factors influencing contraceptive use among urban men in nigeria

FACTORS INFLUENCING CONTRACEPTIVE USE AMONG URBAN MEN IN NIGERIA

TABLE OF CONTENTSTitle Page iCertification iiDedication iiiAcknowledgement ivList of Tables viTable of Content viiAbstract x

Chapter One: Introduction1.1 Background to the study 11.2 Statement of the problem 51.3 Research Questions 61.4 Objectives of the study 71.5 Significance of the Study 71.6 Operational Definition of Terms 10

Chapter Two- Review of Literatures2.0 Literature Review 112.0.1 The problem of high fertility and rapid population growth 172.0.2 The problem of HIV/AIDS 182.0.3 Problem of unintended pregnancy and induced abortion 202.1 Theoretical Framework 212.2 Conceptual Framework 232.3 Hypotheses 25

Chapter Three -Methodology

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3.0 Study Area 263.1 Target Population and Sample size 283.2 Data Source 283.3 Research Design 293.4 Data Processing 303.5 Variable Description and Measurement 313.6 Limitations of the Study 32

Chapter Four - Data Presentation and Analysis of Research Findings4.0 Introduction 334.1 Selected Socio-Demographic Characteristics of Respondents 334.1 Percentage Distribution of Respondents by Demographic andSocio-Economic Characteristics 364.2 Bivariate Analysis 374.2 Percentage Distribution of selected Socio-Economic Characteristics and Use ofContraceptive Methods 404.3 Test of Hypothesis 424.4 Multivariate Analysis 444.4 Logistic Regression Model predicting Contraceptive Utilization among Urbanmen in Nigeria 46

Chapter Five- SUMMARY, CONCLUSION AND RECOMMENDATION5.0 Summary 475.2 Conclusion 485.3 Recommendations 49References 50



ABSTRACTContraceptive use all over the world has attracted attentions. This is not unconnected with rapid increase in population which is militating against socio-economic development and reproductive health issues. Involvement of men in contraceptive use may bring about increase in its usage. Many studies have being carried out on the contraceptive use of women while fewer studies are available on its usage by men. This study therefore focuses on factors influencing contraceptive use among urban men in Nigeria. Univariate, bivariate and multivariate analyses are carried out. The study involves men ages 15-49 with a total sample size of 4,948. Substantial proportion of them (97.44%) knows about contraceptive methods but only 23.38% of them are currently using contraceptives. Factors influencing contraceptive use are age, religion, level of education, marital status, wealth index, ethnicity, employment status and number of living children. These factors should be considered when designing intervention programmes and policies to enhance the use of contraceptives among men in urban areas of Nigeria.



CHAPTER ONEINTRODUCTION1.0 BACKGROUND TO THE STUDYReproductive health program and services are usually directed towards women’s reproductive health and offered their services exclusively to women, especially issues with family planning, maternal care all through the pregnancy period, prevention of unwanted pregnancy, risky abortion and the improvement of safe motherhood. However, the part of men in reproductive health and family planning has been disregarded by the family planning programs and most contraceptive methods are designed for women only.

Reproductive health of couples largely depends on the attitude of men; i.e. husband, towards family planning program and their knowledge on contraceptive methods. The family planning program in Bangladesh could not be used properly because of all kinds of activities and policies are being concentrated mainly on women. Most of the family planning field service delivery system is female based and field workers are also females.

Recently, there is growing evidence that male plays fundamental role to avoid risky sexual behaviors and influences the couple’s contraceptive decision making process. Men can play important roles by giving support during the pregnancy period to women. The declaration of the International Conference on Population and Development (ICPD) can be considered as a major step to raise the male’s responsibility about reproductive health and family planning. The ICPD held in Cairo 1994 emphasised men’s involvement. “Special efforts should be made to emphasize men's shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behavior, including family planning; prenatal, maternal andchild health; prevention of sexually transmitted diseases, including HIV; prevention of unwanted and high-risk pregnancies; shared control and



contribution to family income, children's education, health and nutrition; and recognition and promotion of the equal value of children of both sexes. Male responsibilities in family life must be included in the education of children from the earliest ages”.

The World Health Organization (WHO) gives a clear outline of the reproductive health; it declared that reproductive health means a state of total physical, psychological and social wellbeing, and just not the absence of disease or illness (UNFA, 1995). Reproductive health includes reproductive processes, functions and system at all stages of life (UNFA,1995). This organization considers all aspects of reproductive life such as people are able to have a responsible, satisfying and safe sexual life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so (UNFA, 1995). They emphasis that men and women have equal right to get information about reproductive health and access to safe and satisfactory methods of fertility control and the ability to access to appropriate health care services (UNFA, 1995).

It is clear that male’s involvement in family planning and reproductive health may improve equality in gender relation, promoting better relationship between men and women through which they can take decision regarding family planning jointly and equal responsibility of sexual behavior (Hossain, 2003).

Studies tried to explore reasons for low participation of men in family planning activities as well as unwillingness to use contraception. Those studies provided information relevant for policy making. However, more information is needed on men and contraceptive for informed decision making. This study therefore investigates the factors or determinants of male involvement in family planning and reproductive health systems. It is



designed to identify the factors influencing contraceptive use among urban men in Nigeria.

The issue of contraceptive use all over the World has attracted attentions due to its importance in decision making about population growth and development issues. In this wise, Geographers have become increasingly alarmed by the precipitous rise and its effects on population growth, not only in Nigeria or the United States of America, but throughout the World.

Family planning means a well-planned family with limited members whose maintenance is possible with available resources and tools and thus builds a healthy and well to do unit. A well planned family is the base for planned development and richness of the society and of the country. It can also be stated that the family planning is the key point for a planned development.“Family planning was accepted as the best way to control the rapidly and massively growing population by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country.

Nigeria is the most populous country in Africa, with more than 177 million people;it alsohas a high annual rate of population growth 2.47% and a total fertility rate of 5.25, lifetime births per woman. Additionally, the country has relatively high levels of infant mortality (74.09 infant deaths per 1,000 live births, and maternal mortality; 630 maternal deaths per 100,000 live births. 2010est, CIA World Fact book-August 23, 2014). 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 birth rate through voluntary fertility regulation methods compatible with the nation’s economic and social goals. During 1992–1993, an information, education and communications campaign was launched to change Nigerians’



attitudes toward family planning, and to thereby increase their contraceptive use. Thecampaign was based on evidence that family planning messages relayed through the mass media can influence contraceptive behavior.

The role of men in fertility and family planning in sub-Saharan Africa is becomingincreasingly important in the context of raising population growth most especially in developing countries. Fertility studies in the recent past, however, have been dominated by findings almost exclusively for women (Mbizvo and Basset, 1995; Bankole, 1995; Ottenbarg, 1995; Danforth and Jezowski, 1994; Raimi, 1994; Orubuloye, 1993; Adamchak and Adebayo, 1987).Regrettably, policies and programs based on such findings have not had expected success in increasing contraceptive prevalence and simultaneously reducing overall fertility in sub-Saharan Africa. It is widely acknowledged that men in developing countries make most of the decisions regarding family formation. Most studies carried out in Nigeria and other African countries (Lasee and Becker, 1997; Donovan, 1995; Isiugo-Abanihe, 1994; Roudi & Asford, 1994; Mbizvo & Adam chalk, 1991; Oni & MacCarthy, 1991) have all asserted the domineering position of men on reproductive health matters. According to the results of these studies, men are dominant decision makers within the family. They also gain socially and economically from having large numbers of children, and that men reproductive preferences and motivation influence their wives reproductive outcome. Despite women’s increasing influence on householddecision making, their preferences regarding contraceptive choices and family size may not translate into practice unless they conform to their husbands’ wish. Studies conducted in Africa and Latin America have shown that more than a quarter of men who want to limit or postpone their wives’ childbearing do not use any method to prevent unwanted pregnancy. Male



involvement in family planning should be viewed in terms of not only the share of male method use, but also men’s attitudes regarding method choices and family size preferences. A better understanding of male involvement requires a systematic analysis of men’s attitudes toward spacing and limiting behavior. This study examined contraceptive use among urban men and thesocial-demographic factors that influence contraceptive use among urban men in Nigeria.

1.1 STATEMENT OF PROBLEMAn explicit component of the on-going Structural Adjustment Programme of the Nigerian government is concerned with the adverse consequences of high fertility and rapid population growth; the government is now convinced that high fertility and rapid population growth are barriers to economic development and its efforts to improve the standard of living of its citizens. A major component of the National Population Policy is to reduce the total fertility rate to four by the year 2000,this was not achieved. One important means of achieving this is by widespread and effective contraceptive use.

The low contraceptive prevalence rate is a problem common to both urban and rural areas of the country. (UNFPA, 2000); All socio-economic groups whether high or low have almost equal low rates of contraceptive use, yet the conditions under which Nigerian men will accept family planning and reduce their desire for large number of children have not been fully determined. Only few studies have been done in the past and these have not been conclusive.



Although the National family planning program is relative new, it may not be strong enough to motivate new acceptors. It is therefore very timely to conduct studies into factors influencing contraceptive use in Nigeria as the full and proper understanding of these factors will be very crucial to the successful implementation of the national family planning programs which aim at improving contraceptive use.

While these factors are not fully known, the low contraceptive prevalence rate has been blamed partly on the strong desire for large family size largely due to cultural demand (Federal Office of Statistics, 1992).It has also been suggested that strong, well-managed family planning programs are highly effective and could achieve smaller family size in a wide variety of sociocultural and economic setting (Sadik, 1991).

Contraceptive prevalence is lower in Nigeria than in most countries in sub-SaharanAfrica with a high level of unmet need for contraception in spite of the high rate of sexual activity and contraceptive knowledge, this low contraceptive use has contributed to high rate of unintended pregnancy in the region. Unintended pregnancies are more likely than intended pregnancies to end in negative health outcomes, including low birth weight, infant and child mortality, and maternal morbidity and mortality.

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factors influencing contraceptive use among urban men in nigeria

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