Angela Onwuzoo
It was a Thursday morning and women had gathered in a large number at the Ajara Primary Healthcare Centre, a flagship PHC in Badagry Local Government Area of Lagos State.
As early as 8am, the women, some with their babies strapped to their backs gathered at the centre not for political reason, but to access family planning services.
According to the women, family planning is a choice they have to make if they must prevent unintended pregnancy and its attendant health implications, such as maternal death and unsafe abortion.
Besides helping them to space their children, others said modern contraceptive methods have enhanced sexual relationship with their husbands as they now have sex frequently than their friends who are not using any method, thereby denying themselves of regular sex for fear of becoming pregnant.
The women believe that modern contraception presents an opportunity to reduce the risk of pregnancy without having to reduce sexual frequency.
Our correspondent who interacted with some of the women during a field visit to the PHC, gathered that many of them had embraced family planning because it had empowered them to make the best decision on how to prevent unintended pregnancy while having regular sex with peace of mind with their husbands.
The story of one of the women identified as Omolara, like many others, could make anyone see the numerous benefits of family planning in the life of women and men as well.
“I came here today to take my injection. I have four children, three girls and a boy. I don’t want to have another baby. It was one of my neighbours that told me about the benefits of family planning. And since I started using it three years ago when I was 27 years old, I can vividly say from experience that it truly has lots of benefits.
“I am now 30 and my first child is 10 years old. I got married at the age of 20 and in seven years, I had already given birth to four children.
“One day that my neighbour an elderly woman, called me and said to me that if I didn’t use family planning at the rate I was giving birth, I would end up having the number of children that my husband and I would not be able to cater for. She advised me not to failed to do something about it”, she narrated.
Omolara, a fashion designer continued: “So she told me that the only way I could prevent pregnancy from occurring was to use family planning. She said that frequent birth was not good for the health of a woman.
“The mama also told me that I would enjoy sex more with my husband if I used family planning because there would be no fear of unintended pregnancy. For three years now, I must say that I have been having sex with ease and my husband is happy about it, unlike when I was running away from him to avoid sex for fear of becoming pregnant.”
Sharing the joy she finds in using family planning, another client and mother of three, Mrs Abosede Oke , said: “I have been using family planning for over 10 years now. I came to collect my injection. I have never missed it. I use the injectable method. It works for me. I take it every three months.
“My experience in the past 10 years has been very interesting. I have no side effect. My shape is still intact unlike what some people say about family planning that it makes someone to add unnecessary weight.”
Oke who is in her early 40s said: “I was introduced to family planning by a doctor after my last child 10 years ago. I was three months pregnant when my second child was still 10 months old. I was sick, first I thought it was malaria. But after carrying out a test, I was told that I was three months pregnant.
“That day I cried like a baby in the hospital because I never expected it. The doctor later came and asked why I was weeping bitterly over the pregnancy, I told him that I was still nursing a 10 months old baby that the burden would be too heavy to bear. So he told me to stop crying that after my delivery, I should come for family planning. When I got home and told my husband about the pregnancy, he too was not happy because he wasn’t expecting it”, she said.
The mother of three further shared her experience: “But after my delivery, my husband supported me to go for family planning and to choose any method of my choice based on the counseling of the provider.
“Since then, my husband and I have been having a smooth sexual relationship. The method I chose is working for me. I have three children and we are okay with the three.”
Family planning, according to experts, can prevent closely spaced and ill-timed pregnancies and birth which contributes to some of the world’s highest maternal and infant mortality rates. Nigeria is one of the countries with the highest maternal and child mortality rates globally.
Also, a 29-year-old nursing mother who simply identified herself as Maryjane who came to access the service in the company of her husband, told our correspondent that she was visiting the centre for the first time, based on the positive things she has heard about family planning from community leaders.
“I want to start using family planning from today. I heard that it is good if a woman wants to space her children and have a healthy life. I am 29 and I have four children already. The first is eight years and the last one is six months. My husband is 33, if I fail to use family planning, we will end up having more children than we can cater for and we don’t want that to happen. School fees is expensive. I am only a petty trader and my husband, a furniture maker”, she said.
Maryjane’s husband, who declined to disclose his name to our correspondent, said he supported his wife’s decision to use family planning to enable them take care of the four children they had already.
He stated: “It is a wise decision I must say because it will also help my wife to stop denying me sex for fear of being pregnant. Since our last baby, we have not been having sex regularly. But I was told that after receiving the service today, she will not be running away from me anymore. I love that aspect of peace of mind and ease of having sex that the use of contraceptive will bring to us.”
Research findings have repeatedly shown that beyond saving the lives of women from pregnancy related complications, family planning has many economic and social benefits.
Despite the proven benefits of family planning however, data from Pathfinder International, showed that in developing countries, more than half of all women of reproductive age want to avoid pregnancy. 214 million women are not using an effective method of contraception. And millions of women lack the services they need, leading to 88 million unintended pregnancies in developing countries each year.
Speaking during the visit organised by Media Advocacy Working Group in partnership with Public Health Sustainable Advocacy Initiative with support from Pathfinder International, Family Planning Manager, Badagry Local Government Area, Mrs Iyabo Salami, said the 20 PHCs in the local government including Ajara which is a flagship centre, were witnessing increase in family planning users through advocacy visit to various communities in the LGA by relevant stakeholders.
Salami who disclosed that family planning services were free in Lagos State, affirmed that the women after proper counselling voluntarily choose any method of their choice based on available commodities.
“The commodities available in our PHCs include: Pills (including the minipills for nursing mothers), injectables (taken every two or three months depending on the type selected), implant, Intra-Uterine Device (IUD), male condom, female condom and Tubal Ligation (BTL-permanent methods for women). For those who have complaint about side effects, we change method for them and they have happy using it”, she said.
The FP Manager however, said they were facing challenges of funding to buy consumables needed to provide adequate services to clients and also lack of money to transport commodities from the Central Stores in Oshodi to the health facilities where they are needed.
Salami noted that if not urgently addressed, lack of consumables might affect services and uptake.
“Sometimes I use my money to buy consumables such as cotton wool, iodine, surgical blade, xylocaine and bandage.
“We also do not have enough trained nurses in FP services in the local government. So, I am appealing to the state government to address these challenges to increase uptake”, she said.
The National Demographic Health Survey 2018 showed the state’s Contraceptive Prevalence Rate was at 49.4%. It failed to reach its target of achieving a CPR of 74% by 2018 and has now extended the target to 2020.
To meet the above target, members of PHSAI and MAWG are also calling on the state government to provide adequate funding for family planning consumables in all LGAs and LCDAs in the state as their non-availability would certainly be a barrier to increase in uptake.
