As to monthly income, occupation, and educational status of the respondents, about 25(33.34%) got 301-400 birr, by income, 26(34.67%) were house wife by occupation and most 21(28%) of the respondent can read and write. In case of marital status 21(54.66%) of the respondents were married. (Table-1)
Table-1: Distribution of women of reproductive age group (15-49) by their socio- demographic characteristics in Eri ile LGA, Kwara state, Oromia National Regional Sate South West of Nigeria. (n=75)
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
Family planning is a means of promoting the health of women and families and part of strategies to reduce the high maternal, infant and child mortality and yet, there is very little information on what influences its utilization in Nigeria.
From this study out of 75 study subjects interviewed as if they have accessibility about oral contraceptive, only 68(90.67%) of them were found to be accessible, and this finding is different from a cross sectional survey conducted in Addis Ababa, February. 1-5, 2010 in which, a total of 361 study subject were interviewed making the coverage of study 265 (73.54%) had good accessibility about oral contraceptive and A survey of KAP toward contraceptive utilization conducted among lower, middle and upper class women in Gondar women 1996 which showed 65% of the respondent knew about oral contraceptive method. The likely exception for this dissimilarity might be due to difference in study period, level of education of the study subjects involved and Operationalization of utilization.
According to this study most 18(26.69%) of the respondent having accessibility about oral contraceptive method, mentioned pills and 15(22.05%), 9(13.24%), of them mentioned injectable and IUCDs respectively. This finding is same what similar with a survey of KAP conducted among lower, middle and upper class women in Gondar women 1999, in which 44% of the study subjects mentioned pills, followed by tuba ligation.
Out of 68 respondents knowing oral contraceptive method 27(40.69%) of them strongly agreed that child spacing is important, and 29(42.64%), 10(14.70%), and 2(2.94%) of them agreed, disagreed and undecided respectively with an importance of child spacing; and for limiting the number of children, 32(47.05%), 25 (36.76%), 7 (10.29%), and 4 (5.88%) of them strongly agreed, agreed, disagreed and undecided respectively.
Of the 68 respondents 13(38.35%), 12(36.41%), of them strongly agree respectively with the use of oral contraceptive method is to prevent pregnancy question. From the total score of attitude, the positive and negative attitude level was classified on the seated
criteria, accordingly 12(36.644%) had a positive attitude and the rest 21(63.35%) had a negative attitude. This finding was similar with a cross-sectional survey conducted in Addis Ababa February. 1-5, 2005, in which 279(77.3) had favourable attitude towards modern contraception. (13)
From the of sample the oral contraceptive users 44(34.37%) of them used pills whereas injectable, Norplant, IUCDs, and tubal ligation were used by 51(39.84%), 17(13.28%), 12(9.37%), and 4(3.13%) respectively. This study finding was same what similar with a study done on family planning among mothers of Mexico which shows the use of family planning among women’s of reproductive age group, was high, overall 47% of women use family planning method. Among current users majority relay on IUCDs, pills and injectable are most widely used 8% and 6% respectively. (4)
Generally, as to the accessibility, attitude and practice of respondents, the main factors as challenges to its poor utilization were: religion and culture and fear of side effect . This finding was not much different from what has been observed from the finding in Nigeria which showed that accessibility of mothers of reproductive age group on oral contraceptive was high, 22% of women ever use family planning and 13% of them were not using, 44% did not know any family planning method and 22% were afraid of side effects and did not know where to obtain.
Furthermore, this study further revealed as there is no significant association between socio-demographic characteristics and KAP toward oral contraceptive utilization.
Based on the finding of the study the principal investigator has made the following conclusions:-
- Most 68 (90.67%) ofthe study subject had accessibility about oral contraceptive method and most of them mentioned pills as a oral contraceptive method and benefit of oral contraceptive method were known as to space birth by majority of the
- Fromthe total score of attitude, the positive and negative attitude level was classified on the seated criteria; accordingly majority of respondents had a positive attitude while the rest of respondents had a negative
- There wasno significant association between socio-demographic characteristics and KAP toward oral contraceptive utilization
Recommendations
Based on study finding and conclusion the following recommendations are made to the responsible bodies
- Health education is better to be given to mothers of reproductive age groupregarding the benefit of using preferred type of family planning method, the uniqueness of each type of methods and their side effects by nearby health centre and health extension workers of the Eri ile
- Efforts should be made to change the community attitude on contraceptiveutilization through provision of adequate information and training by Eri ile bureau and other concerned
REFERENCE
- Bohmor 2005 adolescent reproductive health in Nigeria, an investigation needs current policies and program. P-10.
- Friedman,Herbert, 2008 overcoming obstruction to good adolescent health, Network(FP) international vol. 14, pp. 22-23
- Ministryof Health, Guidelines for Family Planning Services in Addis Ababa. MOH 1996.
- J. Health Dev. 2009;23(2)
- Federaldemocratic republic of Nigeria ministry of health
- TekabaAyalew , Unmet need and demand for family planning in Addis Nigerian medical journal of health 1995 vol. 14 no pp. 41-46.
- YohannesTolosa: the role of men in family planning in a rural community of western Nigeria. April,
- SamuelShiferaw and Mandefrew Gebrehiwot.T determination of contraceptive use in urban population 1996. Pp.25.
- JointUnited Nations Programme on HIV/AIDS (UNAIDS), Report on the Global AIDS Epidemic Wikipedia of HIV/AIDS in Nigeria.