Non-compliance, cause of family planning failure – Women

In the last 10 years, the contraceptive prevalence rate (CPR) in Nigeria has hovered between 10 per cent and 14 per cent, an indication of the slow rate of contraceptive use among people of reproductive age. FLORA ONWUDIWE relates the lifestyle of some that experience failed



Nigerian Urban Reproductive Health Initiative (NURHI) in collaboration with Development Communications (DEVCOM) recently embarked on intervention project in which they rehabilitated and upgraded some primary healthcare (PHCs) centres in various local government councils (LGC) in Lagos State.


This development was disclosed during a facility tour of three primary health care (PHC) centres under Ebute Meta Local Government Council (LGC), Lagos Mainland Local Government Simpson Primary Health Centre, Ebute Metta, and Alli Daodu PHC.
The objective of the intervention project was to provide Family Planning (FP) commodities that will help mothers space the birth of their children, which would pave the way for adequate upkeep of the kids while giving mothers the ease to go about their businesses.


During the tour which took place recently, media practitioners who participated in the visit inspected the three PHCs under the Ebute Meta LGC area in Lagos State and confirmed that NURHI had donated hospital equipment, family planning commodities and other care services to the PHCs at the Lagos Mainland Local Government in Simpson Primary School, Ebute Metta, the Comprehensive Health Centre at Ebute Metta and Alli Daodu PHC at Yaba Local Government Council.


Speaking with one of the beneficiaries, Mrs. Abose Yakubu who is a 38-year-old mother of two, explained that she started using FP without proper information about the chosen method in 2016 at Desalu PHC and was referred to the PHC at Simpson Lagos Mainland LGC.

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She said: “I had lost so much blood, because I was not introduced to the FP method that would be good for me. Rather, I was given a book to make my choice.”


Mrs. Yakubu was in company of her friend, who was also a beneficiary. “My friend and I visited the Desalu PHC where they gave us a book to check the method that would be convenient for us. I chose one method in which I had to insert the FP commodity on my left hand side; this was in 2016.


“My friend was having too much flow of blood and the providers then suggested another method for her, but she insisted on removing it.


Subsequently, we were referred to the PHC at Simpson Primary School in Ebute Meta.


Speaking further, she said, “The first day we were at Desalu, providers did not introduce to us the FP method that will be good for us. Rather, they gave us a book to check the ones that will be good for us and we thought that the one we saw would be appropriate and ever since we have been using it the blood flow is too much.


“The same problem happened to the person I brought here. I thought mine will prevent unintended pregnancy, but my husband asked me to remove it.”


“I have two kids, the first is four years and the second child is going to three years. My plan was to give a a little gap before getting pregnant again for my second child, but I was not happy about what I experienced. Hence, I went to remove it.”



On the contrary, that was not the case of Mrs. Evelyn Amaka Ajah, 31-year-old mother of five.


When the New Telegraph had an encounter with her at the Comprehensive Health Centre in Ebute Metta, she chided other clients who complained of complications, saying that they were not compliant to the instructions of matrons or the medical doctors, part of whom constituted the care providers.


She said, “I am a mother of five children; the injection method of FP is good for me and it has not failed me because I kept to the appointment of the providers. I am on appointment every two months and I make sure that I turn up for the appointments.


The contraceptive injection (Depo-Provera, Sayana Press or Noristerat) releases the hormone progestogen into the bloodstream to prevent pregnancy.


If used correctly, the contraceptive injection is more than 99 per cent effective.


Some say in the process of FP, they became pregnant. Part of the reason is because they do not keep to scheduled appointments with the providers.


Speaking to the New Telegraph, Ajah said, “I have been on injection method since I started giving birth and the injection is good for me. It has not failed me; I renew it every two months.


“It is good to use a FP method because it will help you to take care of your children. It is also good to have anbaby that you can take care of.”

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The Chief Matron, Morenke Juliana Adenaiya of the Comprehensive Health Centre in Ebute said since the intervention of NURHI, more clients have been turning up at the centre for the uptake of FP commodities and they are enjoying the services. “We have not recorded the case of any client bleeding because of a chosen method of FP.


“Sometimes they don’t know the difference. We introduce every method to them and they will ask questions to know the method that will be comfortable for them.


“Every FP service here is free except blood pregnancy test, which clients are required to pay to the laboratory.”


Mrs. Wemimo Lawal of Alli Daodu PHC, said that presently she has three children, but will stop having babies when she has four kids.


She said, “I started with the injection method and I spaced my kids for every four years, but I noticed that it was not good for my body. Consequently, I stopped the injection. I had to go for the pills method because it is good for me.”


The Public Health Nurse and Midwife, Mrs. Grace Biokun of the Alli Daodu PHC, said, “Before the intervention of NURHI, which upgraded the PHC facilities, patronage by clients was low, but now the clients come to the centre, seeking FP services every day. We record as many as 10 clients seeking services from the facility every day, resulting to an average of 60 to 80 clients in a month.”


She added that the patronage was very good, saying the level of FP acceptance was on the high side.



“The NURHI intervention took place in 2017 and we can record more than 200 clients; the awareness about FP has encouraged interested clients to adopt different methods except sterilisation.


Reacting to why some contraceptives fail, a Professor of Obstetrics and Gynaecology and Country Director, Jhpiego Corporation, an affiliate of Johns Hopkins University, Baltimore, Maryland in the United States, U.S, Emmanuel Otolorin said, “There are no contraceptive method that is 100 per cent effective, but there are methods that are 99 per cent effective where the rate is only one per cent.


“When that happens people will always quote experience from the one per cent instance. Even that one per cent could have happened probably because the person is already pregnant before she went for the contraceptive.


“So, when you are already pregnant before getting a contraception it is not what will end the pregnancy that was already there. May be the method was not properly applied; may be, it was a fake product. So, there are many reasons for that one per cent failure of some family planning commodities.”


Otolorin however encouraged clients to desist from talking about the one per cent failure of family planning; ’they should talk about 99 per cent success that can prevent pregnancy.”


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