CHAPTER ONE
1.0 INTRODUCTION
1.1 Background of the Study
Uncontrolled population growth has been a challenging issue, continued with high fertility
levels, along with lowering mortality rates, which have resulted in a large disparity between birth
and death rates. Family planning (FP) is a form of thinking and living that people and couples
voluntarily embrace based on their knowledge, attitude, and responsible choices to promote the
health and welfare of family groups and thereby effectively contribute to the social development
of a country (WHO, 2018). Family planning is the deliberate use of contraceptive measures by a
couple to reduce or space out the number of children they have and it primarily focuses on the
mother's reproductive health, having enough space between births, preventing unwanted
pregnancies and abortions, and transmitted diseases and raising people's standards of living
mother, unborn child, and the entire family (Semachew et al, 2018). Modern contraceptive
methods include the pill, injectable, condoms for men and women, emergency contraception,
implants, intrauterine contraceptive devices(IUCD), male and female sterilization, the standard
day method (SDM), and the lactational amenorrhea method are all current contraceptive methods
(LAM) (Guta et al, 2021) Reproductive-age women constitute the main population with concerns
about modern contraceptive usage in the municipality. However, the prevalence of modern
contraceptive use among women of reproductive age has increased worldwide between 2000 and
2019 by 2.1% (55 to 57.1%). There are several factors contributing to this slow increase, such as
a limited selection of methods, limited access to services, particularly for young, less wealthy,
and unmarried people, fear or experience of side effects, cultural or religious opposition, poor
service quality, bias on the part of users and providers against certain methods, and gender-based
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access barriers (Amsalu et al, 2021). One-third of the health problems experienced by women
between the ages of 15 and 49 who are fertile are caused by problems with their sexual and
reproductive health. Unsafe sex is a significant risk factor, especially for women in developing
nations. Therefore, it's critical to provide services for the 222 million women who don't have
access to contraception (Guta et al, 2021). This situation tends to be more worrisome as it poses
the tendency for more occurrences of unintended/unplanned pregnancies among women of
reproductive age, exposing them to sexually transmitted infections (STIs) including HIV/AIDS,
hepatitis etc. However, a family planning program is the key to addressing such issues. There is
still a gap that has to be filled despite the Government of Sierra Leone's efforts to increase family
planning methods and services. As a result, of the above situations, it is necessary to carry out
proper research in the field of family planning, because we can only control the situation by
making proper checks on population growth. Hence, this study assesses the knowledge, attitude
and practices of family planning use among women of reproductive age (15-49) at Panlap-
community.
Family planning/contraceptive services have been highlighted as a key instrument for reducing
maternal fatalities which calls for the implementation of strategies to improve the use of
contraceptives. However, the proper utilization of family planning services allows individuals
and couples to plan their families, such as how many kids they want to have and how their births
should be spaced and timed properly (WHO, 2016). Additionally, family planning has the power
to save lives. Family planning can also significantly enhance the health and well-being of
women, families, and communities. Long-acting contraception prevents 20-35 % of all maternal
deaths by enabling smaller families and balancing resource use with population needs. It is a
human right and essential to women's empowerment as well as efforts to lower poverty, boost
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economic growth, increase female productivity, lower fertility, and improve child survival
(Abdillahi, 2020). Globally, in 2020, according to the United Nation family planning utilization
report, it was estimated that 1.1 billion of the 1.9 billion reproductively active women (15-49
years) are estimated to need family planning, meaning they want to postpone or limit having
children. 85 million of these women use a traditional method of contraception, whereas 851
million use a modern approach. A further 172 million women do not use the method at all,
despite their desire to avoid pregnancy, and thus are considered to have an unmet need for family
planning. Additionally, female sterilization, utilized by 24% of women of reproductive age (15-
49) globally who use modern methods, is followed by condoms, implants, intrauterine devices
(IUDs), pills, and injections (UN, 2020). In Sub-Saharan Africa, according to the United
Nations, Department of Economic and Social Affairs, Population Division (2019), the continent
of Africa recorded 30% of unmet family planning needs and the population of women of
reproductive age (15-49) is anticipated to expand quickly by 2030, and there is a big gap in
family planning needs (UNDESA, 2019). In Africa, 42% of reproductive-aged women use any
form of contraceptive. Not surprisingly, 22% of African women had unmet needs for family
planning the majority shared by Sub-Saharan Africa which is the highest in the world. Sierra
Leone is a developing nation and encourages its people to use contraceptives to help them
prevent unintended births, increasing the health of mothers and children and reducing population
growth. Despite this, the rate of unwanted pregnancy among women reproductive-aged 15-49
remained high at 21% according to a UNFPA report in 2019. This can be due to the increased
demand for contraception among these women in Sierra Leone. This situation is extremely
concerning since it has the potential to increase the number of unintended pregnancies and
expose them to various sexually transmitted diseases and STDs (UNFPA, 2020).
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1.2 Statement of the Problem
15 % of currently married women in Nigeria are using a contraceptive method, an increase of
only 2 % points since the 2003 NDHS. Most of these contraceptive users rely on a modern
method (10 percent); 5 % use traditional methods. Injectables (3 percent), male condoms (2
percent), and the pill (2 percent) are the most commonly used modern methods. Other modern
methods are used by 1%t of women or less. Interestingly, 3% of currently married women use
withdrawal as a method of contraception. The use of contraceptive methods among currently
married women increases with age from 2 % among women age 15-19 to 22% among women
age 40-44, after which it falls to 13% among women age 45-49.
The link between knowledge, attitude and utilization of modern family planning methods has
drawn attention to women's perception about the positive and negative aspect of modern
contraception. (Sulthanaet al., 2015) noted that the reluctance to use modern methods stemmed
from fear that uses might cause infertility, producing damaging side effects and forgetting to take
the contraceptive pills was a serious risk. Large family size creates the conditions
1.3 Aim and Objectives
The aim of this research is to focus on knowledge, attitude and utilization of modern family
planning among antenatal attendee at specialist hospital Jalingo , Taraba state.
The objectives of this studies are :
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1. To assess the knowledge of modern family planning among the antenatal attendees at
specialist hospital Jalingo in relation to levels of education.
2. To determine the attitude of antenatal attendees toward modern family planning in relation to
their age.
3. To determine the utilization of modern family planning among antenatal attendees in relation
to their occupation.
1.4 Research Questions
1. What is the knowledge of antenatal attendees toward modern family planning at specialist
hospital Jalingo in relation to level of their education ?
2 .What is the attitude of antenatal attendees toward modern family planning in relation to their
age?
3. What is the utilizations of modern family planning among antenatal attendees at specialist
hospital Jalingo.
1.5 Research Hypotheses
H O : There is no significant relationship between knowledge and level of education of antenatal
attendees toward modern family planning at specialist hospital Jalingo.
H O : There is no significant relationship between attitude and age of antenatal attendees toward
modern family planning method at specialist hospital Jalingo.
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H O : There is no significant relationship between utilizations among antenatal attendees at
specialist hospital Jalingo.
1.6 Scope and Limitation of the Study
The study cover knowledge, attitude and utilization of antenatal attendees at specialist
hospital Jalingo, Taraba state. There are some limitation to this framework, the major limitation
was time, a research like this that is supposed to take enough time because of other competing
academic activities.
1.7 Significant of Study
Understanding family planning methods and utilization will help to reform policies and
improve interventions for antenatal attendees to increase the use of modern
contraceptives and, as a result, promote contraceptive use in the Municipality. Therefore,
the purpose of this study was to assess the knowledge, attitude and practices of family
planning among women of reproductive age (15-49) at Panlap-community. The outcome
of the research could aid in the development of public health interventions, health
education strategies and formulation of policies regarding family planning utilization that
may help reduce the rate of unintended pregnancy among these women of reproductive
age (15-49). Results from this study will also help create awareness and promote family
planning and further add value to the already existing literature on the topic. Lastly, the
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study discovered a link between knowledge and performance. Women's practical
experiences regarding family planning.
When the knowledge, attitude and utilization (K.A.U.) of modern family planning are
ascertained or determined, clinic service provider in the process of counseling the
antenatal attendees would use the result of women to know how they space their children
using modern family planning.
The research work would also serve as the data bases for future research in the study
area.
The finding of this study will help the health workers, health educators, health promoters,
teachers, parents, school administrator planner to appreciate K.A.U. of modern family
planning which help in promoting the health of the mother and their children.
1.8 Definition of Terms
1. Family Planning: is defined as the spacing of the number of children and having a baby
when one wants, by choice and not by chance (gemson 2006).
2. Knowledge: is the understanding of or information about subject which has been obtained
by experience or study, and which is either in a person mind or possessed by people
generally, (oxford Advanced leaners Dictionary 2000).
3. Attitude: A feeling or way of thinking that affects a person’s behavior.
4. Utilization of family Planning: is the decision of couple or individual to have the required
number of children at the appropriate time through utilization of contraceptive methods
for the purpose of delaying spacing or limiting.
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5. Conception: it is deliberate use of method or other techniques to prevent pregnancy as a
consequence of sexual intercourse.
6. Abortion: is defined as the interruption of pregnancy before the 28th weeks of gestation.
7. Attendees: a person who is present and participates in a gathering.
8. Modern: Relating to the present or recent times as opposed to the remote past.
9. Contraceptive: the internal prevention of conception through the use of various devices.
10. Diaphragm or cap: is a barrier method of contraception.
11. Spermicides: is a chemical that you put deep into your vagina right before sex.
12. Norplant: is a prescription medicine used as contraception to prevent pregnancy.
13. Family planning: refers to the practice of spacing births or avoiding unintended
pregnancies (WHO, 2018).
14. Antenatal care :is the care you get from health professional during pregnancy
15. Reproductive age group: The term "reproductive age group" refers to sexually active
women at risk of an unplanned pregnancy, according to my definition (WHO, 2018)
16. The practice of family planning: a conscious effort to control the number and spacing of
their children through artificial and natural contraception.
17. Family planning access: Availability of government-sponsored mother and child health
care centers that provide family planning services (Adams et al, 2021)
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