By Justina Asishana
People in Maikunkele, the headquarters of Bosso local government area of Niger State, were fazed when they realised that one of their sons had decided to devote his time to work in family planning. From surprise to acceptance, and then to an increased adoption of family planning services in the area.
David Monbai, a family planning provider at the Maikunkele Primary Healthcare Centre of Bosso local government area of Niger State, is also an advocate of family planning. He advocates for the reduction of maternal mortality in the Nigeria. Initially, they saw one of them talking about family planning, was like one of them promoting promiscuity in their female-folks. Thanks to his efforts, the men in Maikunkele community are now accepting and encouraging their wives to imbibe family planning methods.
Family planning or child spacing as most people prefer to call it, remains a forbidden topic in most households. While women desire it, they remain scared over how to broach the issues to their husbands and gain their permission to take up one of the child spacing methods.
According to the National Demographic Health Survey 2018, the unmet needs of women for Family Planning is at 16.1 per cent while the national contraceptive prevalence rate is 15.1 per cent. Many myths and misconceptions surround family planning. Such tales made acceptance of family planning or child spacing not easy to achieve in the country. Experts believe that adequate family planning awareness and use of child spacing methods can prevent 64,484 unsafe abortions, avert over 179,152 unintended pregnancies, and reduce the annual maternal mortality rate of 40,000 in Nigeria.
If women with an unmet need for contraceptives were able to use modern methods, it would reduce maternal deaths by a quarter and child deaths would increase by as much as one fifth.Social barriers limit the adoption of family planning methods in Africa. The reasons include opposition by partners, families, or communities as well as lack of knowledge and sensitisation about family planning for women.
However, every field has its peculiarity and oddness. Many believe female health workers should lead family planning advocacies. Experts say women in the lead enables the women to accept these methods and make their husbands comfortable in leaving their wives to visit the health centres, most especially in the northern part of Nigeria.
David goes out to sensitise the people about Family Planning while focusing on women. He mostly appeals to the men and explains why they need to allow their wives to access the services brought to them by the government and development partners. Males in the northern region of Nigeria generally have a good awareness of family planning and its methods. Even so, they have negative perceptions, low levels of usage of products and poor spousal communication about family planning.
Most reports have identified men as one of the main obstacles of family planning usage. Experts blame them for preventing the use of family planning services by women. David set out to address these challenges when he became a family planning provider. Looking at one of them talk about what they misconstrued as a way of promoting promiscuity in their wives, the men in Maikunkele community now accept and encourage their wives to use the family planning methods.
In an interview with David during a visit to Maikunkele Primary Healthcare Centre, he asserted his belief that family planning should be an agreement between the husband and wife, while stressing that the husband must support the wife in accepting family planning services.
“Family planning is an agreement between husband and wife. It is best to sit with your husband and decide what you want and how you want to go about it. I am a son of the soil. I am a family planning coordinator and a master trainer. People know me very well, and they know what I can do and what I cannot do. My people see me giving health talks and provide family planning, so most people have more courage in me and believe in me. This is why the acceptance of family planning in this area has increased without any hitches. Level of awareness is now up to 89 per cent. It is a continuous process because as more innovations are coming, so do we adopt to those innovations,” he said.
David explained that all the staff at Maikunkele Health Centre were know about family planning. He adds that because the Centre runs for 24 hours, they offer family planning services to meet with the increasing demand.” We offer 24 hours service because everyone here is knowledgeable about family planning and how to administer it to people. We always have all the family planning commodities intact.”
According to him, some women still come to the clinic to access family planning services without the knowledge of their husbands. He stresses the importance of the men agreeing with their wives on family planning. He added that it would go a long way to reduce the increasing rate of maternal mortality. He then advised the women to take note of the type of methods they use, and the date of renewal as a failure to renew the methods means they are risking pregnancy.
“If they do not renew it, they are taking a risk. Pregnancy can occur. There cannot be midway between failure and success. If the medication prescribes three months, stick to the prescription. After three months, if you do not renew it, you are only putting yourself in the way of pregnancy. There is no midway about it; it won’t work after its prescribed time. “Speaking on some challenges, he said that some clients tend to deceive some health workers. Because some of these ladies take in unexpectedly, they try to get some of these drugs to remove the pregnancy. He then said that all health workers now conduct a pregnancy test for anyone who wants to access any of the family planning services.
“Some clients tend to deceive health workers. Some will be pregnant and will still come for family planning, although it may harm them. That is why we run a routine pregnancy test. By the time the test comes out positive, we will not attend to the person. They do not know that if you do implant while pregnant, the implant will not work until the baby is delivered.”
Speaking on how he attends to a patient, David said, “When a patient comes, I welcome the patient and make her feel at home, ask the necessary history like the background of the woman, how many children does she have and so on, I establish a good rapport with her. I then carry out a routine test.”
On the effects of COVID-19 on family planning services in Maikunkele Primary Healthcare Centre, David said that he was providing more planning services than before. “COVID-19 is what nobody expects, but it has not affected family planning services. People have accepted it. I believe COVID-19 has kept men close at home to their wives. It has reunited women and men together and brought them to an agreement.”
“This period, we have had more clients in the clinic because some wise women are now negotiating with their husbands regarding family planning. Most times, we meet them here as early as 7 am when we come. That gives us more clients because couples are staying together more during this period. COVID 19 did not affect family planning services in any way; rather it increased access to the services.”
David stated that the health centre offers family planning services every day. All methods and commodities are available to clients.