By Chioma Umeha
Lagos – I married early 2008. I have six children
now; this one will make the seventh one. I attend antenatal care(ANC) at a
private hospital, Holy Trinity Maternity near my house at Okokomaiko, Ojo Local
Government Area (LGA) Lagos. They did not tell me anything about family
planning in my hospital. I delivered my six children there.
These were the words of Sabina Acho, a 32-year-old
mother who have had six children in the space of eight years. , a petty-trader
told this reporter that no one had told her of the need to go for family
planning, even at ANC.
She had prolonged labour and was induced to
deliver in her first four pregnancies. Sabina bled heavily and nearly developed
vesico vagina fistula (VVF). So she had the last two babies through ceasarian
section (CS) to avoid further complications. Now she is in her seventh
pregnancy. Evidently traumatised, Sabina told Independent that she survived
delivery of sixth child only by whiskers.
Sabina does not seem to know that family planning
can help her. Her words: “I was in labour for three days. I thought the baby
will come, even the nurses were surprised. This is because I used to deliver by
myself, except that my fifth baby. This my sixth baby also would have died so
they did CS for. If I had known, If I was told, If my hospital had taught me
about family planning, I won’t be in this situation now.”
The story of Chika Adule, civil servant, aged 24
is not different. She had her first baby through CS at a private hospital, St
John Maternity Home, Ikotun, Alimosho Local Government Area (LGA), Lagos state.
Her first baby was barely four months and she became pregnant again. Due to
fear that the surgery has not fully healed, she considered abortion, though she
did not know how to go about it.
Coming from a Christian background, she was scared
and did not have the courage to tell her husband.
She decided to have it her own way, but little did
she know that it was the beginning of her afflictions. Armed with counsel from her best
friend, she opted for abortion.
Unfortunately, in Nigeria, abortion is yet to be legalised.
Then, she and her friend decided to patronise a
quack doctor. The abortion was carried. Three days later, she developed
complications, bleeding heavily. Chika’s husband became worried and rushed her
to a nearby hospital where it was discovered that she just had an
abortion. So she lost her womb due
to the unskilled exercise.
Expressing regrets, she told Independent in an
interview: “I did not know about family planning. We were not taught about
family planning during antenatals. If I was aware, I would have settled for one
of the various methods of family planning, I would not have lost my womb.”
Chika and Sabina represents thousands of women in
Lagos who lack access to Family Planning (FP) counselling in private health
facilities in the State.
According to experts, FP counselling is a process
by which a provider uses appropriate communication skills to provide correct,
adequate and unbiased information on available options of family planning to
individuals, couples and groups to help them understand and accept family
planning.
The information provided will enable the client or
couples accept family planning and choose a method.
Precious John is enjoying the benefits of family
planning because she had FP counselling.
She has an understanding husband. “I delivered my
three babies at the Federal Medical Centre, Ebute Metta, Lagos. Initially, I
was very afraid to use family planning listening to what people say about it,
but I am happy I did family planning.
Joyfully, she added: “It has helped me space my children
and gave me opportunity to avoid pregnancy long enough to get gainful
employment and stable family relationships without depending on public
assistance.”
Though the Lagos state 2013, National Demographic
Health Survey (NDHS) percentage of distribution of users by sources of
contraceptive methods showed that almost ¾ of women in the State source their
FP methods in the private sector, they lack access to FP counselling.
Commenting on the situation, family planning
expert with FistulaCare plus Project, Mrs. Amina Umma Bala, explained that
there are a lot of organisations that are supporting public facilities in
providing counselling, but do not support private ones.
Bala stressed that FP should not be done without
counselling. According to Bala, absence of family planning counselling is a big
issue and set back to effective FP services. “Family planning counselling must
precede FP service and commodities provision. Nobody has the right to choose
for a client. Every client must have a right to FP counseling to make informed
choices.”
She said: “FP counselling is key to its
acceptance. The information provided during counselling will enable the client
accept family planning and voluntarily chooses a method.”
Similarly, experts have also expressed serious concern
that only very few women are utilizing the Family Planning services even in
public health facilities, despite the efforts of Lagos State government in
providing both (FP) counselling and services
According to them, this has given rise more unwanted pregnancies,
unsafe abortion and maternal deaths. From The NDHS 2013 shows that the maternal
mortality rate for the state is an alarming 555 per 100,000 women.
Evidence from the 2014/2015 Lagos State Maternal
and Newborn Health Service Delivery scorecard also shows that only two per cent
of women of reproductive age use contraception in the state. According to the
scorecard developed by Lagos State Accountability for Maternal and Newborn
Health (LASAM) with support from Mamaye, Lagos state has made insufficient
progress in the use of modern family planning methods.
A similar survey carried out in 2014 by the
National Population Commission and ICF International on family planning
consumption in Lagos State shows that the percentage of married women using contraceptives
has decreased from 49.6 to 48.3 per cent.
In view of this, the Nigerian Urban Reproductive
Health Initiative (NURHI), has begun training the Ward Health Committees (WHC)
Lagos State on sensitization of communities about child spacing and the need to
access family planning services at the PHCs.
During the sensitization forum held at Sango PHC
Pen Cinema, Agege, recently, the WHC Chairman Iloro PHC, Agege, Elder Emmanuel
Adekoya, said there is still low acceptance of modern family planning methods
at Agege community. “Many of the people do not yet see the need for modern
family planning methods so there is need for more advocacy and teaching. It is
also necessary to upgrade the health facilities so that better service will be
delivered, which is what NURHI is currently doing and we have tried to support
this. Before, the generators and boreholes at the PHC were not working but now
we have repaired it,” he said.
Meanwhile, The Lagos Advocacy Working Group (LAWG)
has called on Lagos State government to increase family planning budget in the
state.
They made the statement on Monday during their
review recently, at Alausa Ikeja, Lagos. Speaking at the forum the Programme
Officer of the Nigerian Urban Reproductive Health Initiative (NURHI), Adewale
Haastrup, called for increase awareness and orientation of the communities on
the benefits of family planning uptakes.
They urged donor agencies with specialty on FP
counselling and services to expand their reach to private clinics.
