MYTHS AND MISCONCEPTIONS ON MODERN CONTRACEPTION
Myths and Misconceptions remain among the top hindrances to women using or continuing a method of contraception, especially in Nigeria. With a birth rate of 38.4 births/1,000 population (world bank 2017), a population of over 190 million (world bank 2017), and Contraceptive Prevalence Rate (CPR) of about 15% (FP2020 2018) Nigeria remains a “priority” country within the global family planning community. Additionally, with infant and maternal mortality rates as high as 64.6 deaths/1,000 live births and 328.4 deaths/100,000 live births (world bank 2017) respectively, it has become imperative for the Nigerian government and key stakeholders to prioritize family planning/childbirth spacing.
FEDERAL GOVERNMENT’S RESPONSE
In response to the above, the Federal Government alongside development partners has developed and implemented a number of initiatives targeted at improving access to and availability of family planning services across the country. The interventions have also focused on improving the availability and dissemination of accurate information on family planning. Successes have been recorded across a number of these interventions with knowledge on modern contraception at a record high of 84% for females and 94% for males (National Family Planning Communication plan 2017).
Despite the success being recorded with respect to dissemination and availability of information on family planning, method uptake is still low with frequent discontinuation amongst existing users. A number of factors have contributed to the current situation including side effects that arise from using contraception and myths/misconceptions associated with family planning. Both factors listed have been quoted by subject matter experts as the “biggest” contributors to low uptake even within the Nigerian context.
WHAT DOES RESEARCH SAY?
In a study published by Guttmacher Institute (2015) it was noted that on average, women in Nigeria and Kenya believed 2.7 and 4.6 out of eight selected myths. The MLE baseline surveys conducted between 2010 and 2011 across six Nigerian cities, also showed that the proportion of women who believed that contraception was harmful to their health ranged from 33% in Abuja to 57% in Ibadan. Other myths associated with the use of contraception as documented by a number of national and community surveys include;
- It poses considerable health risks such as cancer.
- It causes permanent infertility.
- It decreases the desire for sexual intercourse.
- It harms a woman’s uterus.
- Pills accumulate into a life-threatening mass in the stomach.
- Pills can cause birth defects and bleeding from organs.
The above myths have been spread via conversations amongst women and men. Research also shows that misinformation by poorly trained service providers has contributed to the spread of myths further endorsing existing fears and reservations towards method uptake at the community level.
THE WAY FORWARD
To effectively combat the current situation, immediate re-orientation of the populace is required. The re-orientation may take several forms and involve a series of activities. However, in Nigeria, [i]programs that encourage community-level discussions may be most effective at reducing the spread of myths and misconceptions associated with family planning.
Other approaches as recommended by FP2020[ii] include;
- Engaging male partners: Enhancing couple communication about method characteristics can be effective in supporting continued use, particularly in the postpartum period.
- Ensuring client confidentiality: In some settings, male opposition to family planning may cause discontinuation of any method, thus ensuring client confidentiality is a priority intervention.
- Dispelling misconceptions: Service providers need to dispel misconceptions about the timing of initiating a method, especially when switching, through the pregnancy checklist or testing, and also for the perceived need for occasional “rest periods” from using hormonal methods.
- Counseling women who experience prolonged amenorrhea: Knowing that their menses will return and the average time for this to happen can reassure women who want to plan to become pregnant in the future.