CHAPTER ONE: INTRODUCTION
The issue of family planning all over the world has attracted attention due to it important in decision making about population growth and development issues. Uncontrolled birth is a major contributing factor of an increase in the world’s population, particularly in Nigeria. Statistics shows that the population of the world was about one billion in 1859 in 1930, the population had doubled (two billion) in 1976, the total population was said to be four billion. Today, it is more than six billion, with Nigeria having a population of over 162 million, thus being the largest country in Africa and the 7th in the world map (United States Census Buxau, 2010). Life is a precious gift that every individual hunger for and in an attempt to grab this gift, our health must be maintained. There are so many problems that have been found to result from poor family planning method. Some of these problems include: Over population, criminal abortion, child dumping, increased child morbidity and mortality, as well as increases material morbidity and mortality rates. Over population as one of the consequences of poor family planning has succeeded in causing a lot of harm to individuals, families, society and the nation at large. Maternal mortality and child mortality have been found to occur due to poor family planning practice, according to the statement of the WHO (World Health Organization) and United Nation Education, Scientific Children’s Organization (UNESCO) in 1991) that over three million children and two hundred thousand women die each year and also women’s health and action research (2004) had showed rates of child and maternal mortality and morbidity rate in the world due to poor altitude towards Ante-natal care in which family planning is one of the objectives. The President of Nigeria, his Excellency, Goodluck Ebele Jonathan was quoted in Vanguard newspaper on June 28, 2012saying “Nigeria families should have only the children they can afford. To ensure this order was followed , a new planned Parenthood Federation of Nigeria (PPFN) was created. He said it may be time for birth control legislation. Family planning, until recently, a very sensitive subject in Africa, is now very increasingly accepted as a necessary ingredient of socio-economic development. It is now thought to be an important health measure that contributes to the health of parents, children and the entire nation. Because of the great effect over population has on socio-economic status, education and health in general, a full understanding of this phenomenon and the major factors governing it are essential, thus the need to adopt family as a means of checking the escalating birthrate cannot be over emphasized. Unfortunately, this idea is not adequately emphasized on, especially in the rural areas, where it was observed that they have a high regard for large families and children are seen as a blessing from God. They believed that the more children a man has, the more hands to help with work especially on the farm. It is also believed that children give status to a women and security in old age. In Oghara-efe Community in Delta State, it was observed that husband often make sexual demands with little or no consideration for material health and the children’s survival. They compound their wives potential mortality rate by either not allowing her to seek family planning, advice or will not seek it as a collection responsibility. This present mentality in Oghara-efe community and its consequent socio-economic, educational and health effect on the villagers makes it important for this study to be carried out.
The end of the last century witnessed increased recognition of the need to involve men in sexual and reproductive health (RH) issues and initiatives, and to understand their needs and perceptions in reproductive health matters. Before the current concern for male involvement began, reproductive health issues and services had become synonymous with women’s RH, and men were assumed to have no special interest in such matters. The tacit exclusion of men from active involvement in these issues in many developing societies, particularly Africa, represents a lack of appreciation of the social reality of daily living in these societies. Indeed the characteristic lack of male involvement in reproductive initiatives, including family planning, is a major obstacle to sustained fertility decline in sub-Saharan Africa, given the considerable authority and power vested on men as decision makers in the home and society. However, the opinions of men in family planning were considered secondary even in patriarchal African societies, which view the society as men’s world (Isiugo-Abanihe, 2003).
Patriarchy, the control of the family by men, which often involves patrilineality and patrilocality or marital residence with husband’s kin, is at the root of both gender socialization and male dominance in sexual, reproductive and productive issues. For most of Africa, socio-cultural and ethnic realities form the basis for patriarchal and gendered socialization of children, and confer privileges on men by defining appropriate male and female roles as opposite and polarized. The socialization process makes Nigerian men influential and dominant in all spheres of life, giving them the final say on various family issues. They are at the center of decision-making in the traditional political economy and are important agents of change. Therefore, any successful attempt at social engineering must begin with men. They should also be well informed on the reproductive process and
responsible parenthood so that they can positively impact on the lives of their wives and children (Ibid).
Irrespective of culture or ethnic orientation, and whether under Islamic, Christian or traditional African beliefs and precepts, the socialization process and role system in Nigeria generally confer on husbands the authority and role of making decisions on matters affecting marital and family life, which certainly will include the use and non use of family planning services, and indeed childbearing itself. Above all, Nigerian men enjoy enormous educational, occupational and economic advantage over women. Implicitly, they wield power and influence in the home and society and dictate the pattern and trend of events in a cultural environment where male values hold sway. More so, there are some social and institutional factors that favor men in matters affecting the family. This is related to the fact that they control economic resources and the significant role they play as household heads, custodians of their lineage, protectors and providers of the family (Ibid).
African family structures affect individual perception of child-related processes and affect reproductive decision-making and actual fertility behavior. Men play an instrumental role in every aspect of sexual and reproductive dynamics, from the timing of intercourse and contraceptive use to sexually transmitted disease treatment and antenatal care. They also function as ‘gatekeepers’ to women’s sexuality and reproductive health because of many powerful roles they play as husbands, fathers, uncles, religious leaders, doctors, policy makers, local and national leaders (Varga, 2001; Drennan, 1998). This is because men in these societies contribute more resources in running the family, which gives them more authority to control the sexuality of their wives among other matters. Thus, the perceived wishes of the husband may influence the behavior of the wife (Duze and Muhammad, 2006).
Taking cognizance of the increasing realization of the role of men in family life, the
International Planned Parenthood Federation (IPPF) staff consultation on male involvement
in family planning stressed that men have a basic human right and responsibility to family planning services (IPPF, 1984). This is because reproduction cannot take place without them and male involvement will also encourage male responsibility in sexual behaviour (Isiugo-Abanihe, 2003).
In 1988, the Federal Government of Nigeria announced a population policy, which aimed at achieving lower population growth through reduction of fertility rates. The Nigerian population policy document stated that appropriate information and education programmes shall be designed and implemented to promote awareness in men of their responsibility for adequate caring and for having appropriate family sizes (FGN, 1988). The policy rightly emphasized the importance of men in family life; hence one of its eight implementation strategies was devoted to men. The document succinctly summarized the position of men with respect to family life in Nigeria thus:
“In our society, men are considered the heads of the families and they take far-reaching decisions including family size, subsistence and social relations….The average man bears greater burden in caring for the family. Special information and enlightenment programmes are necessary to increase awareness of men as to the need of having the appropriate size of family they can foster within their resources. (FGN, 1988:19)”
During the past 15 years, many in the reproductive health field have come to appreciate the need for the constructive involvement of men in family planning programmes and services. The 1994 International Conference on Population Development (ICPD) held in Cairo, Egypt articulated why and how male involvement should occur. Recognition is growing that men are interested in and need reproductive health information and services, both for themselves and for their partners (Drennan, 1998; Reingheim, 2002; AGI, 2003) and that reproductive health of individuals depends heavily on the relationship between the people concerned. Awareness has increased that services should not only be directed towards women but also towards men and couples (Reingheim, 2002).
In recent years, the Government of Nigeria has intensified efforts to educate the generality of her population on the need for reproductive health and responsible parenthood in particular. However, in spite of the introduction of family planning services as a means of curbing high fertility rates, the population still increases because of the attitude of the people involved. This is noticed especially in men and the role they play in reproduction (Olawepo and Okedare, 2003). From the results of the National Demographic Health Survey (NDHS) of 2008, the South-West (NW) zone ranks lowest in male use of family planning methods with 0.1%, the South-East is 0.2%, the South-Central (1.9%), the South-West has the highest (6.1%), the South-East (4.6%), and the South-South (4.4%). There is also an indication that FP practice is generally low in Nigeria with 31.7% in the South-West, 26.2% in the South- South, 23.4% in the South-East. In the South-Central it is 13%, South-East is 4.0% and 2.8% in the South-West (NDHS, 2008).
Oghara LGA, a Hausa society located in southern Nigeria is patrilineal with a strong male influence on many household decisions including those involving reproduction. This makes the attitudes of male toward family planning and contraceptive use a significant factor influencing the overall fertility level in the region. Given the decision-making powers of Nigerian men and the fact that they also control economic resources, it is important to consider their attitudes towards and willingness to use contraceptives to control family size.
Both men and women have prominent roles to play in the decision to use family planning methods and in determining the number of children a couple should have. The man and woman are important factors in bringing children to life, yet demographic studies on reproduction have tended to focus on women alone. For long, programmes on family planning have been directed towards women only, overlooking men who exert greater
influence on family size and family planning decisions. In the light of the current gender imbalances, it is inadequate to talk about the attitudes and involvement of only females in family planning without taking the male involvement context into account.
Of the six geo-political zones in Nigeria, the South-West zone (comprising of Delta, Kano, Katsina, Kebbi, Jigawa, Sokoto, and Zamfara States) has the highest population growth rate of 3.14%, accounting for the largest population size of over 35 million people. It also has the highest number of women in the reproductive ages (15-49 years) of 8.2 million or about 46.8% of the total female population and the highest fertility rate of 5.7. Overall, this zone constitutes the largest proportion of the age group (0-4 years) which is 19.9% of the total population and the highest percentage of the young population (0-14 years) of 47.4%, more than the national rate which is 41.8% (NPC, 2009). While Nigeria’s infant mortality rate stands at 75 per 1000 live births; child mortality rate is 88 per thousand populations (PRB, 2009). Maternal mortality for Delta State also stands at 1,000/100,000 live births (Delta State Ministry of Health, 2007). The NW zone has the highest sex ratio of
104.1 in excess of males, more than the national sex ratio of 103.3. Although the overall adult literacy rates (age 10+) of the nation have improved, the NW ranks the second lowest with 55.7% compared to the highest of 81.9% in the South-East. However, Delta State has the highest adult literacy rate of 67.4% in the NW, with a gender gap of 11.5% between males and females.
The South-Western zone also has the highest percentage of disabled persons of 5.15% with Delta State having 4.9% of its total population (149,352 persons) with one form of disability or the other. The largest family size (number of people in a household) in Delta State, accounts for more than 8 persons in over 1.5 million households (NPC, 2009). One of the great impacts of such problems is the high level of poverty experienced in the southern
region especially in the NW. Could these figures and levels observed, which are pretty high
in the NW be due to the large population size of the southern region and the result of non- involvement of men in family planning?
Oghara LGA is predominantly made up of Muslims and a Christian minority. The negative perception of family planning by most people in this society (and to a larger extent southern Nigeria) is remarkably influenced by the Islamic religion, which is deeply rooted in their culture and tradition. Islam teaches that children are gifts from God. The negative view about family planning is also related to the external source of the programme. Muslims view the programme as an attempt by the West to curtail their population. Christians too, especially the Roman Catholic abhor family planning. Practicing it, is regarded a heinous act. However, this is not the only obstacle to the success of family planning. This study is determined to look into the problems associated with the rejection of family planning programmes, especially in southern Nigeria. The active participation of men in family planning is highly required so as to prevent unwanted pregnancies since they are considered to have absolute control over their households and women are expected to respect their husbands’ decisions. There is also the need to remind men of the daunting tasks and responsibilities awaiting them as household heads of large family sizes.
The role of men in family planning decision-making in Nigeria has not always been recognized in the demographic literature. This is evident from the large volume of literature based on studies focused on women, seeking to know their family size intentions, FP practice among other issues. Often, information on husbands’ attitudes towards family size and contraceptive use is obtained through their wives on whom most researchers have focused their interest. However, such information based on wives’ perceptions of their husbands’ attitude may indeed differ significantly from men’s actual attitudes and perceptions, if reported by them (Isiugo-Abanihe, 2003).
Abdulazeez (1990) considered knowledge, attitude and practice of family planning among the Nigerian Army’s wives in, Oghara. The study revealed that majority of women, has great awareness of family planning. However, practice of family planning was found to be very poor, with only 25% due to factors such as religion, educational level, and ethnicity.
Isakoto (2002) also studied the effect of family planning on reproductive behavior in Oghara and showed that despite the side effects of contraceptives, women were not deterred to practice family planning. They were determined to limit their family size and space their children for the health of mother and child.
Omotolani (2002) studied people’s perception of family planning methods in Oghara and focused types of family planning methods, knowledge of, attitude towards and level of usage of contraceptive methods. The study revealed that contraceptive knowledge is high but the level of usage is very low in urban Oghara. More than 80% have the knowledge and less than 5% of the people use more than one method. Furthermore, a positive relationship between educational attainment, family planning knowledge, and use of family planning methods were noted.
Similar studies have been carried out in Delta metropolis by Auta (1998); in Offa, Kwara State by Oyeniyi (2000); in Iyara, Kogi State by Akinwunmi (2002). Until recently, few studies in Nigeria have examined men’s role and attitude in FP and fertility decision making process. Ignoring men in fertility research weakens efforts both to motivate and change their attitudes on population matters. It is against this background that this study seeks to address the following research questions:
The aim of this study is to assess the role of men in and their attitudes toward family planning in Oghara LGA. This would be achieved through the following objectives, which are to:
H0 There is no significant impact of men attitude towards family planning and their involvement in Nigeria.
H1 There is a significant impact of men attitude towards family planning and their involvement in Nigeria.
The study covered Oghara LGA, which has thirteen wards (six and seven wards from within and outside the city wall respectively): Angwan Juma, Angwan Fatika, Kaura, Kwarbai A, Kwarbai B, Dembo, Dutsen Abba, Gyallesu, Kufena, Limancin Kona, Tudun Wada, TuKur Tukur and Wuciciri. This study focused on men and women between the ages of 15-50+ years. It also covered issues on male involvement in reproductive health decisions and socio- economic factors affecting the utilization of family planning services within and outside the city wall.
The attitudes of men and women have direct effects on family planning practice. Understanding the role of men in inhibiting or promoting family planning could affect the design of family planning promotion programme and also the success of the programme in Nigeria and other African countries. The lack of success of the family planning revolution is attributable to the failure of the programme to recognize the importance of male attitudes and attributes in fertility decision-making (Duze and Muhammad, 2006).
Most family planning programmes that continue to focus solely on women will continue to achieve only limited success in Nigeria and the many patrilineal societies where similar programmes are pursued. The implications of not involving men in family planning are the high morbidity and high mortality rates of women and children associated with closely-spaced births. Fertility rate is also high, translating into large family sizes and a rapidly growing population, which all have a negative impact on sustainable population growth and developments. Thus, the involvement of men will give family planning a better chance of success in the future, since they exert greater influence on family size and family planning decisions. In addition to reducing the fertility of women and slowing population growth, family planning has a direct positive impact of reducing child and maternal morbidity and mortality; and the prevention of mother to child transmission of HIV, generally producing a healthier and more productive society. Government, policy makers on population, Researchers, non-governmental organizations (NGOs), men, women and children will benefit immensely from this research.
The collection of data from the study area was not without complications both for the researcher and research assistants. Most of the respondents were curious about why the researcher was interested in the role of men as well as their attitudes towards family planning. They assumed the researcher was being influenced by the western culture of having very few numbers of children; and also the ideology that Nigeria’s population is very large, thus requires the help of family planning programmes, to curb high population growth. Some even thought the researcher was spying for the government as such refused to disclose their personal information. For some of the respondents who were not educated and unaware of family planning, the researcher and her assistants expended so much time explaining some questions that were not clear to respondents. Translating questions from English to Hausa languages was difficult also; the researcher had to seek the help of a good translator who could capture the essence of those questions written in English language. Questions about age, income and spousal communication were regarded offensive by some respondents, because they felt the researcher was invading their privacy. Distance to some of the wards consumed resources in terms of time and finance. The issue of family planning especially in a Muslim and Hausa dominated area is not without controversies, thus the researcher had to be extra careful in communicating to respondents, more importantly where the researcher, who is a female, was directly involved with the respondents who were male. Some respondents were surprised at the researcher’s courage to carry out this kind of study, particularly when Islam frowns at the issue of family planning. Some respondents even questioned the legality of such study in Islam and one respondent openly asked if the researcher was not committing a sin. This contributed to low response to some questions. It took the researcher a long period of time to obtain data from the study area, and this eventually reduced the total return of
questionnaires with 54 unanswered.
Informed consent of respondents to participate in the research was sought. Participants were provided with broad outline on issues the research will be exploring such as questions to be asked, the amount of time required to complete an interview etc. Confidentiality and privacy of participants were assured as well as the anonymity of informants. Where respondents were illiterates or unaware of FP; the researcher highlighted the motives of family planning to clarify misconceptions. This helped encourage respondents’ participation in the research. Although the FGDs of men and women were conducted separately, the men talked more than the women. As such women were interviewed independently to ensure secrecy and full participation. The researcher and research assistants tried convincing respondents who were reluctant to give the required information that the research was purely for academic purpose. The FGDs and IDIs were conducted simultaneously in English and Hausa languages to allow full contribution of participants.
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