Nursing Project Topics

Factors Militating Against Family Planning Amongst Women in Rural Communities

Factors Militating Against Family Planning Amongst Women in Rural Communities

Factors Militating Against Family Planning Amongst Women in Rural Communities

Chapter One

General and Specific Objectives

General Objective

To assess the determinants of utilization of family planning services among women of child bearing age in rural areas of Imo state, Northern Nigeria.

Specific Objectives

  • To determine the level of knowledge of family planning among women of child-bearing age.
  • To determine the attitudes of rural women of child-bearing age towards family
  • To determine the level of use of family planning products and services among rural women of child-bearing
  • To determine the factors associated with utilization of family planning services among women of child-bearing



 Historical perspective of family planning

Family planning refers to the use of modern contraception and other methods of birth control to regulate the number, timing, and spacing of human births. It allows parents, particularly mothers, to plan their lives without being overly subject to sexual and social imperatives. However, family planning is not seen by all as a humane or necessary intervention. It is an arena of contestation within broader social and political conflicts involving religious and cultural injunctions, patriarchal subordination of women, social-class formation, and global political and economic relations.

Attempts to control human reproduction is not entirely a modern phenomenon. Throughout history, human beings have engaged in both pro-and antinatalist practices directed at enhancing social welfare. In many foraging and agricultural societies a variety of methods such as prolonged breast-feeding were used to space births and maintain an equilibrium between resources and population size.

The idea of modern population control is attributed to Thomas Malthus (1766–1834), who in 1798 articulated his doctrine attributing virtually all major social and environmental problems to population expansion associated with the industrial revolution. However, as a clergyman turned economist, Malthus was opposed to artificial methods of fertility control. He advocated abstinence and letting nature take its toll and allowing the poor to die.

In contrast, birth control emerged as a radical social movement led by socialists and feminists in the early twentieth century in the United States. The anarchist Emma Goldman (1869–1940) promoted birth control not only as a woman’s right and worker’s right, but also as a means to sexual freedom outside of conventional marriage. But soon birth control became increasingly medicalized and associated with science and corporate control as well as with the control of reproduction within marriage and conventional family life. As the radicals lost their leadership of the birth control movement to professional experts, mostly male doctors, by the 1920s birth control, which refers to voluntary and individual choice in control of reproduction, became aligned with population control, that is, a political movement by dominant groups to control the reproduction of socially subordinate groups.

During the influx of new immigrants in the 1920s and 1930s and during the depression, when the ranks of the unemployed were swelling, eugenicist (hereditary improvement) ideology and programs for immigration control and social engineering gained much ground in the United States. Even the birth-control pioneer Margaret Sanger (1879–1966) and suffragists such as Julia Ward Howe (1819–1910) and Ida Husted Harper (1851–1931) surrendered to ruling-class interests and eugenics, calling for birth control among the poor, blacks, and immigrants as a means of counteracting the declining birth rates of native-born whites. Influenced by eugenicist thinking, twenty-six states in the United States passed compulsory sterilization laws, and thousands of persons—mostly poor and black—deemed “unfit” were prevented from reproducing. By the 1940s, eugenicist and birth-control interests in the United States were so thoroughly intertwined that they became virtually indistinguishable. In the post–World War II era, compulsory sterilization became widespread in the so-called Third World where the birth rates have been higher than in the industrialized countries (in 1995, fertility per woman was 1.9 in the more developed regions and 3.6 in the less developed regions).

In the late twentieth century, the fear of demographic imbalance again seemed to be producing differential family-planning policies for the global north and the south. This was evident in corporate-scientific development of stronger contraceptives largely for poor women of color in the south and new reproductive technologies for fertility enhancement largely for white upper- class women in the north. Some insurance companies in the United States continue to refuse to cover conception in the early twenty-first century. Countries concerned with population “implosion” in the north such as Sweden, France, and Japan are pursuing pronatalist policies encouraging women to have more children while at the same time pursuing antinatalist policies encouraging women in the south to have fewer children.

Given the massive increase in population in the south hemisphere countries since World War II, much of global family-planning efforts have been directed toward those poor countries of the so- called Third World. The followers of Malthus, the neo-Malthusians, have extended his thinking, blaming global poverty, political insecurity, and environmental degradation on the “population explosion” and calling for population control as the primary solution to these problems. Their efforts have helped turn family planning into a vast establishment of governmental and nongovernmental organizations with financial, technological, and ideological power emanating from the capitals in the north toward the remote corners of the south. Within countries in the south, the hierarchical family-planning model spreads from professional elites in the cities to the poorest men and women in the villages. In India alone, there are an estimated 250,000 family- planning workers. Every year vast amounts of money are spent to promote “contraceptive acceptance” among the poor populations in the world. Contraceptive use in the “developing world” has increased from less than 10 percent of couples of reproductive age in the 1960s to more than 50 percent (42 percent excluding China) in the 1990s. The rapidly falling birth rates in the Third World are generally attributed to the “family-planning revolution” represented by expanding use of modern contraceptives.





 Study Design

It is a community based cross-sectional household study that was conducted to investigate use and factors associated with utilization of family planning services in Obibe Ezena community, Owerri North, Imo state

Study Population

The study population comprised of all married women of child-bearing age (15-49 years) residing in Obibe Ezena community, Owerri North, Imo state



 socio-demographic data

Table 1: Age distribution of child-bearing women in Obibe Ezena community, Owerri North, Imo state, 2020



This study sought to identify the determinants of utilization of family planning services amongst women of child-bearing age in rural areas of Imo State. This is very relevant given the high total fertility rate among Nigerian rural women (6.2/ woman) compared to women residing in urban areas (4.7/woman). Also the maternal mortality rate in Nigeria is unacceptably high (545/100,000 population).

Majority of the participants were in the 15-24 year age group. According to NDHS 2013, this is the age group that showed a steady rise in fertility rate. Majority of those not utilizing family planning services fall within this age group though no statistical significant association was found between age and family planning services (FPS) utilization.




This study has established that women of child-bearing age in rural areas of Imo state have low level of knowledge on family planning and its methods. Attitude towards family planning is poor with cultural and religious misconceptions playing vital roles. Level of use of family planning methods is also low. Established determinants of utilization of family planning services include male non-involvement, family setting, age and religion.


A.   State Government:

  1. Health education of the people in the rural areas should be intensified by the health education unit of the primary health care management
  2. Conduct research on causes on husband non –approval or male non-involvement as regards to utilizing
  3. Intensify advocacy to religious leaders in the community as well as conduct interactive sessions so as to enlighten them on the benefits and urgent need to clarify issues on status of religion regarding family planning to their
  4. Promote community involvement in public health programs.
  5. There should be concerted efforts to the policy makers to intensify awareness on utilization of modern methods of
  6. The State Ministry of Health in collaboration with the primary health care management board should roll out more programmes such as organizing workshops and seminars to educate married couple on the benefits of family planning practices. This will bridge the gap between awareness and knowledge and practices of family

B.   Family planning service providers:

  1. Community-based family planning clinics need to be expanded and strengthened in the rural areas so as to disseminate information and provide counseling on family planning practices and contraceptive usage. This will help married couple choose appropriate methods so as to reduce the fear of side effects associated with contraceptive usage.
  2. Family planning services should be incorporated in all public hospitals and clinics within the rural areas with the view of increasing access to and supply of This will help reduce if not eliminate the accessibility constraint.
  3. Traditional leaders, opinion leaders, religious leaders and the community as a whole should be made part of the awareness and practice campaign. This will help reduce the negative perceptions society have about people who practice family

C.  Clients (WCBA):

  1. Client orientation and empowerment with regards to family planning.
  2. Clients should be encouraged to be committed users of family planning
  3. Clients should be encouraged to give feedback on the service


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