BY CHIOMA UMEHA
Notwithstanding that a 60-year-old nurse, Abiola Adekoya, is a retired civil servant, she is still working tirelessly to ensure that every woman who needs to delay pregnancy or totally avoid pregnancy has access to family planning on a pro-bono basis in Lagos. For Adekoya, no Nigerian woman should die from pregnancy-related reasons if there is unhindered access, availability and use of family planning.
The family planning facilitator and resident social worker in Local Council Development Area (LCDA) Lagos State, in an exclusive interview with this Reporter said that the use of family planning enables mothers and their babies to be healthier, and avoid risky pregnancies. “I started my family planning training in ogun State between 1986 and 1987,” the veteran in family planning stated, describing her foray into pro-bono services. “In 1991, I was transferred to the Lagos State Service Commission (LSCC), where I worked in various Local Government Areas (LGAs). I joined the Family Planning Unit in Ikorodu before being transferred to Kosofe and then to Lagos Mainland before retiring.” "I have a lot of skill acquisition as a family planning provider because I also trained at Lagos University Teaching Hospital (LUTH) Idiaraba, Mushin," Adekoya stated when asked how she acquired her amount of expertise.
Family planning was taught to us at LUTH. Since retiring in 2015, I've collaborated with a number of development partners, including 'DKT,' which introduced family planning education to my community. We provided family planning services to 150 women in my town and others in other LGAs. “I was also one of the family planning providers trained and sponsored by Pathfinder International, Nigeria, and Nigeria Urban Reproductive Health Initiatives (NURHI). I did radio call-in programs in Radio Lagos through the support of Pathfinder International Nigeria.”
She stressed on the importance of family planning, noting that it offers unlimited benefits to every woman who adopts any of the methods. Implants, injectables, lactation, tablets, condoms, amenorrhea, patch, ring, bead, and irreversible procedures such as bilateral tubal ligation and vasectomy are among the family planning options offered in various clinics in Lagos, according to Adekoya. She urged family planning service providers to educate clients on the many methods available and their potential adverse effects so that they may make informed decisions.
The veteran pro-bono family planning service provider said she had trained over 300 health workers on family planning. She renewed her commitment to continue to raise awareness on family planning considering its numerous health and economic benefits to individuals and the entire country on pro-bono basis. For instance, she said, “In mainland, I trained 60 community health provider on family planning, between 2015 and 2016 alone.” Similarly, Adekoya said that has provided family planning for countless women in her community, neigbouring communities among other LGAs in Lagos State. The seasoned family planning expert said, “In my community here, I have introduced family planning to many women and they are embracing it.
Family planning is a tool for safe motherhood. It saves lives. It creates a healthy family.” However, the mother of four and grandma of many children cited a lack of a budget line for consumables as a major barrier to women fully embracing family planning. In many African nations today, when the economy is constantly falling, raising healthy and happy children is a big struggle. Furthermore, many African countries, including Nigeria, are in poor health and have high rates of child and maternal mortality. Studies show that unplanned pregnancies without family planning cause population growth in many countries around the world.
In view of this, all countries are increasingly being called upon to curb population explosions by introducing family planning methods. However, for some women in the Agboyi-Ketu area of Lagos, contraception and various types of family planning remain excellent tools for controlling frequent births and inducing desired family sizes. Mrs. Tina Ajayi, 42-year- old mother of three is one of several mothers taking advantage of family planning in Alapere, Ketu, Agoyi-Ketu Local Council Development Area (LCDA) of the state.
The implant procedure brought enormous joy to the happy mother of three. She acknowledged her delight at the implant procedure. "Ever since I started family planning, I have loved having sex with my husband without concern of getting pregnant," Ajayi told this reporter during a recent field trip to the area. I'm more relieved now than I was before, and I don't have to worry about unintended pregnancies. All this is possible because my husband supported this family planning process. It is our right to decide how many children we want.”
Similarly, Mrs. Titilayo Adelabu claimed that using contraception prevented her and her husband from having more children than they could handle. "You can see I already have six children, which is even too much," the clearly pleased mom stated. When I was pregnant with my sixth child, a matron approached me and advised me to utilize family planning to avoid having a seventh child. God forbid, the sixth one was a mistake, I murmured. But, because I am readily pregnant, I was terrified and had to listen to the retired nurse matron. The matron counselled me and then introduced me to the Intra Uterine Contraceptive Device (IUCD), assuring me that it would last longer,” Adelabu added. IUCD is a long acting reversible contraception that goes into the uterus.
“Though I had some negative effects at first, I am happy about it because my body has accustomed to it,” the businesswoman continued. I now enjoy sex with my husband without concern of becoming pregnant, thanks to the matron.” Mrs. Shola Akin, a 28-year-old mother of two, claimed that family planning makes her happy. She claims that the procedure has given her two children a better quality of life, while also allowing her to have a planned pregnancy. Akin appeared to be pleased. “I selected implants so that my children would have plenty of room. I became pregnant six months after my first child was born. It was difficult for me to care for my first child and manage my pregnancy at the same time. I don't want to make the same mistake.” Studies have shown that infants born to women who conceived less than six months after giving birth had a 40 per cent increased risk of being born prematurely and a 61 per cent increased risk of low birth weight as compared with infants born to mothers who gave birth after 18 months or two years between pregnancies.
There have been increasing concerns about growing unmet needs and low CPR amid poor budgets for contraceptives as Nigeria recently launched the Family Planning (FP2030) commitment and dissemination of other Reproductive Health Policy documents. Though family planning is recognised as an important tool in the prevention of unintended pregnancies, unsafe abortions, child and maternal deaths, its budgets are either not released or released untimely, therefore meeting set targets remain unrealistic. Recall that the Federal Government had a target in 2012, to increase Modern Contraceptive Prevalence Rate (mCPR) to 36 percent by 2018.
However, on July 11, 2017, at the family planning summit in London, this target was rebased to 27 percent by 2020. Meanwhile, two years later, the modern contraceptive rate in the country remains at 12 percent. With the steady decline of funding from donors, coupled with the unmet need for modern methods of contraception in 2021, put at 12 percent of all women, there is an increasing call for government at all levels to increase domestic funding for improved access to family planning services. With 10.6 million Nigerian women lacking access to contraceptives due to growing demand, stakeholders have urged the Federal Government to increase funding for family planning.
The 2018 Nigeria Demographic Health Survey (NDHS) confirmed that 10.6 million women in the country do not have access to contraceptives, despite the growing demand for family planning. The 2018 report further showed that Nigeria has a low modern contraceptive prevalence rate of 12 percent. This is below the sub-Saharan average of 24 percent. The Federal Government had in 2011 rolled out a policy meant to enable women to access contraceptives free of charge, however, only 12 percent of Nigeria’s estimated 42 million women use modern contraceptives.
Family planning providers like Adekoya with passion for pro-bono services believe that if all unmet needs for modern contraception in the country were satisfied, unintended pregnancies would drop by 77 percent, from 2.5 million to 555,000 per year. Further, the annual number of unplanned births would drop from 885,000 to 200,000 and the number of abortions would decrease from 1.3 million to 287,000.