1.1 Introduction
Family planning programs are pivotal for achieving reproductive health goals and population management. However, the effectiveness of such programs heavily relies on the acceptance and utilization of family planning methods by couples. Despite concerted efforts by governments and various organizations to promote family planning, there remains a significant proportion of couples who do not accept these methods. Understanding the factors contributing to non-acceptance is crucial for designing targeted interventions and improving the reach and impact of family planning initiatives.
This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.
1.2 Background of Study
Family planning programs have been integral to global efforts to promote reproductive health, reduce maternal and infant mortality, and achieve sustainable development goals. Despite substantial progress in increasing access to contraceptives and reproductive health services, there remains a significant proportion of couples who do not accept or utilize family planning methods. Understanding the underlying factors contributing to non-acceptance is essential for developing effective interventions and improving the uptake of family planning services. Previous research has identified various socio-cultural, economic, and individual-level factors that influence the decision-making process regarding family planning. Socio-cultural norms and beliefs surrounding fertility, gender roles, and reproductive health practices shape attitudes towards family planning within communities. Economic factors such as poverty, limited access to resources, and concerns about the affordability of contraceptives impact the ability of couples to plan and space their pregnancies effectively.
Family planning is nothing new in society; in fact, it has been practiced for so long in industrialized nations that many in less developed nations are unable to identify it. in the field of study, it was customary for a woman to send her newborn to her mother, who would care for him or her for a year or two. Her time with her mother was intended to be used for nursing the child before she returned to her husband. In this manner, natural child spacing occurred without being enjoyed. However, the clear issues of violence against both born and unborn children led to the invention of family planning in Nigeria. These reasons were based on child jumping that is a child that is unwanted can be dump into the street, gutter, mot, some are found in front of orphanage, bush part and to public toilet. In 1954, Adeniyi Jones established the first family planning centre in Nigeria she continue without support until 1969 when pathfinder provide fund to sustain the programme.
Fortunately for her in 1984 The family planning centre of Nigeria (FCN) was further organized for woman for better services. This include provision of family planning methods to improve maternal mortality and those with health risk 1989, president Ibrahim Babagida limited the number of children to 4 (four) per parent or couple, this programme was very good but could not be sustained because of poor service and management. in the word of Gribbe, J. (2008) cited in Mabel Oshomah work he opine that “family planning can be better explained as being a situation where people have children by choice and not by change”, to him the happiness of the family squarely depend on the number of children a family has to cater for.
According to World Health Organization (WHO) (2002) conceptive is a drug or device used to prevent woman from getting pregnant, this can sometimes be called birth control according to (FPA) Family Planning Association. It is discussed as a special device that prevents fertilization of egg in the ovum by special device used to limit reproduction, which provide a safe and effective way to regulate fertility of the womb. An individual, his spouse, and their offspring comprise a family. The guy plans and assigns resources to important areas that require improvement because he is the head of the family or household. Should Gribble, J. (2008) indicate that a family's contentment is associated with its size, a guy ought to choose a course of action that will not only enhance the family's well-being but also satisfy his ambition to support a family. He needs to take part in family planning since no man would rather spend his money on unsatisfactory education, amusement, or a decent and comfortable home for the family than on bills for medical care, child care, or sickness.
The President of Nigeria, his Excellency, Goodluck Ebele Jonathan was quoted in Vanguard newspaper on June 28, 2012 saying “Nigeria families should have only the children they can afford. To ensure this order was followed, a new Planned Parenthood Federation of Nigeria (PPFN) was created. He said it may be time for birth control legislation. Family planning, until recently, a very sensitive subject in Africa, is now very increasingly accepted as a necessary ingredient of socio-economic development. It is now thought to be an important health measure that contributes to the health of parents, children and the entire nation. Because of the great effect over population has on socio-economic status, education and health in general, a full understanding of this phenomenon and the major factors governing it are essential, thus the need to adopt family as a means of checking the escalating birthrate cannot be over emphasized.
Unfortunately, this idea is not adequately emphasized on, especially in the rural areas, where it was observed that they g=have a high regard for large families and children are seen as a blessing from God. They believed that the more children a man has, the more hands to help with work especially on the farm. It is also believed that children give status to a women and security in old age. In Oghara-efe Community in Delta State, it was observed that husband often make sexual demands with little or no consideration for material health and the children’s survival. They compound their wives potential mortality rate by either not allowing her to seek family planning, advice or will not seek it as a collection responsibility. This present mentality in Oghara-efe community and its consequent socio-economic, educational and health effect on the villagers makes it important for this study to be carried out. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Factors Leading to Non-acceptance of Family Planning among Couples.
1.3 Statement of Problems
Investigation revealed that many couples lack sufficient knowledge about family planning methods, their benefits, and how to access them, leading to misconceptions and misinformation. Also, negative experiences or perceptions of healthcare providers, including lack of confidentiality, judgmental attitudes, or discrimination; undermine trust and confidence in seeking family planning support.
Additionally, religious beliefs and cultural traditions may either support or discourage the use of contraceptives, shaping individual attitudes and behaviors towards family planning within communities. Also, geographic barriers, inadequate infrastructure, and insufficient availability of family planning services, particularly in rural or remote areas, limit couples' access to information and contraceptives.
Furthermore, stigma surrounding contraceptive use and reproductive health services, as well as social pressure to conform to traditional family norms, may deter couples from openly discussing or seeking family planning support. Moreso, there is inadequate policy frameworks, lack of funding, weak healthcare systems, and challenges in implementing comprehensive family planning programs hinder efforts to address the multifaceted barriers to acceptance among couples.
1.4 Aim and Objectives of Study
The aim of the study is to assess the Factors Leading to Non-acceptance of Family Planning among Couples Attending Specialist Hospital Sokoto State. In achieving this aim, the following specific objectives were laid out as follows:
- To identify socio-cultural factors influencing non-acceptance of family planning among couples, including prevailing norms, beliefs, and attitudes towards fertility and reproductive health;
- To explore the economic barriers hindering couples’ acceptance of family planning methods, including financial constraints, and affordability of contraceptives;
- To examine the role of religious and cultural influences in shaping attitudes and behaviors towards family planning among couples;
- To identify policy and implementation challenges that hinder efforts to address non-acceptance of family planning among couples; and
- To proffer solution or recommendation that will further improve on the existing use of contraceptive method and to further open the eyes of couples in full participation in family planning.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Does the health of couples influence the attitude of women towards Family Planning?
- What is the role of religious and cultural influences in shaping attitudes and behaviors towards family planning among couples?
- What are challenges that hinder efforts to address non-acceptance of family planning among couples?
- What are the economic barriers hindering couples’ acceptance of family planning methods, including financial constraints, and affordability of contraceptives?
- What are socio-cultural factors influencing non-acceptance of family planning among couples, including prevailing norms, beliefs, and attitudes towards fertility and reproductive health?
1.6 Significance of Study
The significance of the research findings shall bring about recommendations that will serve as eye opener to the couples in area of lacking active part or participation in family planning by bringing out the need for me to encourage their wife use of family planning method financial emotional, psychologically and emotionally. Understanding the factors leading to non-acceptance of family planning among couples is of paramount importance for several reasons:
- Informing Policy and Program Development: Insights from this study can inform the development of evidence-based policies and programs aimed at promoting family planning acceptance.
- Improving Reproductive Health Outcomes: Promoting family planning acceptance can contribute to improved reproductive health outcomes, including reduced maternal and infant mortality, fewer unintended pregnancies, and better spacing of births.
- Empowering Couples and Enhancing Gender Equity: Understanding the socio-cultural, and gender dynamics influencing family planning decisions can empower couples to make informed choices about their reproductive health.
- Reducing Socio-economic Disparities: Economic barriers often limit access to family planning services and contraceptives among marginalized populations.
- Strengthening Health Systems: Insights from this study can guide efforts to strengthen health systems and improve the quality and accessibility of family planning services.
Furthermore, this research study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.7 Scope of the Study
The scope of this research is focused on the Assessment of Factors Leading to Non-acceptance of Family Planning among Couples Attending Specialist Hospital Sokoto State.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.9 Definitions of Terms
Family planning:
It refers to the practice of controlling the number of children rural women has and the interims between their births, mostly by means of contraception or voluntary sterilization so to improve family planning services and practices.
Factors:
They are elements that bring about certain effects or results and also what could cause rural women not to embrace family planning services.
Family Planning:
Family planning refers to the conscious decision and practice of individuals or couples to regulate the number and spacing of their children through the use of contraceptive methods or other reproductive health services.
Non-acceptance:
Non-acceptance denotes the reluctance or refusal of individuals or couples to adopt or utilize family planning methods for regulating their fertility and planning their families.
Access Barriers:
Access barriers denote geographical, logistical, and structural challenges that limit individuals' ability to access family planning services, information, and contraceptives.
Economic Barriers:
Economic barriers refer to financial constraints, poverty, and lack of access to resources that hinder individuals or couples from accessing and utilizing family planning services and contraceptives.
Individual-level Factors:
Individual-level factors include knowledge gaps, misconceptions, fears of side effects, and personal beliefs that influence an individual's decision to accept or reject family planning methods.
Religious and Cultural Influences:
It encompasses the impact of religious beliefs, traditions, and cultural norms on individuals' attitudes and behaviors towards family planning practices.
Gender Dynamics:
Gender dynamics refer to the social, cultural, and power relations between men and women within relationships, households, and communities that influence decision-making and access to family planning services.
Policy and Implementation Challenges:
Policy and implementation challenges encompass the barriers and limitations within policy frameworks, healthcare systems, and program implementation that affect the delivery and uptake of family planning services.
