1.  Program
 Author Index
Session: 1.1.03 Effectiveness of Family Planning Efforts
ID: Res587
Date/Time: Wednesday, November 13, 2013
Author(s): Molly Cannon
Zulfiya Chariyeva
William Sambisa
Olugbenga Oguntunde, USAID/Targeted States High Impact Project Nigeria
Aminu Garba, Community Health and Research Initiative
Saba'atu Danladi
Nurudeen Lawal
Title of Abstract / Titre: Increasing Family Planning Utilization among Women of Reproductive Age in Bauchi State, Northern Nigeria:
Opportunities and Challenges
Abstract Type / Type de
résumé:
Research Abstract
Topic / Sujet: Family planning practice
Significance/background
/ Importance/contexte : Fertility rates have significantly declined in many parts of the world especially in developed countries. In contrast,
most developing countries, including Nigeria, still have high fertility rates. The total fertility rate (TFR) of Nigeria is
5.7. The contraceptive prevalence rate (CPR) is 9.7%. Furthermore, Nigeria experiences high maternal mortality rates
(545/100,000 live births) and infant mortality rates (75/1,000 live births) largely due to short birth spacing and poor
health delivery system. The health indices of northern Nigeria are worse than those of other regions of country. In
Northeastern Nigerian where Bauchi State is located, the TFR is 8.1, CPR 2.0%, maternal mortality 1,540/100,000 and
infant mortality 109/1,000.
Within the context of low CPR, contraceptive use in Nigeria consists primarily of relatively less effective short-term
FP methods. Despite extensive research showing effectiveness and acceptability of long acting reversible
contraceptives (LARCs) (i.e., implants and IUCDs) in populations at highest risk of maternal deaths, LARCs remain
unpopular and underutilized in Nigeria, and northern Nigeria is no exception. Thus, it is imperative to find more
effective ways for delivering FP services to tackle the unmet needs for FP in northern Nigeria and the country in

2. general.
Main
question/hypothesis /
Question
principale/hypothèse:
The study aimed to identify and characterize factors that act as facilitators and barriers towards provision of LARCs
and other contraceptives in Bauchi State. Using the Socio Ecologic Model, the study questions included: To what
extent are FP services, especially LARCs, available and accessible to rural women? What are the intrapersonal and
interpersonal factors that influence FP decision making? What are the community factors that influence FP uptake?
What are the organizational and policy factors that influence provision of FP services?
Methodology /
Méthodologie:
This was a cross sectional descriptive study examining the multiple levels of influence of adoption of FP methods at
the individual, community and institutional level. The study was conducted in purposively selected sample of 12 health
facilities and hard-to-reach communities located in 10 rural communities of Bauchi state. The study adopted a mixed
method approach; using both qualitative and quantitative methods to collect data. This study was triangulated to create
a comprehensive picture that addressed the study objectives.
With respect to qualitative methods, six (6) focus group discussions (FGDs) with FP and non-FP respondents (n=15
and 17 respectively) and six (6) in-depth key informant interviews were conducted with community leaders. With
regard to quantitative methods, the study administered structured exit interviews to FP clients attending the 12 selected
health facilities (n=94), administered structured questionnaires to service provider (N=12), and (iii) reviewed FP
service statistics in the selected health facilities (N=12).
Results/key findings /
Résultats/conclusions
principales:
Eighty-three percent of FP exit interview respondents were 20-39 years old, married and had an average number of 4
children. Twenty four respondents indicated they did not want any more children (26%). Hormonal methods such as
injectables (75%) and oral contraceptive pills (52%) were the most commonly used methods and service statistics
validated this. The study revealed several constraints to use of LARCs and other modern FP method: side effects,
misconceptions and rumors, limited information about LARCs, and other socio-cultural factors.
Community factors also play an important role. Given the strong role of religious leaders and men in FP uptake in
Bauchi, there is a need to sensitize and train these groups regarding the advantages of FP to their wives, children,
communities, and families. This study points to the importance of reaching community structures such as WDCs
(mainly dominated by men) which will play an important role in reaching male and religious leader audiences, and to
liaise with other community structures and health facilities.
Organizational and institutional factors such as insufficient provider and community health extension worker training
for LARCs, stock-outs of contraceptives, non-availability of FP protocols and guidelines, and lack of supportive
supervision were also identified as barriers.
Knowledge contribution
/ Contribution aux
connaissances sur le
sujet:
Despite overwhelming evidence on the safety and effectiveness of LARCs in preventing pregnancy and contributing to
decreasing maternal and child deaths, barriers to LARC uptake and more importantly to FP in general remain strong in
Northern Nigeria. FP programmes that address multiple levels of influence including individual, community and
institutional factors are likely to improve uptake of FP in Bauchi state, Nigeria