Family Planning Among Rural Postpartum Women in Nigeria

Assignment Task

Abstract

Aim: Contraception is an operation in which individuals and married couples freely and without force decide on their preferred or planned number of children, as well as the schedule and distance of their births, to advance the well-being of the family and efficaciously support the social growth of a nation. Despite years of FP initiatives, Nigeria is one of the nations where considerable progress in the usage of contraceptives has not been seen. It is on this the research work aims to explore the perception of family planning (contraception) method amongst women of child-bearing age in Lagos, Nigeria.

Perspective and Methodology: A systemic literature review for qualitative research methodology will be used to elicit information and resulting data will be analyzed using an extraction table.

Methods: PubMed, CINAHL and EMBASE will be searched for relevant qualitative studies related to the research topic using keywords. In addition, a citation search will be conducted to obtain other relevant references that were not included in the electronic database search.

Introduction

Nigeria, known as the "giant of Africa," has experienced enormous population growth during the past with a birthrate of 5.71%. It is presently the seventh most populous nation in the world, as evidenced by an estimated 195.88 million residents, a rate of growth of 2.61%, and a population projection of 350 million residents by 2050 (NBS, 2018). With nearly 21 million residents, Lagos State was the most populous state in Nigeria in 2016 as a result of this population growth, which is due to the large birth rate and other important economic reasons (Odusanya, 2018).

Family planning (FP) is a crucial part of Sustainable Development Goal 3 and is expressly addressed in SDG 3.7: "By 2030, ensuring that all people have access to FP, knowledge, and education, as well as the inclusion of reproductive health into national plans and initiatives" (United Nations, 2016). Marginalized groups, including refugees and migrants, frequently miss out on "national plans and initiatives" because they confront special obstacles to access and knowledge that would enable couples to strategize and space the desired number of children. FP is essential for avoiding the negative social, economic, and health effects of unintended pregnancies (Najafi-Sharjabad et al., 2013).

According to the World Health Organization (WHO, 2018), contraception is an operation in which individuals and married couples freely and without force make a decision on their preferred or planned number of children, as well as the schedule and distance of their births, in order to advance the wellbeing of the family and efficaciously support the social growth of a nation. Less than 10% of women of child-bearing age in Nigeria use contraceptives, despite attempts to make the products accessible, despite the fact that knowledge, perception, and usage of contraception vary greatly among most developed and developing nations including Nigeria (Aliyu et al, 2010).

Despite years of FP initiatives, Nigeria is one of the nations where considerable progress in the usage of contraceptives has not been seen. 5.7 children are born to every woman in the nation (National Population Commission, 2013), which is higher than the region's bordering Ghana's fertility rate of 4.0 and Kenya's fertility rate of 4.6. Despite the great knowledge of family planning in Nigeria, only 10% of women currently utilize contemporary contraception, according to Aransiola et al (2014).

Contraceptive usage is less common among rural residents than urban people, and within the poorer community than the wealthier population (Aransiola et al, 2014). This article investigates how women of childbearing age perceive family planning (contraception) methods in the context of this.

Literature Review

Numerous researches have attempted to evaluate the perception and knowledge of contraception in various nations, but they have typically concluded that while awareness of contraception is great, usage of it is often less and only sometimes high. In sub-Saharan Africa, particularly Nigeria, several studies have been conducted on the knowledge of FP techniques, their use, and the variables impacting it. However, the research’s breadth and geographic scope are constrained (Adetokunbo et al., 2011). There haven't been many results of research that looked at geographical, ecological, sociocultural, and other variables that could influence how FP techniques are used and factors related to unmet family planning needs among women of reproductive age in the various areas of Nigeria.

Just a small percentage of households employ FP methods, according to Akamike et al. (2020), and those who do not believe it interferes with the plan and will of God for fruitfulness. The research also discovered that for several of females of childbearing age in sparsely populated Ebonyi State, Nigeria, the artificial approach (43%) and the natural approach (57%) were both used most frequently. Even so, present in those using artificial techniques, the large percentage used condoms (32.7%), implants (27.3%), injectables (23.64), and drugs(16.4%).

Aliyu et al. (2010) used a multi-stage random sample approach to analyze 200 married women in the Samaru Community in Zaria, Nigeria, to examine their awareness, attitudes, and practices about contraception. According to the survey, few people utilize contraceptives. In a research conducted by Omo-Aghoja et al. (2009) to ascertain the awareness, behaviours, and perceptions of contraceptives in rural Southern Nigeria, they demonstrate that despite high levels of awareness, contraceptive usage is low. They believed that the decisions made by male partners also have a role in determining the use of contraceptives in Nigeria

In Nigeria, Ejembi et al. (2015) look at contextual variables that affect the usage of contemporary contraceptives. The study discovered that community and individual characteristics have influenced the use of contemporary contraceptives in Nigeria. According to Asaolu et al. (2021), there is little understanding of and implementation of contemporary and natural contraceptive techniques among university students in Calabar, Nigeria. Instead, the folkloric form of contraception is the most accepted option.

The view of FP usage among couples in the Anomabu community in Ghana is examined by Armah-Ansah (2018). The study indicated that despite Ghana having had an FP program for almost half a century, the incidence rate of FP is still minimal. A major cause contributing to the low incidence rates of FP in Ghana is the perception among couples. The survey also found that married men and women in Ghana have high levels of awareness about contemporary FP methods.

Nsubuga et al. (2016) examined the sexual conduct, awareness, attitudes, and use of contraception among female university students in Uganda. The study found that although there is a significant amount of awareness about contraceptive methods, there is also a high level of viewed acceptability of contraceptive usage. In an effort to comprehend FP knowledge, attitudes, and practices among married couples in Jimma Zone, Ethiopia, Tilahun et al. (2013) conducted a study. The study's findings show that the sample group is familiar with FP techniques. While conventional techniques are more familiar to males, long-term contraceptive options are the most convenient for women.

Furthermore, formal education was said to have contributed to greater awareness and understanding of forms of contraception. In comparable research, Dingeta et al. (2021) used multivariable logistic regression analysis to examine the association between contraceptive use and socio-cultural characteristics among young married women in Eastern Ethiopia. The study discovered low rates of contraceptive use, however, social economic variables were found to be to blame for these rates among young married women in rural Ethiopia.

Research Question and Aims

This research seeks to explore the perception of family planning approaches amongst women of child-bearing age in Lagos, Nigeria. The study's findings may help policymakers put good policies into action by highlighting the value of FP to the public at large and encouraging the authorization of contraceptives to lower the incidence of maternal and infant mortality rates.

The objectives of the study include:

• To determine the perception about contraception among women of child-bearing age in Lagos, Nigeria.
• To determine the level of awareness of women about contraception among women of child-bearing age in Lagos, Nigeria.
• To identify barriers against the use of modern contraceptives among women of child-bearing age in Lagos, Nigeria.
• To identify barriers against the use of modern contraceptives among women of child-bearing age in in Lagos, Nigeria.

Perspective and Methodology

The point of view of a certain stakeholder in the relevant area that the researcher adopts as their vantage point for observing occurrences while conducting a research endeavour is a researcher's perspective (Clark, 2020).

It is crucial to recognize how this idea differs from the several different ways that the word "perspective" is employed in the IS field (Clark, 2020). We specifically exclude epistemological, ontological, and nomological presumptions. We are also not referring to positivism, interpretivism, or any other study methodology. The stakeholder whose interests are acknowledged as aims and whose value system penetrates the researcher's perception of the phenomenon is the subject of our attention. In a metaphorical sense, the point of view out of which events are seen through which they are experienced is known as the researcher’s perspective.

The viewpoint of a researcher is very different from that of an "object of study" or "unit of study." The collection of occurrences that the researcher observes is the "object of study," whereas the "unit of study" denotes the degree of detail at which the observation is made On the contrary, the viewpoint of the researcher describes the angle or orientation from which the phenomenon is observed. Therefore, a researcher takes a viewpoint that allows assessments to be conducted of a subject of study at an abstract level known as the unit of study, together with a technique that makes it possible to gather and analyze data.

Given the researcher's paradigm, which continues to support the use of a qualitative approach to be most suitable in answering the research questions, the researcher will choose to conduct a structured literature review of qualitative studies related to the research topic. The researcher needs ethical approval since the population of interest is vulnerable, but securing this authorization takes time and effort. The researcher decided to undertake a systematic literature review (SLR) of the qualitative studies connected to the study issue as a result.

Every field should include a review of the pertinent literature evaluation (Mengist, Soromessa, & Legese, 2019). It aids in mapping out the current information and identifying any gaps regarding certain concerns, which will assist to expand the knowledge base. SLR as opposed to conventional narrative reviews uses a reproducible, scientific, and open production process. In order to fully address a certain research subject, it is beneficial to compile all relevant works and papers that meet our pre-established inclusion criteria. To reduce the likelihood of bias during the search, identification, assessment, synthesis, analysis, and summary of research, it employs clear-cut and methodical techniques.

Whenever the process is carried out correctly and with the least amount of mistakes, the research can produce trustworthy results and conclusions that can assist decision-makers and scientific professionals in taking the appropriate actions (Tranfield, Denyer & Smart, 2003). A well-designed SLR process is crucial because it guarantees that the work is thoroughly planned before the review activity itself begins.

Hence, the purpose of this sample SLR investigation is to investigate how women of childbearing age perceive family planning (contraception) methods. According to SLR's definition, "the current body of finished and documented work produced by researchers, academics, and practitioners" is identified, evaluated, and synthesized (Fernández del Amo et al., 2018). SLR is a systematic, clear, and reproducible approach to doing this.

Methods: Literature Search Strategy

The execution and method of the search will be included in this step. The search strategy aids in the definition of acceptable search terms and the identification of pertinent databases for the collection of pertinent material (Fernández del Amo et al., 2018). Although the number of databases for SLR searches might be limited or specified, the quantity is mostly influenced by the nature of the subject matter (Papaioannou et al., 2010). As a result, the specification of the search string should be dependent on the terminology chosen for the population in the SLR application within the PICO framework.

Scientific databases from PubMed, CINAHL, and EMBASE were searched for pertinent publications. The following criteria have to be met in order to be considered for publication: (1) English publication; (2) study of women's perspectives of FP methods in Nigeria; (3) availability of full-text article; and (4) peer review.

To perform a more complete investigation inside the selected database platforms, search phrases were combined using boolean variables such as "OR" and "AND" (Alharbi & Stevenson, 2020). Furthermore, the bibliographies of the qualifying works taken into consideration were manually reviewed. If the aforementioned database sites show that study findings seem scant, grey literature would be added (Paez, 2017).

The following search phrases were used on the Pubmed, CINAHL, and EMBASE databases: (Perception OR Opinion OR Impression OR Viewpoint OR Discernment OR Feeling OR Thoughts OR Judgement OR Use OR Utilization) AND (Family Planning OR Contraception OR Contraceptives OR Birth Control) (Family Planning OR Contraception OR Contraceptives OR Birth Control) AND (approaches, tactics, strategies, procedures, or other means) (Women OR Females OR Girls) AND (Reproductive Age OR Child-bearing Age) (Reproductive Age OR Child-bearing Age).

The databases' publications were entered into the Zotero program, and duplicates were eliminated (Roy, 2021). Each article was carefully examined for relevancy. Articles were considered suitable if they met the criteria for eligibility. If an article did not match the aforementioned qualifying requirements, it was rejected. After removing pointless publications, full-text papers were acquired and their relevance was evaluated using quality evaluation methods. No grey literature was consulted because the database scan results were sufficient to undertake the inquiry.

Methods: Quality Assessment

The process of evaluating journals' quality based on their research methodology and the results obtained is known as the quality evaluation. In literature reviews, the quality assessment is crucial since it guards against prejudice and errors during the research process (Brackett & Batten, 2022). We used the assessment from the Critical Appraisal Skills Programme (CASP tool) for Qualitative Studies to assess the quality of this study technique.

Many medical professionals are familiar with the CASP method since it is frequently employed as a pedagogical tool to criticize research and its application is emphasized in several undergraduate and postgraduate programs. The CASP system's tools are also comparable to those created by several other organizations (Buccheri & Sharifi, 2017). To help readers through the evaluation process, CASP consists of several checklists, each of which contains several questions presented in a systematic manner (CASP, 2018). It has the benefit of having a variety of methodological checklists, including those for randomized trials, various kinds of epidemiological studies, and qualitative research, in addition to being familiar. Their usefulness is improved by their commonality in method and style.

The CASP tool may be used to assess the advantages and disadvantages of any qualitative research approach (CASP, 2018). Ten questions are included in the tool, each of which focuses on a distinct methodological facet of a qualitative investigation (see Appendix 1). The tool's questions compel the researcher to think carefully about whether the chosen research methodologies were acceptable and if the results are meaningfully presented. The CASP tool was created to be used as a teaching and learning aid in a workshop environment (CASP, 2018).

The WHO and Cochrane both recommend the CASP tool for use in qualitative data synthesis, and it is seen to be a user-friendly alternative for a novice qualitative researcher (Noyes, et. al., 2018). We selected the technique in part because of these factors; the first writer lacked existing formal qualitative study evaluation knowledge. The CASP instrument was created for use with health-related research, therefore it was judged acceptable for our review's setting. The openness of research practices and disclosure requirements were found to be pretty well measured by the CASP instrument; however, research design and conduct were found to be substantially less well measured. The CASP tool was shown to provide a clear sign of the methodological components of a research and the information that ought to be provided but to yield lesser consensus between and among reviewers compared to the other evaluation approaches (such as a quality framework and unprompted expert judgement) (CASP, 2018).

Data Extraction Tool

Data extraction is a phase in the literature review process that requires a lot of time and resources (Walker et al., 2022). A literature review's data-extraction stage needs to be carefully planned and piloted (Elamin et al., 2009). In addition to designing the data-extraction processes, this preparation includes choosing the best instrument and testing its effectiveness when carrying out the particular review. The pertinent information will be thoroughly examined for each item that has been chosen and met the numerous inclusive and exclusive criteria, and then it will be thematically analyzed and summarised in an excel spreadsheet. An Excel file serving as the data extraction tool will include details on the study's caliber, setting, participant characteristics, article number, journal authors, research design, and setting (Campbell et al., 2018).

The steps taken in this technique followed those outlined in Braun and Clarke's (2006) theme analysis methodology. This adaptable strategy made it possible to combine qualitative and quantitative investigations. There were six phases in this procedure. The complete data set was first reviewed three times, and first programming suggestions were made. Second, each item was meticulously examined and hand-coded. Codes and extracts that were regarded as notable instances were also compared. Thirdly, when all data had been coded and compiled, it was organized into probable topics.

This required examining the connections among distinct codes and classifying them by general themes. The concepts were polished and examined in step 4. Themes were identified and described in the fifth step. Finally, all codes and accompanying extracts that characterized each of the approved themes were tallied.

Budget and Likely Funding Sources

A project's budget is the numerical representation of a financial plan for anticipated project costs over a specific time period (Patil, 2019). A funding application's budget plan is a crucial component. It illustrates the necessary expenditure for the suggested project. It provides donors with a forecast of costs and a strategy for how the organization will manage the project, spend the money over a certain period, and where their funds will go.

This investigation is self-funded. Direct and indirect expenses are the two primary categories used to split the budget part.

1. Direct Cost: These expenses include database subscriptions, paper purchases, library service fees, data analysis costs, and publication costs.

2. Indirect costs: It is often known as overhead expenses. The institution offers a laboratory, power, library, and other resources to operate a planned research project.

This Medical Science has been solved by our PHD Experts at My Uni Paper.