Literature review on family planning in nigeria
Monthly summary and review of significant recent research of published sing contraceptive access for hard-to-reach populations with vouchers and social franchising in ugandaoctober 2017family physicians and provision of immediate postpartum contraception: a cera studyoctober 2017contraceptive counseling among pediatric primary care providers in western pennsylvania: a survey-based studyoctober 2017residents perceive limited education on family planning and contraception for patients with severe and persistent mental illnessoctober 2017optimization of contraceptive dosage regimen of centchromanseptember 2017when doctors deny drugs: sexism and contraception access in the medical fieldseptember 2017contraceptive use and unplanned pregnancy among female sex workers in zambiaseptember 2017manual vacuum aspiration (mva) – a safe option for evacuation of first trimester miscarriage in cardiac patientsaugust 2017adolescent reproductive and contraceptive knowledge and attitudes and adult contraceptive behavioraugust 2017uterine perforation by intrauterine devices: a 16-year reviewaugust 2017manual vacuum aspiration (mva) – a safe option for evacuation of first trimester miscarriage in cardiac patientsjuly 2017adolescent reproductive and contraceptive knowledge and attitudes and adult contraceptive behaviorjuly 2017uterine perforation by intrauterine devices: a 16-year reviewjuly 2017postabortion contraceptionjune 2017a randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothersjune 2017emergency contraceptive pill users' risk perceptions for sexually transmitted infections and future unintended pregnancyjune 2017evaluation of two intervention models on contraceptive attitudes and behaviors among nulliparous women in shanghai, china: a clustered randomized controlled trialjune 2017effect of male partner's support on spousal modern contraception in a low resource settingmay 2017a survey regarding acceptability of oral emergency contraception according to the posited mechanism of actionmay 2017missed pills: frequency, reasons, consequences and solutionsapril 2017experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in africamarch 2017contraceptive counselling for women with multiple unintended pregnancies: the abortion client's perspectivemarch 2017family planning and zika virus: need for renewed and cohesive efforts to ensure availability of intrauterine contraception in latin america and the caribbeanmarch 2017factors influencing unintended pregnancy and abortion among unmarried youth in vietnam: a literature reviewmarch 2017contraceptive non-use and emergency contraceptive use at first sexual intercourse among nearly 12 000 scandinavian womenfebuary 2017healthcare provider attitudes regarding contraception for women with obesityfebuary 2017contraception for adolescents with chronic rheumatic diseasesfebuary 2017intrauterine contraception after medical abortion: factors affecting success of early insertionjanuary 2017use of combined hormonal contraceptives among women with migraines and risk of ischemic strokejanuary 2017key role of drug shops and pharmacies for family planning in urban nigeria and kenyajanuary 2017postpartum uptake of contraception in rural northern malawi: a prospective studydecember 2016etonogestrel-releasing contraceptive implant for postpartum adolescents: a randomized controlled trialdecember 2016motivational interviewing to promote long-acting reversible contraception in postpartum teenagersdecember 2016improving the quality of postabortion care services in togo increased uptake of contraceptionnovember 2016barriers and myths that limit the use of intrauterine contraception in nulliparous women: a survey of brazilian gynaecologistsnovember 2016a prospective cohort study of the feasibility and acceptability of depot medroxyprogesterone acetate (dmpa) administered subcutaneously through self-injectionnovember 2016pediatricians' attitudes and beliefs about long-acting reversible contraceptives influence counselingoctober 2016influence of contraceptive choice on vaginal bacterial and fungal microfloraoctober 2016immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study of follow-up outcomesoctober 2016adolescent female text messaging preferences to prevent pregnancy after an emergency department visit: a qualitative analysisoctober 2016factors associated with short inter-pregnancy interval in women who plan postpartum larc: a retrospective studyseptember 2016comparing effectiveness of active and passive client follow-up approaches in sustaining the continued use of long acting reversible contraceptives (larc) in rural punjab: a multicentre, non-inferiority trialseptember 2016accessible contraceptive implant removal services: an essential element of quality service delivery and scale-upseptember 2016is hpv vaccination in pregnancy safe? A qualitative analysis of adolescent girls' views on factors associated with teenage pregnancies in bolgatanga, ghanajune 2016effects of relationship context on contraceptive use among young womenjune 2016knowledge and use of emergency contraception among students of public secondary schools in ilorin, nigeriajune 2016use of effective contraception six months after emergency contraception with a copper intrauterine device or ulipristal acetate – a prospective observational cohort studymay 2016postpartum contraception: an exploratory study of lactation consultants' knowledge and practicesmay 2016sexual behavior, satisfaction, and contraceptive use among postpartum womenmay 2016postpartum contraception: a missed opportunity to prevent unintended pregnancy and short inter-pregnancy intervalsmay 2016aspiration abortion with immediate intrauterine device insertion: comparing outcomes of advanced practice clinicians and physiciansapril 2016an evaluation of a family planning mobile job aid for community health workers in tanzaniaapril 2016the impact of balanced counseling on contraceptive method choice and determinants of long acting and reversible contraceptive continuation in nepalapril 2016compliance and use behaviour, an issue in injectable as well as oral contraceptive use? A study of injectable and oral contraceptive use in ry 2016use of emergency contraception in nigeria: an exploration of related factors among sexually active female university studentsfebruary 2016effect of a mobile phone-based intervention on post-abortion contraception: a randomized controlled trial in cambodiajanuary 2016risk of hiv infection in depot-medroxyprogesterone acetate (dmpa) users: a systematic review and meta-analysisjanuary 2016maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intakejanuary 2016emergency contraception: sources of information and perceptions of access among young adultsdecember 2015integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban uttar pradesh, indiadecember 2015the safety of hormonal contraceptives for women living with hiv and their sexual partnersnovember 2015health worker roles in providing safe abortion care and post-abortion contraceptionnovember 2015impact of bodyweight/body mass index on the effectiveness of emergency contraception with levonorgestrel: a pooled-analysis of three randomized controlled trialsnovember 2015the effect of early menarche on the sexual behaviors of korean female adolescentsnovember 2015service provider perspectives on post-abortion contraception in nepaloctober 2015provision of intrauterine contraception in association with first trimester induced abortion reduces the need of repeat abortion: first-year results of a randomized controlled trialoctober 2015medical eligibility criteria for contraceptive useoctober 2015ectopic pregnancy with use of progestin-only injectables and contraceptive implants: a systematic reviewseptember 2015the effectiveness of an adolescent reproductive health education intervention in ugandaseptember 2015impact of male partner's awareness and support for contraceptives on female intent to use contraceptives in southeast nigeriaseptember 2015knowledge and usage of emergency contraceptives among university students in ghanajuly 2015unsafe abortion requiring hospital admission in the eastern highlands of papua new guinea – a descriptive study of women's and health care workers' experiencesjuly 2015contraceptive prevalence and preference in a cohort of south-east nigerian womenjune 2015non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methodsjune 2015postpartum contraceptive use and unmet need for family planning in five low-income countriesjune 2015men's perspectives on their role in family planning in nyanza province, kenyajune 2015improving male involvement in family planning in rural southeastern nigeriamay 2015fertility awareness in adolescents in sub-saharan africa: evidence from demographic and health surveysmay 2015measuring adherence to birth control pills among college womenmay 2015unmet need for contraception among married women in an urban area of puducherry, indiaapril 2015combined hormonal versus nonhormonal versus progestin-only contraception in lactationapril 2015immediate postabortion initiation of levonorgestrel implants reduces the incidence of births and abortions at 2-years and beyondapril 2015potential public sector cost-savings from over-the-counter access to oral contraceptivesmarch 2015simulated clients reveal factors that may limit contraceptive use in kenyamarch 2015demand generation activities and modern contraceptive use in urban areasmarch 2015young women’s access to and use of contraceptives: the role of providers’ restrictions in urban senegalfebruary 2015place of persistence trouble during oral contraception and subsequent use of emergency contraceptionfebruary 2015effect of body weight and bmi on the efficacy of levonorgestrel emergency contraceptionfebruary 2015multicenter study of contraceptive vaginal ring (nuvaring(®)) in normal daily practice in indian womenjanuary 2015hormonal contraception--habits and awareness female students of the university of novi sad, vojvodina, serbiajanuary 2015consumer attitudes towards and satisfaction with emergency contraception counselling: experience from clinic and retail pharmacy settingsjanuary 2015cycle-related changes in mood, sexual desire, and sexual activity in oral contraception-using and nonhormonal-contraception-using couplesdecember 2014same-day intrauterine device placement is rarely complicated by pelvic infectiondecember 2014fertility awareness online: the efficacy of a fertility education website in increasing knowledge and changing fertility beliefsdecember 2014informed push distribution of contraceptives in senegal reduces stockouts and improves quality of family planning servicesoctober 2014emergency contraception (ec) in senegal: challenges and opportunitiesoctober 2014building on safety, feasibility, and acceptability: the impact and cost of community health worker provision of injectable contraceptionoctober 2014home-based contraceptive dispensing become a routine part of public health nurse practiceseptember 2014risk factors for unplanned and unwanted teenage pregnancies south african womenseptember 2014knowledge of emergency contraception among adolescents in public and private brazilian high schoolsseptember 2014a tiered analytical approach for investigating poor quality emergency contraceptivesaugust 2014an assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban nigeriaaugust 2014continuous or extended cycle vs. Limited awareness and high reported acceptability: evidence from argentinajuly 2014informed push distribution of contraceptives in senegal reduces stockouts and improves quality of family planning servicesjune 2014medical barriers to emergency contraception: a cross-sectional survey of doctors in north indiajune 2014preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in kenya and rwandajune 2014medicines and emergency contraception in schools, the role of the nursejune 2014the free perinatal/postpartum contraceptive services project for migrant women in shanghai: effects on the incidence of unintended pregnancymay 2014continuous compared with cyclic use of oral contraceptive pills in the dominican republic: a randomized controlled trialmay 2014randomized clinical trial of self versus clinical administration of subcutaneous depot medroxyprogesterone acetatemarch 2014routine counseling about intrauterine contraception for women seeking emergency contraceptionmarch 2014popular contraceptive methods in women aged 35 years and older attending health centers of 4 cities in khuzestan province, iranmarch 2014behavioral interventions for improving dual-method contraceptive usemarch 2014interest in and experience with iud self-removalmarch 2014performance of nurses in prescribing hormonal contraceptives in the primary health care networkfebuary 2014midwives experiences and views of giving postpartum contraceptive advice and providing long-acting reversible contraception: a qualitative studyfebuary 2014contraceptive use among women presenting to pharmacies for emergency contraception: an opportunity for interventionfebuary 2014knowledge and practice of emergency contraception among female undergraduates in south eastern nigeriafebuary 2014skipping the pill-free interval: data from a dutch national samplejanuary 2014immediate versus delayed initiation of the contraceptive patch after abortion: a randomized trialjanuary 2014contraception for adolescents in low and middle income countries: needs, barriers, and accessjanuary 2014"i'll see what i can do": what adolescents experience when requesting emergency contraceptionjanuary 2014twelve-month follow-up of advance provision of emergency contraception among teenage girls in sweden – a randomized controlled trialnovember 2013accuracy of information on emergency contraception on the internetnovember 2013use of emergency contraceptive pills among female sex workers in swazilandnovember 2013counseling on vaginal delivery of contraceptive hormones: implications for women's body knowledge and sexual healthseptember 2013evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothersseptember 2013immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for useseptember 2013copper t380 intrauterine device for emergency contraception: highly effective at any time in the menstrual cycleseptember 2013contraception during the perimenopauseseptember 2013does integrating family planning into hiv care and treatment impact intention to use contraception? 2013use of hormonal contraceptives and hiv acquisition in women: a systematic review of the epidemiological evidenceseptember 2013one-year continuation of the etonogestrel contraceptive implant in women with postabortion or interval placementseptember 2013beyond the clinic walls: empowering young people through youth peer provider programmes in ecuador and nicaraguaseptember 2013dual use of long-acting reversible contraceptives and condoms among adolescentseptember 2013family planning knowledge, attitude and practice among married couples in jimma zone, ethiopiajuly 2013racial and ethnic differences in men's knowledge and attitudes about contraceptionjuly 2013use of depot medroxyprogesterone acetate contraception and incidence of bone fracturejuly 2013misunderstanding the risk of conception from unprotected and protected sexjuly 2013non-contraceptive benefits of oral hormonal contraceptivesjuly 2013interventions for emergency contraceptionjuly 2013thrombotic stroke and myocardial infarction with hormonal contraceptionjuly 2013early versus delayed insertion of intrauterine contraception after medical abortion - a randomized controlled trialjuly 2013nigerian lawyers and reproductive health rights: a survey of knowledge, practices and opinions on law reforms among the bar and bench in north eastern nigeriajuly rs and publisher: paula and david bloomer in memory of -in-chief: professor sir sabaratnam arulkumaran, former president, ational federation of gynecology and ted by a distinguished international board and a panel list executive objectives of this site – view use cookies to ensure you get the best experience from our using the website or clicking ok we will assume you are happy to receive all cookies from planning, new research - literature review. 2013use of hormonal contraceptives and hiv acquisition in women: a systematic review of the epidemiological evidenceseptember 2013one-year continuation of the etonogestrel contraceptive implant in women with postabortion or interval placementseptember 2013beyond the clinic walls: empowering young people through youth peer provider programmes in ecuador and nicaraguaseptember 2013dual use of long-acting reversible contraceptives and condoms among adolescentseptember 2013family planning knowledge, attitude and practice among married couples in jimma zone, ethiopiajuly 2013racial and ethnic differences in men's knowledge and attitudes about contraceptionjuly 2013use of depot medroxyprogesterone acetate contraception and incidence of bone fracturejuly 2013misunderstanding the risk of conception from unprotected and protected sexjuly 2013non-contraceptive benefits of oral hormonal contraceptivesjuly 2013interventions for emergency contraceptionjuly 2013thrombotic stroke and myocardial infarction with hormonal contraceptionjuly 2013early versus delayed insertion of intrauterine contraception after medical abortion - a randomized controlled trialjuly 2013nigerian lawyers and reproductive health rights: a survey of knowledge, practices and opinions on law reforms among the bar and bench in north eastern nigeriajuly rs and publisher: paula and david bloomer in memory of -in-chief: professor sir sabaratnam arulkumaran, former president, ational federation of gynecology and ted by a distinguished international board and a panel list executive objectives of this site – view use cookies to ensure you get the best experience from our using the website or clicking ok we will assume you are happy to receive all cookies from ational perspectives on sexual and reproductive health. Journal of peer-reviewed s have found an association between attitudes toward family planning and the use of contraceptive methods, but the relationship between these two has not been critically examined and quantified. Randomly selected sample of 927 married men and women living in urban and rural areas of nigeria were asked how strongly they agreed with 26 attitudinal statements regarding family planning. A factor analysis was used to measure the association between the respondents' attitudes toward family planning and their contraceptive dents' perceptions of family planning were associated with contraceptive use: those who approved of family planning were twice as likely as respondents who disapproved to be using contraceptives. Furthermore, respondents who communicated with their spouse about family planning were three times more likely than those who did not to be using a contraceptive. Contraceptive practice was also more common among men who were exposed to family planning through the media than among those who were s found to be associated with contraceptive use should be utilized by the nigerian government in its family planning awareness campaign. Changes in attitudes toward contraception among nigerians may increase their practice of ational family planning perspectives, 1999, 25(2):a is the most populous country in africa, with more than 88 million people; it also has a high annual rate of population growth (3. In response to these and other serious demographic and health issues, the nigerian government put into effect a national population policy in 1989 that called for a reduction in the birthrate through voluntary fertility regulation methods compatible with the nation's economic and social 1992-1993, an information, education and communications campaign was launched to change nigerians' attitudes toward family planning, and to thereby increase their contraceptive use. The campaign was based on evidence that family planning messages relayed through the mass media can influence contraceptive behavior. For example, in nigeria, one-quarter of new clients attending a family planning clinic identified a television campaign as their source of referral. Other studies have shown that exposure to a mass media family planning campaign increases contraceptive l studies have reported changes in nigerians' knowledge of and attitudes toward family planning. In the 1981-1982 nigerian fertility survey, only 34% of all women reported that they had heard of any family planning method. By 1990, when the nigerian demographic and health survey was conducted, the proportion of women who knew of any contraceptive methods had increased by about one-third, to 46%, and the proportion of women who knew of specific methods also had grown. Furthermore, 41% of married women who knew of a contraceptive method had discussed family planning with their husbands.
Seventy-one percent of married women who knew a family planning method said that their husbands also approved of family article investigates the association between nigerians' attitudes toward family planning and their contraceptive behavior. To ascertain what gains the family planning campaigns in nigeria have made and what factors motivate contraceptive use, we set out to answer the following question: do positive attitudes toward family planning affect contraceptive use? The answer will help policymakers and program planners determine what issues need to be stressed in the design of future family planning awareness campaigns in article presents data on contraceptive use, knowledge, attitudes and practices in nigeria, obtained from a national survey conducted between 1992 and 1993. Nike is an agrarian community on the outskirts of recently, lagos, which is located on the southwestern coast of nigeria, was the capital city of nigeria. The analysis in this article is limited to the 927 married respondents, because those who were unmarried may not have been sexually active and therefore may not have needed to practice dents were asked to rate their level of agreement with 26 attitudinal statements describing the impact of family planning on the family, individual health and well-being, and marital relations and stability, on a scale from one (strongly agree) to five (strongly disagree). For example, the respondents were asked to rate their level of agreement with the statements: "family planning helps a couple to become responsible parents" and "family planning leads to a broken home. Therefore, a logistic regression model was used to examine the effect of the factor-analyzed family planning attitudes on current contraceptive use. Were generally supportive of family planning, although overall women were more likely than men to agree with the positive attitudinal statements (table 3). Fewer than three-quarters of men, but more than four-fifths of women, agreed that family planning helps a woman regain her strength between pregnancies and that it protects the health of mothers. Although roughly one-fifth of respondents overall supported the statement that a couple practicing family planning will have conflict in their marriage, 25% of the men agreed with it. Female respondents (55%) were also more likely than males (40%) to agree that having a large family strains a couple's were far more likely than men to agree with the statement that men should share in the responsibility for family planning. While almost three-quarters of women registered a high level of support for men playing a role in family planning, only one-third of the men the 26 statements examined in the factor analysis, five were associated with no factor—an indication of their irrelevance. Factor 1, which associates family planning with health benefits and a better standard of living, represents respondents' positive attitudes toward family planning. The factor correlates favorably with such statements as "child spacing protects the health of mothers" and "practicing family planning will create a better society. 2 correlates highly with the statements that measure the perceived association between contraceptive use and conflict in the home, such as "the practice of family planning will cause a loss of confidence between a husband and a wife. Table 5 presents results both of the general model and of the final the chief predictors of contraceptive use for all respondents combined were education, religion, approval of family planning, media exposure, spousal communication and approval and agreement that female education should be encouraged (factor 3). Who approved of family planning were two times as likely to be using contraceptives as those who disapproved. Those who agreed strongly that a girl should finish her education before marriage (factor 3) were almost twice as likely as those who did not to be practicing family analysis also highlighted the importance of significant others in the decision to use contraceptives. For example, spousal approval and communication with one's spouse were significant variables: respondents with spouses who approved of family planning and those who had discussed family planning issues with their spouses were more likely to be contraceptive gregation of the analysis by gender indicates that for the men, the critical variables that influence the probability that they will use family planning were their religion and ethnicity.
Other predictors were family planning approval, media exposure, place of residence and spousal approval and predictor variables for the female respondents were age, education, ethnicity, family planning approval, media exposure, communication with their spouse and his approval of family planning, and the social support of others. Women who agreed strongly with the statement that the practice of family planning breeds conflict in the home were 37% less likely than those who disagreed to use family planning. Thus, respondents who associated family planning with health benefits and an improved standard of living (factor 1) were more likely than those who did not to be practicing contraception. Conversely, those who agreed that family planning breeds conflict in the home (factor 2) were less likely than those who disagreed to be using contraceptives. This is often the reason men and women in developing countries give for not practicing family planning. Contraceptive use was more likely among respondents, particularly females respondents, who agreed that family planning encourages delayed marriage (factor 3) than among those who findings demonstrate that people's perceptions of family planning affect whether they will use it. Those who think that practicing contraception provides health benefits are likely to use a method, as are those who perceive that family planning will help them to improve their standard of living. Furthermore, this analysis suggests that there is an association between attitudes toward family planning and contraceptive study also shows the impact social support can have on contraceptive use. Their endorsement of family planning may thereby increase contraceptive use among their family and other community members. Spousal communication, too, is an important predictor of contraceptive use and must also be considered in family planning service delivery. Finally, the association between ethnicity and contraceptive use indicates the importance of considering the social and cultural implications of family planning service we accept the factor structure as valid, then nigerians' increased contraceptive use may be attributable to their changed perceptions of family planning, brought about both by the government's information, education and communication campaign and by the country's economic hardship. Thus, family planning awareness programs have had and may continue to have an influence on nigerians' contraceptive behavior. The following five statements were not associated with a factor: "a woman who has too many children looks tired and worn out"; "if a man really loves a girl, he will wait for her to finish school"; "early marriage and childbearing can damage a girl's health": "wives who practice family planning will be abandoned by their husband"; and "it is embarrassing for me to talk to my spouse about family planning. Obby odimegwu is a research demographer and is on the faculty in the department of demography and social statistics, obafemi awolowo university, ile-ife, nigeria. United states agency for international development (usaid) and overseas development assistance (oda), situation analysis report: the family planning situation analysis study, washington, dc, usa: usaid; and great britain: oda. Federal government of nigeria, national population policy for development, unity and self-reliance, ikoyi, lagos, nigeria: federal ministry of health, 1988. Odimegwu co, determinants of choice of traditional and modern methods of contraception, unpublished manuscript, department of demography and social statistics, obafemi awolowo university, ile-ife, nigeria, 1995; mcguire wj, the myth of mass media impact: savagings and salvagings, public communication and behavior, 1986, 1:173-257; bankole a, rodriquez g and westoff cf, the mass media and reproductive behavior in nigeria, paper presented at the annual meeting of the population association of america, cincinnati, oh, usa, april 1-3, 1993; and westoff cf and rodriguez g, the mass media and family planning in kenya, international family planning perspectives, 1995, 21(1):26-31. Ibid; adewuyi aa, omideyi ak and raimi mo, evaluation of public service announcement on family planning knowledge, attitudes and practice in nigeria, main report submitted to fhs/iec division of the fhs project victoria island, 1992; and raimi mo, the impact of public service announcements on family planning knowledge and practice in nigeria, paper presented at the ninth population association of nigeria conference, benin city, nigeria, may 3-5, 1994. Erlbaum associates, rd obby odimegwu is a research demographer and is on the faculty in the department of demography and social statistics, obafemi awolowo university, ile-ife, nigeria.
Issue : 1 | page : t knowledge and pattern of use of family planning methods among a severely ill female nigerian psychiatric outpatients: implication for existing ola f ment of behavioral sciences, university of ilorin teaching hospital, ilorin, kwara state, of web pondence address:mosunmola f tunde-ayinmodedepartment of behavioral sciences, university of ilorin teaching hospital, ilorin, kwara state nigeriasource of support: none, conflict of interest: nonecheckpmid: ct background: despite the acknowledged benefits accruable to the mentally ill from the use of contraceptives, research and dedicated reproductive health services for this group of people in nigeria are still underdeveloped or non-existent in many cases. Materials and methods: a cross-sectional descriptive study of 100 women with severe mental illness attending psychiatric outpatient clinic in ilorin, nigeria, using a semi-structured questionnaire. Results: a majority (88%) of the women had good knowledge of family planning, many (61%) were interested in its use but at least half of them had not used any method and current use was just 27%. Attitude to family planning was generally positive as indicated by desired family size (71%) of less than 4 children with 6 out of 10 desiring future intention to use. Most (81%) of these women desired that family planning information be provided at the psychiatric clinic but fewer of them discussed this with their partners. Conclusion: considering discrepancies between knowledge, interest and use, the potential health benefits of fertility regulation, and the adverse effects of unregulated family, and contraceptive use is still relatively low. The large number of women who desired clinic-based family planning education suggests that the introduction of such program is feasible. Méthodes et matériaux: une étude descriptive transversale de 100 femmes avec des troubles mentaux sévères traitant clinique psychiatrique à ilorin, nigeria, à l'aide d'un questionnaire semi-structuré. Mots clés: connaissances actuelles, l'utilisation de la planification familiale, patients psychiatriques femmes gravement maladeskeywords: current knowledge, family planning use, severely ill female psychiatric to cite this article:tunde-ayinmode mf. Current knowledge and pattern of use of family planning methods among a severely ill female nigerian psychiatric outpatients: implication for existing service. 4],[5],[6] pregnancy in patients with severe mental illness should be properly planned to avoid adverse consequences for the patient, the child, and the family. 1],[2] large family result from unregulated fertility which has adverse consequences for the mother, her children, and the family too. 7],[8] family members could become overburdened because of care for the patient and her children particularly during periods of exacerbation, relapse, or hospital admission and if the children are many such families could become dysfunctional if the stress is not mitigated. 11] regulating family size in heritable conditions like schizophrenia could serve preventive purposes by limiting potentially the number of children exposed to the risk of the disorder. 12] modern contraceptives are the best methods of family planning (fp) because of their effectiveness in regulating fertility and family size and as tools in preventive reproductive health. 12],[13] unlike in developed countries, there is little or no evidence in literature from developing countries like nigeria that mental health workers have adapted to the trends in sexuality, fertility, and marriage counseling of patients with severe mental illness. There are reports of discharged and continuing care patients being counseled on these issues and of successful separate family planning services for institutionalized psychiatric patients from more developed countries. 1],[2],[14],[15] even at that, inadequacies exist in knowledge of mental health workers about how to provide family planning, manage fertility issues, handle ethical issues, how to obtain informed consent, and role of reproductive decision on family life and on the management of the patient. 1],[2],[11],[15] in nigeria, while the importance of family planning in the mental health has for long been recognized, [16],[17] we still do not have any organized fertility regulation program.
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The presence of homeless mentally ill patients or psychotic vagrants on the streets of many of the cities in nigeria with some who may be pregnant or nursing or rearing children presents an unfortunate scene. 18],[19] however, the role of the family in the occurrence of mental health needs to be further researched, it is also important to study the reproductive decision making in these ly ill patients in nigeria are managed in the community often as day care. 21] family planning is part of primary care but special services for the mentally ill is s that may restrict the mentally ill patients from being able to use the regular family planning program for the general population include stigma, socio-economic and educational disadvantages, illness-related and decision-impairing factors (e. 2],[6],[23] scientific literature search for evidence of sexuality pattern, fertility behavior, and special family planning programs, pattern of knowledge, and use of family planning among women with severe mental illness in nigeria has not been too rewarding. In fact, a literature search did not yield any study from the north central zone of the country which was the setting of this investigation. This study is an attempt to characterize knowledge and use of family planning among these patients attending our clinic and thus provide some insight into their fertility behavior. Materials and methods study design and populationthis paper is reporting a segment of data from a larger descriptive cross-sectional analytic study on marital, parenthood, parenting, family profiles, and reproductive behavior of women with severe mental illness. Those with impaired cognition from whatever cause or unresolved psychotic on and background of studythe study was carried out at the outpatient clinics of the department of behavioral sciences, university of ilorin teaching hospital, ilorin, north-central nigeria. Usually health education talks are given by nurses to patients at the start of the ng methodall consecutive patients approached, who met the inclusion criteria and gave consent to participate during the period of the study were recruited into the mentsthe study was carried out using a semi-structured questionnaire with four sections respectively on socio-demographic characteristics, family characteristics, illness-related characteristics, and family planning characteristics of the collection and analysisthree research assistants and the investigator collected the data. 1: some clinical and socio-demographic characteristics of the womenclick here to viewfamily planning characteristicsknowledge and use the level of knowledge of any family planning method was 88% and that of interest in using was 61% but only 27% were currently using a method and 51% had never used a method before. The method of family planning known in decreasing order was: male condom (68%); injectables (64%); the pills (56%); iud (37%); and sterilization (16%). 2: family planning characteristics of the womenclick here to viewless than half (48%) discussed family planning issues with their spouses, only 5% had ever received family planning information from our clinic or hospital even though 81% desired to have such information provided by the s for non-usethe most common reason for not using family planning despite knowledge and interest was categorized as follows in order of frequency: fear of side effects of the methods (25/63); desire for more children or for as many children as possible (21/63); dislike of methods because of cultural and religious inhibitions (9/63); indecision (2/63); and spousal opposition (1/63). For usethe most common reasons for using family planning can be categorized in order of frequency as follows: termination of child bearing (15/27); increasing inter-birth intervals, i. Birth spacing (8/27) and limiting the number of children likely to reasons for not having interest at all in any family planning method in order of frequency include: want unlimited number of children (16/39); dislike of methods because of cultural and religious inhibitions (6/39); fear of side effects of the methods (5/39); "i don't just like it" (12/39) [table 3]. 3: family planning methods used and reason for use and non-useclick here to viewreasons for discontinuationsthe reasons for family planning discontinuation following previous use were: fear of methods (16/22); pregnancy (3/22), and termination of sexual relationships (2/22). Discussion this is a study of knowledge and use of family planning among an outpatient population of women with severe mental illness, a majority of whom had schizophrenia, were educated, and gainfully employed. These women were relatively knowledgeable about modern methods of family planning but had low level of interest and much lower level of use. The study also suggests that many of the women are still at risk of large family size and unintended pregnancies. Desire for family planning education program was high, creating opportunity of modifying reproductive behavior at the individual level in the l studies in nigeria suggest that the knowledge of family planning in the general population may have increased substantially despite the low prevalence of use.
In the case of our women with severe mental illness, discrepancies between knowledge, interest, and use may have resulted from the potential obstacles that make the regular family planning outlets unattractive or inaccessible to these patients. These points have been used to support psychiatric clinic-based family planning initiatives, more so that many of these patients have frequent contact with mental health workers and hardly the general health service. 1],[2],[15] several suggestions have been made as to the most appropriate method for evaluating these patients for family planning. Both facts suggest that much more efforts will have to be made to get this group of women to further use family planning. Most common factors that are known to be responsible for non-use of family planning in nigeria include: fear of side effects of methods, myths about family planning, cultural and religious oppositions, and opposition by spouses. 28],[29] the findings of this study are similar except that spousal opposition was not the general population in nigeria, the order of frequency of methods known and used is the pills, condom, the injectables, and iud; [28],[29],[30] this is slightly different from this study in which the condom was the most frequently used method. The need to educate the male partner on the appropriate use and limitations of condoms should be emphasized, particularly what to do in cases of inappropriate use to avoid unintended gh it can be sometimes difficult to get the male partner to accept family planning and even more difficult to come to the clinic in our setting being often occupationally engaged. Encouragingly the male factor as the reason for not using family planning was not a major factor in this study contrary to its generally recognized impact in many studies. 32],[33] men continue to determine the level of fertility of their families and contraceptive decisions; their rate of acceptance and willingness to adopt family planning has a great impact on prevalence and family size. 32] the fact that the male condom was the most known and used method suggests the significant role male spouses play in the reproductive health of the affected women and not surprising only very few of them gave their spouses opposition as a reason for not having interest or using family r to the general population, the use of hormonal contraceptive injectable and the pills in this study was frequent occupying the second and fourth position, respectively; [21],[28],[29],[30] traditional methods (deliberate postpartum sexual abstinence) although on the decline are still important methods particularly in developing countries like nigeria. 34],[35] abortion as a method of family planning is illegal in nigeria but there are reports that its rate may be quite high. A majority of those who were using family planning used it because they had completed their families and wanted to terminate child bearing, this positive trend of more terminal contraceptors than birth spacing contraceptors and the remarkable desire for smaller family is not compatible with the condom being the most frequently used method. 28] although some of the women knew sterilization, none used it conforming to the national trend; sterilization is a poorly accepted or used method in nigeria because of cultural and religious opposition; [28],[29] there is a lot of work that need to be done to redirect the interest of women to the more effective means of contraception. Women who are well motivated to use family planning should be encouraged to use effective of side effects was the main reason for discontinuation of contraceptive use. A majority of those who had never used any family planning method gave cultural and religious reason for this resistance which poses serious challenge for public enlightenment and family planning education at the clinic level. Conclusion the study has provided some evidence that many of our women with severe mental illness are knowledgeable and interested in family planning but are not using any modern methods; this gap suggest that a lot still need to be done to meet their family planning needs. In addition, many current users were using methods incongruent with family size or reproductive aspirations; therefore, intervention at psychiatric outpatient clinics is necessary to change reproductive behavior of these women and improve their reproductive health. This may include clinic-based psychiatric-focused patient education and referral service to be delivered by specially trained mental health workers or family planning limitation of this study is that it is hospital based thus limiting the ability to generalize it to the wider population but the sample is representative of the target population of women with severe mental illness. Relationship between family attitude and social functioning in schizophrenia: a nine-month follow-up prospective study in spain.
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