A cross sectional, community-based, descriptive study among women of reproductive age group (15-49 years) in Nigeria to explore the possible reasons for contraceptive non-use despite reported high awareness was carried out. Data were obtained using a standard questionnaire instrument and applied on 2001 respondents. Contraceptive prevalence among sexually active respondents was 14.8% for all methods, 10.1% for modern methods and only 0.8% for emergency contraceptives. The most frequently stated reasons for non-use of contraceptives, among those who had never used any contraceptives but who did not want more children were: "did not think about it", "against religious belief " and "fear of side effects." Prior counseling significantly improved the continuation rate of contraception. Multivariate analysis showed that older, married and more educated women tended to use contraceptives more. Health-care providers should be trained to offer counseling services to all clients in general, and young, unmarried and uneducated women in particular in order to improve their acceptance of contraceptives. RÉSUMÉUne étude à base communautaire sur le comportement du contraceptif au Nigéria. Nous avons mené une étude descriptive traversale à base communautaaire auprès des femmes dans le group en âge d'avoir des enfants (15-19 ans) au Nigéria afin d'explorer les raisons qui peuvent expliquer le non-usage des contraceptifs malgré le haut niveau de sensibilisation. Les données ont été recueillies à l'aide d'un instrument de questionnaires standards administrés aux 2001 répondantes. La fréquence contraceptive parmi les répondants qui sont sexuellement actives était de 14,8% pour toutes les méthodes, 10,1% pour les méthodes modernes et juste 0,8% pour les contraceptifs d'urgence. Les raisons les plus fréquemment données pour expliquer le non-usage des contraceptifs parmi ceux qui n'ont jamais utilisé les contraceptifs, mais qui ne voulaient pas encore d'enfants étaient: "je n'y ai pensé", "contre la croyance religieuse" et "la peur des effets secondaires". L'analyse multifactorielle a montré que les femmes les plus âgées, mariées et instruites avaient la tendance d'utiliser les contraceptifs. Il faut former des prestataires de services médicaux pour qu'ils puissent rendre les services d'orientation à tous les clients en général, mais sourtout aux jeunes, aux célibataires et aux femmes non-instruites afin d'améliorer leur acceptance des contraceptifs. (Rev Afr Santé Reprod 2006; 10[2]:90-104)
BackgroundUnderstanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives.Methods and FindingsA multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15–49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15–24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives.ConclusionStrategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.
Long-term advocacy and investment in female education will contribute significantly to primary prevention of late or non-attendance of ANC. Pre-conception clinics and community awareness campaigns would be necessary tools to reach these women and encourage them to register early when pregnant.
Objective:To assess the effect of psychosocial support on labour outcomes. Methodology: A randomised control trial conducted at the University College Hospital Ibadan, Nigeria, from November 2006 to 30 March 2007. Women with anticipated vaginal delivery were recruited and randomised at the antenatal clinic. The experimental group had companionship in addition to routine care throughout labour until two hours after delivery, while the controls had only routine care. The primary outcome measure was caesarean section rate. Others included duration of active phase, pain score, time of breast-feeding initiation and description of labour experience. Multivariable analyses were used to adjust for potential confounders. The level of statistical significance was set at 5%. Results: Of the 632 recruited, 585 were eventually studied: 293 and 292 were in experimental and control groups, respectively. Husbands constituted about two-thirds of the companions. Women in the control group were about five times more likely to deliver by caesarean section (95% confidence interval (CI) 1.98-12.05), had significantly longer duration of active phase (P < 0.001), higher pain scores (P = 0.011) and longer interval between delivery and initiation of breast-feeding (P < 0.001). However, those in experimental group had a more satisfying labour experience (odds ratio 3.3 95% CI 2.15-5.04). Conclusion: Women with companionship had better labour outcomes compared to those without. It is desirable to adopt this practice in our health-care settings as an alternative strategy to provide comparable quality services to would-be mothers in labour.
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