Godwin Haruna
5 May 2008
Lagos — In this part of the world when myths are created around a subjectmatter, it becomes very difficult to erase. Experts say this is the kind of misconception woven around contraceptive use in Nigeria thereby fuelling maternal mortality. However, they suggest that the side effect of contraceptive use is no more than taking an over dose of paraceutamol. Godwin Haruna writes
Mr. and Mrs. Sunny Ufom, (not their real names), a middle class family live and work in Lagos. About six years ago they were blessed with a set of twins and Mrs. Ufom said they had to wait for five years before they had their third child last year. In the intervening period, Mrs. Ufom relied on the injectable type of contraception to keep her safe from conception. She told THISDAY last week that when they had made up their minds to have another baby, she stopped going to the Lagos University Teaching Hospital (LUTH), where she assessed the family planning services. Three months after, she took in and she had her baby last year.
The experience of the Ufoms contrast with that of Mr. and Mrs. Ken Enemake, another middle class family in Lagos. About two years ago, they had their first son. Three months later, Mrs. Enemake went from one neighbour to another trying to find out how she and her husband could have intercourse without falling into trouble. She would not want to go to the hospital because of the bad information she hears about the experiences of people either becoming infertile or being infected with fatal diseases as a result of contraceptive use. Wallowing in such ignorance, she became pregnant when her baby was just eight months and less than two years after getting married they have two children today. Although she delivered her first child naturally, the second came through caesarian section essentially because her body had not recovered from the travails of the first child. Experts say she is lucky to be alive to tell her story and also for her babies to be doing well too.
These are two live stories that are at the centre of maternal deaths in the country. A recent United Nations report has confirmed Nigeria as having the second highest number of maternal mortality ratio in the world after India. In Nigeria, this maternal mortality ratio is unfortunately high, ranging from 800 to 1, 500 per 100,000 live births. While 90 per cent of the population knows about family planning, only about 10 per cent access it.
The alarming maternal mortality ratio in Nigeria results from poor primary health care and emergency obstetrics care associated with still birth, ill-equipped and badly-managed hospitals, and carelessness on the part of medical and health personnel. It is said that because of exorbitant bills, many pregnant women are still delivered at home by traditional birth attendants and in the process many of them die.
In most Nigerian villages, women still give birth in the hut with no running water, no sterilization equipment and no skilled birth attendant capable of providing emergency obstetrics care. Socio-cultural and economic factors that relate to the low status of women, poverty, ignorance about family planning services and traditional harmful practices also account for the alarming maternal mortality ratio in Nigeria. With the current trend, experts doubt the possibility of Nigeria meeting one of the Millennium Development Goals (MDGs) of reducing maternal deaths by 75 per cent by the year 2015.
Speaking to THISDAY last week in Ibadan, Dr. Bukola Fawole, obstetrician and gynaecologist with the University College Hospital (UCH) in the city, identified family planning as key to the reduction in maternal deaths in the country. Fawole said way back in 1987, the International women Conference in Nairobi revealed that over 500 maternal deaths occur annually and 99 per cent of these deaths occur in developing countries. He said almost 8 million of survivors suffer serious health problems. These include vesico vaginal fistula (VVF), emclampsia, anaemia, sepsis and a variety of others. He said 61 per cent of maternal deaths occur in ten countries mostly in sub-Saharan Africa including Nigeria.
Speaking on why people do not use contraceptives in Nigeria, Fawole said: "A major impediment to contraceptive use in Nigeria is lack of information. People are unaware of the true benefits of family planning measures. If one went out into the street and asked people generally, most certainly people will confirm that they are aware and they will mention virtually all the methods.
"However, in terms correct knowledge, this is quite poor. People don't have correct information or knowledge that would have to guide their acceptance of using these methods. Unfortunately for us what we have in terms of information in the community is mainly wrong information; therefore, people associate all sorts of myths, misconceptions with family planning methods. Most of this wrong information they gather from friends, relations, who perhaps have used certain methods wrongly".
He said people do not visit family planning clinics to receive the correct information from health professionals, who really know and could guide them on the correct use of these methods. He added that family planning information should not be obtained second-hand, because since a method that worked for couple A might not work for couple B. In addition to this, Fawole said people should be wary of information obtained from providers, who are not trained because the information they offer might not be correct.
"As a matter of fact we do know that it is not all family planning methods that are appropriate for an individual. Therefore our people should always seek the right information and also very importantly, be examined and then be helped to select the proper methods that are appropriate for them by healthcare professionals. When people do that, they will appreciate that family planning methods have a great number of benefits and they will be helped to use the method they have selected for as long as they wish to help the space their children", the consultant said further.
He discountenanced the misconception that family planning pills could make the user infertile, and added that any one obtained at a certified clinic has no such effects. He said such ones obtained from qualified providers have the potential of promoting the health of the couple.
He said the only fact which he knows is that because of the way the family planning method works, if she discontinues use, she may not conceive immediately as it would take a short time for the effect of that family planning method to wear off. As soon as this happens, he said, the woman should experience conception if there are no other complications, which might not certainly come from the pills.
Fawole said he was aware that some religious denominations emphasise the natural methods of family planning to control births. As a professional, he said that too, is highly recommended for couples. "The duty of the family planning provider is to give correct information. All methods of family planning guide the woman to select the method they prefer. Of course, we counsel adequately regarding the natural planning method, which is most suitable for women, who know their circle", he added.
Fawole said the natural methods also have different types, which includes exclusive breast feeding. He said a woman does not ovulate provided she breast feeds her baby exclusively and it is effective mainly for six months after child birth. He also spoke of a method whereby a woman with help from a qualified provider, understands her menstrual circles and therefore, she is able to determine the fertile period and times when she is not. So, she now knows the time to avoid intercourse having been properly counseled.
Another natural method he mentioned involves a woman employing signs to determine the time she is save and to know the time she is likely to be fertile. He said the man necessarily would be involved in this to determine when to have intercourse or avoid it.
He said essentially, where the citizenry have all got it wrong is with getting the correct information and this, he added, has resulted into the myths created around family planning. "Unfortunately for us, we have allowed the myths and misconceptions to become widespread. That wrong information have been disseminated widely and so the urgent task we have now, is to work against this myths by disseminating the right information through all available means. We must provide information for the populace to reassure them that all of these methods are safe when there used appropriately by the correct individuals. That you have obtained a method does not mean you should not visit the clinic regularly. More women will be enrolled with the correct provision of the right information", he stated.
Be the first to Write a Comment!
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
