Experts Worry Over Declining Use Of Family Planning In Lagos

•Blame Trend On Myths, Misconception

Family planning commodities. Inset: Dr. Salami

By Chioma Umeha

Unmet needs for contraceptives among women in the Southwest region of Nigeria have been going down in the last decade. But, this has not been the case for Lagos State, the latest Multiple Indicators Cluster Survey (MICS) conducted by National Bureau of Statistics (NBS) has shown.

For instance, in 2007 the unmet needs for contraceptives among married women in the South West region was lowest in Lagos State, but the new survey by NBS which was carried out with support from the United Nations Children’s Fund (UNICEF), shows that while unmet  need for contraceptives is on the decline in the region, it is on the increase in Lagos State.

In 2007, unmet needs for contraceptives was 12.1 per cent in the South West region, Lagos figure was put at 8.1 per cent.

However, a report obtained by DAILY INDEPENDENT has revealed that by 2017, the unmet contraceptive needs had dropped significantly across the region.

The breakdown of the MICS 2017 report revealed that the unmet needs in Lagos was 29.6 per cent, it had become higher than the regional average which was put at 28.4 per cent.

Experts said that they are ‘seriously worried’ about the ugly trend. The development has raised many difficult posers about the reasons for the trend. Did something undesirable happen to family planning efforts over the last decade in Lagos?  Why is the use of one contraceptives on the decline  in the state? These are some of the recurring questions among analysts.

Reacting, stakeholders in the health sector of the Lagos State have attributed the trend to growing misconceptions that have continued to trail family planning in the state and its environs.

Among the most common are beliefs that family planning causes excessive bleeding and infertility, they lamented.

Mrs. Sherifat Bakare, (not real name) a 34-year-old trader and a mother of three had little knowledge of Family planning when she got married over a decade ago. While Elizabeth Samuel, (not real name) a 42-year-old mother of two said she heard about family planning over the radio.

The two mothers used lived with phobia of family planning methods are reportedly overcoming their fear following renewed advocacy and awareness campaigns.

However, these two mothers represent millions of married women in Lagos who have fear for family planning.

When DAILY INDEPENDENT visited Lagos Island Maternity, Bakare and Samuel were among some of the mothers who expressed their satisfaction with family planning methods.

Both women shared their experiences and explained how they overcame the myths, challenges and misconceptions surrounding family planning uptake and the side effects.

Bakare said; “I belonged to a group of Nigerian women that believe it is God that gives children and provides for their upkeep, hence no faith in family planning.

“However, this perception changed when I became pregnant with my second child, five years after marriage, and a health care provider educated me about family planning and its benefits.”

But, Bakare said her initial excitement about the advantages of family planning was dampened by friends who discouraged her about it, claiming that family planning would make her bleed, become infertile and then develop fibroids.

She said, “My friends in the market place discouraged me, saying family planning will make me not to have children again, and blood will be gushing out of my body without stopping that actually discouraged me.”

However, she remarked that her husband’s support made her to return to the hospital after her second child.

“I was afraid to do it because of what my friends told me. That was why I had to stop after six months of using the injectable. I was able to space my children because my husband used the withdrawal method.

“But, when I finally gave birth to my last child, I went to the family planning unit of Lagos Island Maternity Hospital. They educated me on the benefits of family planning along with the side effects, which can be managed.

“It was at that point I realised that what my friends at the market place were saying were all lies.”

On her part, Samuel said she heard about family planning over the radio and was able to do injectable when she travelled to South Africa after her first child.

Unfortunately, she experienced some complications as she was bleeding continuously after menstruating. When she went back to the clinic to report her experience, the health provider asked her to continue.

Samuel told DAILY INDEPENDENT; “When the bleeding continued, I stopped the use of injectable. After 10 years, I conquered my fear and decided to go back to using a family planning method but this time, I use implant.”

Experts believe that there is need for providers of family planning services in the state to counsel clients on the various methods available and the side effects, so that they can make an informed choice.

They emphasised on the need to focus on both providers and clients with regards to attitude change.

Commenting recently, Dr. Jide Idris, the Commissioner for Health, identified misconceptions and myths as part of the major barriers to the uptake of family services in the state.

Idris spoke at the Isolo Local Council Development Area (LCDA) Town Hall Meeting on Family Planning in Lagos, called for collaboration among all stakeholders from every sector to improve family planning services.

He listed some traditions and misconceptions militating against adequate Family Planning uptake, especially Modern Contraceptive Prevalent Rate (MCPR) in the state.

Some of them, he said are beliefs that family planning causes excessive bleeding, cancer, infertility among other issues.

Similarly, Dr. Folashade  Oludara, Director, Family Health Unit, Lagos State Ministry of Health, corroborating the Health Commissioner stressed that some old beliefs are seriously mitigating family planning services in the state.

Sharing some of their experiences, Oludara told some select journalists from different media platforms, including DAILY INDEPENDENT in her office, recently said; “Some people told our family planning team in one of their sensitisation programmes that family planning is bad.

“They insisted that a woman need to bring out all the eggs God have given her by birthing, else it would turn to cancer.”

In some instance, she said “There are communities we go to in Lagos State that vehemently refuse immunisation and life-saving commodities, saying it is government’s ploy to make their children infertile and family planning is not left out,” she explained.

The Director, Family Health Unit also listed some benefits of FP to include; child spacing, high productivity of the mother, improved quality life of the children as well as the family.

She further tasked the media to ensure propagation of accurate information on Family Planning.

Oludara said, “Media needs to spread the correct information at all times, and not confuse the people the more.”

She therefore charged the media to help change these myths and misconceptions surrounding the usage of FP services in the country in order to increase its uptake and safe women from dying from preventable causes.

On her part, Dr. Moriam Olaide Jagun, the Senior Programme Officer, Palladium Technical Support Unit, corroborating the views of the Health Commissioner, identified behaviour change as a method of tackling misconceptions against family planning in the state.

Jagun who is currently working with the Lagos State Ministry of Health to implement its family planning programme noted that the State is making progress with regards to family planning commodities.

She explained that Lagos State is the first state to put in money to the last mile distribution.

The procurement of the commodities is done by the United Nations Population Fund (UNFPA) and given to the Federal Ministry of Health and it’s been distributed to various states in the country but Lagos State pays money for it to get to various facilities (last mile distribution), Jagun explained.

But, she stressed, that there is big gap in the area of unmet needs of married women seeking contraceptives.

The family planning expert lamented; “There is still more room for improvement. The number of unmet need is high. What we need to do as media practitioners is to advocate reaching the State’s 74 per cent target.”

She also tasked the media for its support to help change the myths and misconceptions surrounding the use of family services in the State in order to increase its uptake and save women from dying from preventable causes.

Jagun said; “When churning out reports, let’s write stories that will raise the profile of family planning. The awareness concerning family planning is high but what people need to know is that family planning methods are safe, free in both public and private health facility.

“Government is interested in pushing family planning forward and increase uptake. More people are using it, but most people are still scared to talk about it.

Jagun added; “Most people know about family planning, but we need to transcend from awareness to usage. I encourage people who are using family planning method to advocate for it. It will help increase uptake.

The reproductive health expert who spoke with journalists at a three-day  Pathfinder International/Media Dialogue on Family Planning, said with family planning, mothers and babies become healthier, because risky pregnancies are avoided, adding that fewer children means more food for each child.

“Family planning is cheap and abortion is expensive, you can get family planning free at any public health facility because the government has made provision for it.

Listing the economic benefits of family planning, she said; “Once it is administered to the woman, she will have enough time to take care of her existing children, husband and family at large. The woman will be economically viable to her family.

“For every dollar spent on family planning, six dollars is been saved for the country and the six dollars can be used to do other things in the health system.”

“For the myths and misconceptions, we need to debunk it, she insisted, adding, “The side effects are real for some of the methods, some people bleed, have headaches and even gain weight but there is different method for everyone.

“That is why the clients must be properly examined to check the various methods and the right one to choose from.”