By Abiose Adelaja Adams
An increase in uptake of family planning services in many hospitals in South west Nigeria is indicative that more women are now empowered to exercise their reproductive rights.
This trend has become obvious as the icirnigeria.org visited some 23 health centres across the six states in the South west zone.
Confirming the trend, team leader of the Nigeria Urban Reproductive Health Initiative, Stella Akinso, reasoned that this marked improvement compared to three years ago is a result of strategic advocacy and public awareness and enlightenment effort of civil societies as well as government agencies.
“We have increased our outreach especially at the grassroots, telling the women the benefits of using family planning methods; we use multimedia channels as well as working through male groups (since we are in a patriarchal society) and religious leaders,” she said.
Apart from empowering the women to control their fertility, family planning also has a direct correlation to reduction of maternal mortality.
“We will not be talking of maternal mortality if there are no pregnancies,” Akinso observed, adding that “cases of women who died in the process of an unsafe abortion would be avoided if empowered with information about birth control.”
In its assessment of Nigeria’s progress on the Millennium Development Goals, MDGs, 4 and 5, the National Primary Healthcare Development Agency reported that maternal mortality has reduced from 545 per 100,000 in 2008 to 350 per 100,000 population in 2012.
“In a month, we can do up to 40 of various methods,” Modupe Shodunke, matron in charge of Alakia Primary Health centre, Ibadan, Oyo State, told the icirnigeria.org reporter about a week ago.
“The response is more and a lot of them come for the IUD,” said B. A Adeyemi, who heads Orita-Obele Basic Health Center, Akure, Ondo State, sharing a similar experience.
“From January till date (September), we have done over 300 various family methods for women. It is really increasing unlike before where you will force them,” she confirmed.
The situation is not different in Ogun State where more women are also voluntarily giving themselves to injectables, pills, insertables and other commodities.
“There is an increase in uptake of the services, and I think it is because of mass community mobilization. And when they come for antenatal, we teach them the importance of child spacing, said Bolanle Asoro, head of facility at Ijebu Ode Health Centre.
Up to five years ago, Nigeria had a very low contraceptive prevalence as there was frequent scarcity of the commodities and when available, they were not taken up. The major reason for this is funding there are also traditional and religious beliefs.
“We have been able to disabuse their minds on the myths and misconceptions about the methods. And those that have concerns about side effects, we have also taught them how to manage such,” Akinso said.
According to her, the average Nigerian woman, given the chance, wants to space her children and be able to engage in more economic activities that bring more money home.
A good example is Tolulope Jaiyesinmi, 35, who decided to do the IUD after her third child.
“It was my pastor’s wife that convinced me. She told me I am very fertile and if I do not do anything about it, I will not be able to work.”
Notably, Nigeria’s fertility rate is 5.7, which means an average woman will have five to six children at the end of her childbearing age, according to 2013 National Demographic Health Survey, NDHS. But family planning will help control this also as a means of poverty alleviation.
“Now I know I need to work to support my husband; the children (aged 6,4 and 2 years) are growing and have to start school. Paying school fees is not easy and is overwhelming for him alone,” Jaiyesinmi said, her voiced laced with anxiety for the school fees to be paid in a couple of weeks, as new academic sessions begins.
She had been unemployed for seven years since her graduation from Olabisi Onabanjo University with a degree in Mass Communication.
But, for now, she runs a provision store and a photocopying and typesetting business to help earn an income even though she hopes someday that her dream of becoming a broadcaster would be realised.
“What I want to do now is to wait for my children to grow before I can do any work. Because I have to look after them,” she said to justify her running a small business from home.
Akinso puts it this way: “A woman who is always pregnant may be limited on certain jobs. But when they are not pregnant, they have the freedom to participate in economic venture, thus promoting gender equity and reduces gender stereotypes.”
She also observed that family planning commodities are one of the international best practices for achieving the MDGs. Akinso, however, adds that the specific percentage increase will be measured at the end of the report collation exercise by third quarter if this year.
There are different methods ranging from oral contraceptive, injectables, intrauterine device (IUD), female condom, cervical cap, diaphragm, etc.