Full Project – Knowledge, attitude and practice of natural family planning among women of child bearing age among attending general outpatient department of General Hospital

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CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND TO THE STUDY

The “natural” in natural family planning does not refer to the naturalness of sexual abstinence nor is it intended to imply that taking one’s temperature is natural. It refers to the monitoring of natural physiological signs and symptoms to determine the fertile period. (William, 2003). An authentic Natural Family Planning (NFP) never interferes with the transmission of life. Its sincere openness to the will of God and respect for life is its most virtues according to (Wilson, 2003). According to Elaine and Hoehn, (2010) the oocyte is viable for 12 to 24hours after ovulation; the chance of pregnancy drops to almost zero the next day. Most sperm retain their fertilizing power for 24 to 48 hours after ejaculation. Consequently, for successful fertilization to occur, coitus must occur not more than two days before ovulation and no later than 24 hours after. From this knowledge of physiology, it can be deduced that a woman is fertile for about 100hours in a cycle. Why then should one continue to enslave oneself with artificial birth controls such as pills, implants, Depo-Provera, intra-uterine contraceptive device etc which are synthetic female hormones. According to Billings, (2010) these can cause about 150 chemical changes in women’s body. Artificial birth control also has serious side effects on the heart, brain, kidneys, blood vessel, increases chances of breast cancer, blood clot and permanent sterility as admitted by several manufacturers of these synthetic hormones.

It is essential to understand what is meant by Natural Family Planning (NFP) in order to realize what produces so many benefits to the marriage and individual woman’s life. In general, NFP is defined as methods for achieving or postponing pregnancy that are based on observations of natural occurring signs  in the  woman’s  body that inform  her of  the fertile  and  infertile  phases of  her cycle  with avoidance of  intercourse  during the  fertile  phase  if  pregnancy is  to  be avoided (Australian  Council  of  Natural  family Planning, 2011)

Fraser and Cooper, (2009) highlights many methods which NFP teaches and can be adopted and practiced by different people based on understanding and knowledge. These methods are calendar-based methods, Basal body temperature, lactation amenorrhea method and symptom-thermal method. Each of these methods has proven effective in their own way depending on accurate identification of the fertile time and modification of sexual behavior.

Sinai, Lundgren, Arévalo and Jennings, (2006) claimed that there was no clear profile  of  clients for  whom  Natural  Family Planning methods would  be  in appropriate. It is worth remembering says Australian Council of NFP (2011) that no method of family planning is 100% effective. Modern method of NFP such as Sympto-thermal method is as effective as the oral contraceptive pills.

Choosing NFP is about sharing the responsibility to understand, accept and manage your fertility with your partner. By keeping a record of the cycles, interpreting the signs of fertility and making decisions concerning the timing of sexual intercourse, couple can either achieve or avoid pregnancy.

To ensure women’s right to a free choice in family planning. the World Health                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Organization,  (2004) recommends that information  related to  family planning should   include, at a minimum, the following for  each  method;  effectiveness, correct use, mechanism  of  action, side effects, health risk  and  benefits reversibility  and protection against sexually  transmitted infection  (STI) , knowledge  about each  of  these  aspect can have practical  implications  regarding acceptance and  satisfaction  with  the  chosen  method  as well  as minimize user errors. It is also important to acknowledge that women have different preferences and can accordingly make a choice of the method best suiting their wishes.

The researcher through her observation has noted that the poor knowledge about NFP was as a result of the  fact that many health  care providers  especially  the nurses  and midwifes  who  are very much closer to these  women have not been  following the WHO’s  recommendation  on the provision of adequate knowledge  on each  method  of  family planning. Some anecdotal story also  confirmed that many  Nurses will  even tell  the  women  seeking method  of  Natural  Family  Planning  that NFP  is difficult  to  practice and ineffective, most women were directly introduced to  the  artificial  contraceptives with  the  information that any unusual  signs and  symptoms  should be  reported to  them. This clearly shows that necessary information which should have help couple or women to make adequate and good decision was not provided.

In spite of all the benefit attached to NFP without a single adverse effect, it has been observed that NFP has received a cold embrace and practice. The above evidences prompted the researcher to assess the knowledge and practice of NFP women of child bearing age attending General outpatient department of General Hospital Ilorin.

1.2 STATEMENT OF PROBLEM

It is estimated that 2–3% of the world’s reproductive age population relies on periodic abstinence to avoid pregnancy. Wikipedia, (2006) In the United States, approximately 4% of women of reproductive age use Natural Family Planning (NFP) to avoid pregnancy. It is unclear says Stanford, Lemaire and Thurman, (1998) whether this low number is related to a lack of available information, women’s lack of interest, or other factors. Kobonga, Baboo and Mweembba, (2010) affirmed that the problem of low utilization of NFP is worldwide as evident by the contraceptive utilization for women in Zambiais at 30%, NFP being 1%.

The researcher through  her keen  observation and  interactions  with people understands  that lack  of  knowledge  of Natural  Family  Planning couples  with  misconceptions  on the practice and  effectiveness  of  NFP, as  well  as  lack  of  adequate knowledge  on the  adverse effects  of  contraceptives  especially  hormonal types  on women’s  body were the source of  poor  knowledge altitude  and practice of  NFP.

This research  will  therefore  assess  the  knowledge,  altitude and practice of  NFP  among the  women  of  child  bearing age attending General outpatient department of General Hospital Ilorin.

1.3 OBJECTIVES OF THE STUDY

The main objective is to examine the knowledge and practice of NFP among women of child bearing age attending General outpatient department of General Hospital Ilorin.

Specific objective is to

1. To determine the level of knowledge of women of child bearing age attending General outpatient department of General Hospital Ilorin on Natural Family Planning.
2. To determine the attitude of women of child bearing age attending General outpatient department of General Hospital Ilorin towards Natural Family Planning.
3. To determine the level of practice of NFP among women of child bearing age attending General outpatient department of General Hospital Ilorin.
4. To identify the methods of family planning used by women of child bearing age attending General outpatient department of General Hospital Ilorin

1.4 RESEARCH QUESTIONS

1. How knowledgeable are women of child bearing age that are attending General outpatient department of General Hospital Ilorin on Natural Family Planning on natural family planning?
2. What is the attitude of women of child bearing age attending General outpatient department of General Hospital Ilorin towards Natural Family Planning?
3. What is the level of practice of natural family planning among women of child bearing age attending General outpatient department of General Hospital Ilorin?
4. What are the identified methods of family planning used by women of child bearing age attending General outpatient department of General Hospital Ilorin?

1.5 SCOPE AND DELIMITATIONS OF THE STUDY

The present study focus on the women of child bearing age attending General outpatient department of General Hospital Ilorin.

1.6 SIGNIFICANCE OF THE STUDY

This study shall help to assess the level of knowledge of the child bearing age women on Natural Family Planning and to also find out their level of practice of Natural Family Planning.

The outcome of this study will be of great significance to help deal with the below situation

Medical team: It is also hope that the findings of this study will be useful for medical team as it will provide them with the subjects’ knowledge, attitude and practice of Natural Family Planning.

Researchers: It is also anticipated that the study will provide baseline information on which further studies can build on as there is a dearth of empirical studies on the area of focus.

Pregnancy complications can be minimized: Family planning helps protect women from any health risks that may occur before, during or after childbirth. These include high blood pressure, gestational diabetes, infections, miscarriage and stillbirth. According to studies, women who bear more than 4 children are at increased risk for maternal mortality, so they need to plan accordingly. Women who get pregnant after the age of 35 are vulnerable to health risks, so they should be protected through careful planning as well. Also, by reducing unintended pregnancies, family planning also removes the option for unsafe abortion.

Adolescent pregnancies can be reduced: Females who are 10-19 years old are more likely to have a preterm baby, or a baby that’s born before the 37 weeks of pregnancy have been completed. Also, a baby born to a teenage mother will have higher rates of neonatal mortality. Family planning and, more specifically, contraception, can protect teenagers from the physical, emotional and financial burden of unplanned pregnancy.

Infant mortality rates can be cut down: When a pregnancy is unplanned, ill-timed, or too closely spaced, it affects the mother’s health which, in turn, affects the health and safety of her unborn child.  Moreover, an infant will have a greater risk of death and weak health if the mother dies while giving birth.

1.7 DEFINITION OF TERMS

Knowledge: The idea an individual holds or had acquired on Natural Family Planning through experiences or education.

Attitude: – A settled way of thinking or feeling towards the use of Natural Family Planning.

Practice: – The actual application or utilization of natural family planning

Natural Family Planning: – Methods for preventing or postponing pregnancy that are based on observations of natural occurring signs  in the  woman’s  body that inform  her of  the fertile  and  infertile  phases of  her cycle  with avoidance of  intercourse  during the  fertile  phase  if  pregnancy is  to  be avoided.

Women of child bearing age: – Women who are still naturally capable of giving birth

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Full Project – Knowledge, attitude and practice of natural family planning among women of child bearing age among attending general outpatient department of General Hospital