Attitude To And Practice Of Modern Family Planning Among Widows Of Reproductive Age

Similar to those of a diaphragm. One of the rings is put into the vagina which serves as internal anchor and the second ring remains outside the vagina to make it possible for the man to find the entrance of the vagina which is now covered by a sheath. It is an effective barrier to sexually transmitted infections (STIs) and semen into the vagina.

The Diaphragm is a vaginal barrier. It is a dome-shaped rubber cap with flexible rim. It is inserted into the vagina, before intercourse, to cover the cervix. The spermicidal could be placed on the dome of the diaphragm, to serve as reinforcement. Diaphragm could be inserted at anytime within the monthly cycle (Okoye & Okoye, 2007).

Intra-uterine contraceptive devices (IUCDs) are small plastic or stainless steel or flexible polyethylene nylon device, that can be inserted by a doctor through the cervix, into a woman‟s womb to prevent pregnancy. Almost all brands of IUCDs have one or two strings or threads tied to them. The rings hang out through the opening of the cervix into the vagina. The strings which can be felt by a woman help her to check whether the IUCD is still in place or not. They also aid removal of the device by a health-care provider (Okoye, 2006).

The injectable depoprovera is a contraceptive given every three months as a single injection to women who want to prevent pregnancy. It contains the hormone, progestin, similar to the natural hormone that a woman‟s body produces. The injection, when given, releases the hormone slowly into the woman‟s blood stream up to three months or more. The injection prevents pregnancy by preventing ovulation from occurring, thickening the cervical mucus, thereby making it difficult for the sperm to pass through it, and inducing reduction or thinning of the endometrial lining (inner surface of the womb). By this action, depoprovera can cause amenorrhea (absence of menstruation) on a long use (Okoye & Okoye, 2007).

Implant is a subdermal contraceptive capable of preventing a woman from becoming pregnant for five years. The commonly used implant is norplant which  consists of six small plastic capsules similar to sticks of matches. The capsules contain 35mg each, of levonorgestrel. Implant is entirely a hospital procedure. The procedure requires a minor incision and the capsules are implanted beneath the skin of the forearm or upper arm. After the insertion, the minor incision is closed with gauze and plaster. No stitches are required and the capsules are not visible on the skin.

Both the insertion and removal, require the expertise of a trained health personnel, mainly doctors. Interestingly, return of fertility is almost immediately after the device is removed (Okoye & Okoye, 2007).

Abortion simply means termination of pregnancy. World Health Organization, WHO (1971) defined abortion as termination of pregnancy before the embryo or foetus attains the age of viability. Okoye(2006) stated that abortion could be spontaneous or induced. Spontaneous abortion is defined as natural or unaided termination of pregnancy before foetal maturity. Spontaneous abortion is commonly referred to as miscarriage. Induced abortion is defined as artificial or intentional termination of pregnancy,  using any of the numerous methods against the laws of the country (Nigeria). This may include the use of drugs, mechanical devices manipulations or instrumentation. This however carries the highest risk of complications and maternal death.

Surgical or terminal methods of family planning on the other hand, are simple or minor surgical operations for permanent contraception. Surgical or terminal methods comprise of male sterilization (Vasectomy) and female sterilization (tubal ligation). The present study was concerned with oral pills, injectables, female condom, male condom, IUCDs, and surgical method. These methods were chosen for the present study because they were the only family planning methods in use in Logo LGA at the time of the study.

There  are  various  demographic  factors  that  influence  widows‟  attitude  to  and practice of modern family planning. The present study was concerned with demographic factors of age, parity, and level of education.

Age has been identified by some studies as one of the strong factors that influence attitude to and practice of modern family planning. In a study by Chacko (2001) among married women, in four villages in rural West Bengal, India; it was found that, one of the factors that most influence a woman‟s use of contraception include her age. Specifically, Chizororo and Natshalaga (2003), reported that the younger women liked the female condom more than the older ones. Ngom and Maggwa (2005) postulated that age significantly increases a woman‟s likelihood of using modern contraception.

Reports  from  researchers  indicate  that  parity  influences  a  woman‟s  chances  of using modern family planning. Chacko (2001) found that the number of living sons a woman has, greatly influences her use of modern contraception. Oyedokun (2007) reported that number of children ever born was also found to be a significant factor that influences women‟s attitude to and practice of contraceptive.

Studies have revealed that level of education has strong influence on attitude to and practice of modern family planning. Kaba (2000) pointed out that educational status of women was found to have an impact on contraceptive use. Those women who have some level of education were found to have better knowledge and tend to use contraceptives. Philippines National Demographic and Health Survey, PNDHS (2000) revealed that women with an elementary school education were more likely than those with more education or with none at all to want no more children and thus tend to use modern contraception. These variables were surveyed and some behaviour-change theories applied, to explain widows, attitude to and practice of modern family planning.

This study was anchored on three theories. These are theory of reasoned action (TRA), theory of planned behaviour (TPB) and self-efficacy theory. The theory of reasoned action (TRA) which suggests that a person‟s behaviour-intention depends on the person‟s attitude about the behaviour and subjective norms, was the theory of anchor for widows‟ attitude to modern family planning.

Widows who develop negative attitude to certain methods of family planning are likely not to use such methods, whereas widows who believe that using certain methods of modern family planning protect them against unplanned pregnancies and sexually transmitted infections (STIs) will likely use such methods. Similarly, the theory of planned  behaviour  (TPB),  which  states  that  peoples‟  evaluation  of  or  attitude  towards behaviour, are determined by their accessible belief about the behaviour, was another theory of anchor for widows of reproductive age‟s  attitude to  modern family planning. The intention or belief of widows to use modern contraceptives, predicts contraceptive use by them. When a widow intends not to use contraceptives, it translates into non-use  of contraceptive. Self-efficacy theory which holds that any change in behaviour must be preceded by a conviction that one can efficiently carry out the desired behaviour was applied to  verify the  findings regarding  Logo  widows of reproductive age‟s  practice of modern family planning. Logo widows of reproductive age may be more likely to practice modern family planning when they believe that they are capable of executing those practices successfully.