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Accessibility, Use, Misuse and Effects of Combined Oral Contraceptives Among Women of Child Bearing Age

Accessibility, Use, Misuse and Effects of Combined Oral Contraceptives Among Women of Child Bearing Age

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Accessibility, Use, Misuse and Effects of Combined Oral Contraceptives Among Women of Child Bearing Age

Chapter One

Objective ofย theย study

Generalย objective

Toย assessย accessibility,ย attitudeย andย use of oral contraceptive amongย womenย ofย reproductiveย ageย groupย inย Eri ileย LGA,ย Kwara state.

Specificย objectives

  1. To assess accessibility of contraceptive utilization of women at reproductive age group in a study
  2. To assess attitude towards contraceptive utilization of women at reproductive age group in a study
  3. To assess practice of contraceptive utilization of women at reproductive age group in a study
  4. To assess the association of socio-demographic characteristics with KAP of womenโ€™s of reproductive age group in this study.

CHAPTERย TWO

LITERATUREย REVIEW

ย Globalย situationย ofย Familyย planning

Inย moreย developedย country,ย theย recentย studyย examinesย recentย levelsย andย trendsย ofย contraception practice throughoutย the world.ย Itย is estimatedย thatย 57% of couplesย with theย wifeย ofย reproductiveย ageย wereย currently usingย someย formย ofย contraceptionย onย average.ย Therefore,ย inย moreย developedย regionย theย averageย levelย ofย useย atย theย mostย recentย measurement was 72% and in less developed region is 53%. The level of current use orย contraceptive prevalence varies greatly among the less developed region from an estimatedย 18%ย ofย couplesย usingย contraceptionย inย Africaย andย onlyย 12%ย inย subย Saharanย Africa,ย toย 79%ย in eastern Asia. For all individual developing countries, in Asia, the level of use is 58%, theย sameย asย inย Latin Americaย andย Caribbean

As the study done on family planning among mothers of Mexico shows the use of familyย planning among womenโ€™s of reproductive age group, was high, overall 47% of women useย familyย planningย method.ย Amongย currentย usersย majorityย relayย onย IUCDs,ย pillsย andย injectableย areย mostย widelyย usedย 8%ย andย 6%ย respectively.

Study done in Brazil peasant association shows that 59.6% of women were with pannedย pregnancy, literacy status of women was statistically, significantly associated with type ofย pregnancyย thatย isย plannedย orย unplanned,ย andย alsoย 80%ย ofย mothersย useย injectableย followedย byย pills(76%).(ย Samuelย G.Shiferaw,ย Mandeferewย Gebrehiwot.Tย 1996.ย Pp.27)

The finding in Nigeriaย shows thatย accessibility of mothers of reproductiveย ageย group onย oral contraceptiveย isย highย ,ย 22% ofย women even using family planning andย 13% ofย them are not using, 43% do not know any family planning method and 22% were afraid ofย sideย effectsย andย didย notย knowย whereย toย obtain.(ย Friedman,ย Herbert,ย L.ย 1993, pp.ย 22-23ย ).

A study doneย in developing countries overย one million whoย are marriedย have unmetย needย for spacing or limiting births. Other suggested countries were large number of women haveย unmetย needย are Pakistan at 7.5ย million,ย Brazil at 3ย million,ย Mexicoย atย 3.1ย million andย Philippinesย atย 2.5ย million.ย Amongย theย mostย commonย reasonย forย unmetย needย areย unsatisfactoryย service,ย lackย ofย information,ย fearย ofย sideย andย oppositionย fromย husband,ย relativeย orย others.โ€™

ย Nigeriaย situationย ofย Familyย planning

A survey conducted in Nigeria showed that 30% of all pregnancies were unplanned. Thisย indicates an enormous unmet needย forย family planning will be about 800,000 unwantedย pregnanciesย everyย yearย (Ethiop. J.ย Healthย Dev.ย 2009;23(2))

Aย studyย doneย onย familyย planningย practiceย andย relatedย factorsย ofย marriedย womenย inย Nigeria, show that almost 67% of women were currently using at least on family planningย method and most common obtained family planning method from the public health sectors.ย Short-termย methodsย suchย asย pillsย andย injectionsย wereย mostย commonlyย used.ย Familyย planning practice was significantly associated with willingness to use long-term permanentย familyย planningย methodย inย futureย andย spousalย discussionย aboutย familyย planningย method.

Amongย thoseย whoย haveย discontinuedย contraceptiveย usageย women,ย theย reasonย forย discontinuation of contraceptive use were, 55% of women were to have children andย 34.7%ย of women reported discontinuation due to fear of side effects and the rest 10.3%, have theย discontinuedย using contraceptiveย by social,ย family influence.ย (Federal democraticย republicย ofย Nigeriaย ministryย of healthย 2007ย report, pageย 29.)

A survey conducted by MSIE on KAP of family planning method from January-Februaryย 2009 in five regions :- Oromia, Amhara,Tigrai, southern people nation, afar and two cityย administrativeย areasย of Addisย Ababaย andย Dire dawa on 1200ย femaleย of reproductiveย ageย group show that 51% of the respondent use modern family planning method like IUCDs,ย implants, male; female sterilization were mentioned by only 3% of respondents, and unmetย needย for family planning is 25%,ย (17% forย spacing,ย 8%ย forย limiting).ย (Belay T.ย 1999.,ย Nigerianย journalย of healthย scienceย 9(1)ย 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).

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CHAPTERย THREE

RESEARCHย DESIGNย ANDย METHODOLOGY

ย Studyย design

The paradigmย of this study was quantitativeย andย itย utilisedย aย descriptive,ย cross-sectionalย surveyย design.ย Itย wasย referredย toย asย suchย becauseย itย wasย centredย onย numericalย data,ย dedicated to describing a particular phenomenon and data was collected during a single,ย relatively brief time period. By using theย cross-sectional design,ย thisย study givesย a snap-ย shotย impressionย ofย theย Accessibility,ย Attitudeย andย Use of oral contraceptive amongย womenย ofย reproductiveย age groupย inย Eri ileย LGA.

Source population

Women of reproductive age group (15-49) that included 211 women in Eri ile health centreย whoย areย coming forย theย healthย careย seek.

ย Studyย population

Womenย ofย reproductiveย ageย groupย willย beย selectedย fromย 211ย sourceย populationย byย systematicย randomย samplingย technique.

CHAPTERย FOUR

MAJORย FINDINGSย ANDย DISCUSSION

Socio-demographicย characteristics

Aย total of 75ย womenย of reproductiveย ageย groupย (15-49)ย were participatedย in theย studyย accounting for a response rate of 97.33%. Majority 27 (36%) of the respondents were in theย ageย range of 20-24ย yearsย andย 36(48%) of the respondents were Muslimsย by religion.ย Inย caseย ofย ethnicity Oromoย covers 39(53.33%)ย ofย the respondents.ย As toย monthly income,ย occupation,ย andย educational status of the respondents,ย about 25(33.34%)ย got 301-400ย birr,ย byย income,ย 26(34.67%)ย wereย houseย wifeย byย occupationย andย mostย 21(28%)ย ofย theย respondentย can readย andย write.ย In caseย ofย maritalย status 21(54.66%)ย ofย theย respondentsย wereย married.ย (Table-1)

Table-1:ย Distributionย ofย womenย ofย reproductiveย ageย groupย (15-49)ย byย theirย socio-ย demographicย characteristicsย inย Eri ileย LGA,ย Kwara state,ย Oromiaย Nationalย Regionalย Sateย South Westย ofย Nigeria.ย (n=75)

CHAPTERย FIVE

CONCLUSION AND RECOMMENDATION

Family planning is a means of promoting the health of women and families and part ofย strategies to reduce the high maternal, infant and child mortality and yet, there is very littleย informationย onย whatย influencesย itsย utilizationย inย Nigeria.

Fromย thisย study out of 75ย study subjectsย interviewedย asย if they haveย accessibilityย aboutย oral contraceptive,ย only 68(90.67%) ofย themย wereย foundย to beย accessible,ย andย this finding is different from a cross sectional survey conducted in Addis Ababa, February.ย 1-5, 2010 in which, a total of 361 study subject were interviewed making the coverage ofย study 265ย (73.54%)ย hadย goodย accessibilityย aboutย oral contraceptiveย andย Aย survey ofย KAPย towardย contraceptiveย utilizationย conductedย amongย lower,ย middleย andย upperย classย women in Gondar women 1996 which showed 65% of the respondent knew about oral contraceptiveย method.ย Theย likelyย exceptionย forย thisย dissimilarityย mightย beย dueย toย differenceย in study period, level of education of the study subjects involved and Operationalization ofย utilization.

Accordingย toย thisย studyย mostย 18(26.69%)ย ofย theย respondentย havingย accessibilityย aboutย oral contraceptiveย method,ย mentionedย pillsย andย 15(22.05%),ย 9(13.24%),ย ofย themย mentionedย injectable andย IUCDs respectively. Thisย finding is same what similarย with aย survey of KAP conducted among lower, middle and upper class women in Gondar womenย 1999,ย inย whichย 44%ย ofย theย studyย subjectsย mentionedย pills,ย followedย byย tubaย ligation.

Out of 68 respondents knowing oral contraceptive method 27(40.69%) of them stronglyย agreed that child spacing is important, and 29(42.64%), 10(14.70%), and 2(2.94%) of themย agreed, disagreed and undecided respectively with an importance of child spacing; and forย limiting theย number of children,ย 32(47.05%), 25 (36.76%), 7ย (10.29%), and 4 (5.88%) ofย themย stronglyย agreed,ย agreed,ย disagreedย andย undecidedย respectively.

Of theย 68ย respondents 13(38.35%), 12(36.41%), of themย strongly agree respectively withย the use of oral contraceptive methodย is toย prevent pregnancy question. Fromย the totalย scoreย ofย attitude,ย theย positiveย andย negativeย attitudeย levelย wasย classifiedย onย theย seated

criteria, accordingly 12(36.644%) hadย a positive attitude andย theย rest 21(63.35%) had aย negative attitude. This finding was similar with a cross-sectional survey conducted in Addisย Ababa February. 1-5, 2005, in which 279(77.3) hadย favourable attitude towards modernย contraception.ย (13)

Fromย theย ofย sampleย theย oral contraceptiveย usersย 44(34.37%)ย ofย themย usedย pillsย whereasย injectable,ย Norplant,ย IUCDs,ย andย tubalย ligationย wereย usedย byย 51(39.84%),ย 17(13.28%),ย 12(9.37%),ย andย 4(3.13%)ย respectively.ย Thisย study findingย wasย sameย whatย similar with aย study done on family planningย among mothers of Mexicoย whichย shows theย useย ofย familyย planningย amongย womenโ€™sย ofย reproductiveย ageย group,ย wasย high,ย overallย 47%ย ofย women useย family planning method.ย Amongย currentย usersย majority relay on IUCDs,ย pillsย andย injectableย areย mostย widelyย usedย 8%ย andย 6%ย respectively.ย (4)

Generally,ย as to the accessibility, attitude and practice of respondents, the main factors asย challenges to its poor utilization were: religion and culture and fear of side effect . Thisย finding was not much different from what has been observed from the finding in Nigeriaย whichย showedย thatย accessibilityย ofย mothersย ofย reproductiveย ageย groupย onย oral contraceptiveย was high,ย 22% of women everย useย family planning andย 13% of themย wereย not using, 44% didย not know any family planning methodย and 22% were afraid of sideย effectsย andย didย notย knowย whereย to obtain.

Furthermore,ย thisย studyย furtherย revealedย asย thereย isย noย significantย associationย betweenย socio-demographicย characteristicsย andย KAPย towardย oral contraceptiveย utilization.

Basedย onย theย findingย ofย theย studyย theย principalย investigatorย hasย madeย theย followingย conclusions:-

  • Most 68 (90.67%) ofthe study subject had accessibility about oral contraceptiveย method and most of them mentioned pills as a oral contraceptive method andย benefitย of oral contraceptiveย method wereย known as toย space birth by majorityย ofย the
  • Fromtheย totalย scoreย ofย attitude,ย theย positiveย andย negativeย attitudeย levelย wasย classified on the seated criteria; accordingly majority of respondents had a positiveย attitudeย whileย theย restย ofย respondentsย hadย aย negative
  • There wasnoย significantย association between socio-demographic characteristics andย KAPย towardย oral contraceptiveย utilization

Recommendations

Basedย onย studyย findingย andย conclusionย theย followingย recommendationsย areย madeย toย theย responsibleย bodies

  • Health education is better to be given to mothers of reproductive age groupregarding the benefit of using preferred type of family planning method, theย uniqueness of each type of methods and their side effects by nearby healthย centreย andย healthย extensionย workersย ofย the Eri ile
  • Efforts should be made to change the community attitude on contraceptiveutilization through provision of adequate information and training by Eri ileย bureauย andย otherย concerned

REFERENCE

  • Bohmorย 2005ย adolescentย reproductiveย healthย inย Nigeria,ย anย investigationย needsย currentย policiesย andย program.ย P-10.
  • Friedman,Herbert,ย ย 2008ย overcomingย obstructionย toย goodย adolescentย health,ย Network(FP) internationalย vol.ย 14,ย pp. 22-23
  • Ministryofย Health,ย Guidelinesย forย Familyย Planningย Servicesย inย ย Addisย Ababa.ย MOHย 1996.
  • J.ย Healthย Dev.ย 2009;23(2)
  • Federaldemocraticย republicย ofย Nigeriaย ministryย ofย health
  • TekabaAyalewย ,ย Unmetย needย andย demandย forย familyย planningย inย Addisย ย Nigerianย medical journalย ofย healthย 1995ย vol.ย 14ย noย pp.ย 41-46.
  • YohannesTolosa:ย theย roleย ofย menย inย family planningย inย aย ruralย community ofย western Nigeria.ย April,
  • SamuelShiferawย andย Mandefrewย Gebrehiwot.Tย determinationย ofย contraceptiveย useย inย urbanย populationย 1996. Pp.25.
  • JointUnitedย Nationsย Programmeย onย HIV/AIDSย (UNAIDS),ย Reportย onย theย Globalย AIDS Epidemicย Wikipediaย ofย HIV/AIDSย inย Nigeria.

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