Making long term family planning methods accessible to rural communities to reduce maternal mortality rate in nigeria

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Making long-term Family planning Methods accessible to rural communities to reduce Maternal Mortality Rate in Nigeria

By

Asanato Judy Isaac, Bako John Chukwudi

Kehinde Damola Omotayo, Arogundande Bimpe

Society for Family Health, Nigeria

Background

Maternal mortality remains a major challenge for health systems worldwide.

Annually 600,000 women died from prevented causes and 99% of these women reside in less developed countries.

High fertility rate, low literacy, poverty and lack of maternity services have worsen the situation in Africa including Nigeria.

Nigeria accounts for 10% of the global estimate of maternal mortality (FMOH 2008) and available statistics revealed that MMR in Nigeria stands at 545/100,000 lives births (NPC & ICF Macro, 2009).

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Background cont’d.

2/3 of births in Nigeria are considered high risk births – birth to women under 18 years, over 35 years and birth interval of less than 24 months.

In order to reduce the MMR and to improve maternal care in Nigeria, SFH initiated the implementation of Women’s Health Project funded by PSI in July 2008.

The project commenced in Ondo state in 1 LGA in 2009.

2 more LGAs were added in 2010

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Sites/LGAs

Akure South (2 facilities were selected) Odigbo (3 facilities selected in communities in

Ore) Ile-oluji (1 facility selected)

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Project Aims

The 5 year project is aimed at; Increasing the knowledge of modern child spacing methods

among couples of reproductive age. Increase positive attitudes and understanding of the importance

of child spacing products Achieve a national reduction in maternal mortality. Improve inter-spousal communication among couples Increasing the number of women using modern methods. Improving the capacity of health care providers to offer correct

child spacing information and services.

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Strategy/Methods

Use of consultants Advocacy Identification and Selection of health

facilities. (6 clinics selected for the project) Selection and training of community

mobilizers and providers. (24 community volunteers were selected and trained on FP methods, use of SFH Child spacing flip chart, IPC and community mobilization)

Strategy/Methods cont’d

6 health care providers were trained on how to insert IUCD and Jadelle implant

Clients received counseling on various Family planning methods and chose most preferred methods applicable to them.

Interpersonal Communication using specially designed child spacing flip charts

Community mobilization Pre-event and event days Data collection and analysis

Findings/Results

Over 1000 men and women of reproductive age were reached with tailored information on Family Planning

Husbands’ consent were gotten before insertion was done

(53.2%) and clients were 18 years and above.

57.1% of women who were mobilized accepted IUCD. (6.3% of them were between the ages of 18 – 24. 43.7% were between the age of 25 – 34 and 18.3% were above 35 years)

11.1% of the women took Jadelle implant and 31.8% settled for pills (Locon F). (0.8% of women that received implants were between the ages 18 and 24. 8.7% of them were between 25 and 34 and 1.6% of the women were 35 years and above).

Findings/Results cont’d

55.6% of women that had IUCD were married while 1.6% were unmarried.

23.81% of the married women and 8.0% unmarried women took pills

11.1% of the women who were married accepted implant.

5.0% of the women who received IUCD or implant had no education

26.2% that received either IUCD or Implant had primary education.

More clients – 31.7% had secondary school education

5.6% of those that accepted IUCD had higher education.

Project revealed that 48.4% of the women that received Family Planning did that for child spacing while 46.8% had no intention of having more children after having 4 - 5 children.

Findings/Results cont’d

Some of the clients (22.2%) were not using any form of family planning methods before the project

Apart from those using injectables, condoms and emergency pills, 5.6% of the clients reached (including older women) adopts abortion as family planning method

This was due to misconception and lack of information about family planning including available services

Acceptability was very high among community women regardless of educational background.

Recommendation

Public enlightenment and education on family planning is key to reduction of Maternal Mortality Rate in Nigeria.

Intervention programme targeting women in rural communities with modern family planning methods should be promoted and increased as this will bring about improvement in maternal and child health in low resource settings where access to health services is limited.

Recommendation cont’d

Steps needed to be taken to improve access to family planning in low resource settings include;

- increase knowledge about the safety of family planning methods - Increase male involvement in family planning - ensure contraceptives are genuinely affordable to the poorest families - ensure supply of contraceptives by making family planning a permanent line item in healthcare system's budgets - take immediate action to remove barriers hindering access to family planning methods.

Thank you for your attention For further information, contact

The Society for Family Health

P. O Box 5116, Wuse, Abuja www.sfhnigeria.org