CHAPTER ONE
1.0 Introduction
- Background of the Study
Giving birth is something in which mankind and animals are equal….But rearing the young, and especially educating them for many years is something which is a unique gift and responsibility of a man. It is for this reason that it is important for human beings to put emphasis on caring for children and the ability to look after them properly, rather than thinking only about the number of children and the ability to give birth. For it often happens that man’s ability to give birth is greater than their ability to bring up the children (Julius Neyerere cited in Centre for Disease Control 1983).
The above dictum could not have been more germane than in a 21st century Africa where many families grapple with the challenges of malnutrition, infant mortality, road accidents, armed robbery, sexually transmitted diseases, maternal mortality, kidnapping, unemployment, hunger, civil strife, among others. One of the subtle but most frightening of all is the issue of maternal mortality which incidentally is one of the biggest problems facing the developing areas of the continent, including Nigeria. In fact, Lindroos and Luukkainen (2004), in the Antenatal Care and Maternal Mortality in Nigeria, were moved to ask a rhetorical question that if maternal mortality is about 800 -1100/100,000 like it is in Nigeria, in a country where the population is over 120 million it means about 54 000 deaths every year. That is only a bit under 10% of all maternal mortality cases in the world per year.
Raphael (2008) corroborates the foregoing statistics as he asserts that Nigeria’s maternal mortality rate is the second highest in the world, after India -1,100 maternal deaths per 100,000 live births. The country is home to 2 percent of the global population, but 10 percent of all maternal deaths take place there. Only about 60% of pregnant women have access to prenatal care in Nigeria and even fewer have access to family planning. These sad and scary statistics have been blamed squarely on the Nigerian government’s inability to provide access to information on family planning and contraception, two issues very closely related to maternal death (Centre for Reproductive Rights, CRR, and the Women Advocates Research and Documentation Centre, WARDC 2008).
Clearly, the health benefits of family planning associated with child spacing and the use of specific methods can play a major role in protecting the lives of infants, children, women and the family as a whole on the continent of Africa.
However, Nigeria is the most populous country on the continent and among the ten most populated nations of the world. Its national population is about 140 million and has been projected to reach 250 million by the year 2015 (Population Reference Bureau, PRB 2004; National Population Commission 2006). The large increase in size of the population is mostly a function of past and present levels of fertility and mortality in the country. In Nigeria, child spacing or the timing of every birth, including the first and last, can improve the likelihood of survival and of good physical and emotional health for the entire family at all stages of life.
All available evidence indicates that the level of reproduction has been persistently high in the last three or four decades and still remains so at present (Fraser and Weisberg 1981; Odaman 2005). If the nation’s population is left to grow uncontrolled, the national resources will sooner or later be outstripped by the increasing demand of the growing population. This was probably the fear Kishindo (1995) expressed about the Malawian experience when he observed that Malawi’s population has been growing at the rate of 3.7% during the 1977-87 intercensal period, compared to 2.9% during the 1966-77 intercensal period and that if the population continues to grow at that rate, it would double in 19 years.
Although the influx of refugees from the Mozambican civil war contributed significantly to the rapid population growth, the 3.2% annual growth, when Mozambican refugees are excluded, is still high in the context of the country’s natural resources.
Earlier, the University of Malawi/UNFPA (1987) reported that attempts were made in the 1960s to introduce family planning services in Malawi but were abandoned following misunderstandings between Ministry of Health officials on the one hand and the public on the other. The public then viewed family planning as a disguised attempt at birth control, which ran counter to traditional cultural values which stress the value of children to society.
It is probably this state of things that made Kishindo (1995) to argue that the success of family planning in Malawi will largely depend on the active involvement of men since it is men as husbands and brothers who ultimately control women’s fertility. Therefore, Kishindo suggested that family planning programmes whether through radio or television media or other means should target both men and women.
In the quest to stem the tide of unbridled population growth, the government of the Federal Republic of Nigeria in 2002 came out with a population policy paper on family planning and fertility regulation. According to the policy paper, the value of family planning and child spacing on the stability and wellbeing of family shall be promoted and family services shall be incorporated in maternal and child health care. This is to help reduce maternal and infant morbidity and mortality as well as reduce rapid population growth in the shortest possible time in order to ensure sustainable development which can be achieved only by reducing population growth to bring it to per with the available national resources. This will invariably lead to the attainment of good quality life and high standard of living in the country. It is perhaps because of the foregoing world leaders in 1974 accepted family planning as a human right of individuals and couples.
Article 14 (F) of the World Population Plan of Action states that:
“All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so; the responsibility of couples and individuals in the exercise of the right takes into account the needs of their living and future children, and their responsibility towards the community”.
Though there is a growing interest with the intense efforts of the government to popularize the use of modern family planning methods by integrating it into maternal and child health in Nigeria, it seems many people still do not apply family planning methods. Lindroos and Luukkainen (2004) contend that Nigeria is a country where modern family planning usage is one of the lowest in the world. This may be due to lack of useful information to those who really need the information as a majority of the Nigerian populace live in the rural areas where there is poor access to modern means of communication including the mass media.
Family planning provides the society with some socio-economic and health benefits (Odaman 2005). Awareness of such benefits can significantly enhance the use of contraceptives, which in turn, will reduce population growth and overtime have positive effects on national development. In this connection, Ugoji (2008) observes that family planning programmes strive to prevent unwanted pregnancies, help achieve birth spacing and help couples limit family size so as to reduce maternal/infant mortality.
Further, Odaman (2005) enumerates some of the family planning methods to include the use of safe period, calendar or rhythm, oral pills, condoms, injectables, intrauterine devices (IUDs), Norplant and sterilization. As regards the foregoing modern methods, Oladeji (2008) contends that communication and decision making play a vital role in ensuring informed choice of family planning and reproductive health behaviour.
Effective communication/ decision making allows people to seek what is best for their own health and to exercise their right to good quality health care (Rimal et al. 2002).
In the same vein, it has been argued that the mass media, especially radio and television have been quite effective in creating family planning awareness in urban Nigeria.
Perhaps, this is because the urban dwellers have greater access to the mass media. According to a survey of predominantly urban areas, about 90% of all urban house-holds have radios and about 60% own televisions in Nigeria (Information, Education and Communication, IEC, July 1996) and the likelihood that people living in urban areas would readily have access to family planning information as purveyed through radio and television media is high. But to make this level of family planning awareness effective among the generality of Nigerians, the mass media should have a hold in the rural areas where a larger number of the people live.
The spread of television and radio, the rise of an independent press, and increasing literacy rates in many countries offer new opportunities for family planners and other health care organizations to inform the public and reach opinion leaders (Piotrow et al. 1994). Making the most of these opportunities requires skill in helping the news media cover family planning.
While examining the knowledge and practice of family planning methods among the currently married adolescent women (CMAW) in India, Narsary (2009) observed that exposure to mass media and husband-wife communication play a significant role in family planning matters. Obaid (2006) and Abd El-Aziz (2006) have also identified radio and television media as effective instruments in family planning education in Jordan and Egypt respectively. Similarly, in a more recent research conducted with an aim to assess the knowledge, understanding and attitude of couples towards family planning across two ecological settings of Jammu district in India, Dhingra et al. (2010) found that television and magazines were the major accessible sources of information on family planning to couples.
Since 1972, the average family size in developing countries has dropped from about six or seven children per woman to about three children. This trend has saved millions of lives and provided additional benefits to women and children who when healthy can achieve greater levels of education and empowerment (International Planned Parenthood Federation, PPF 1992). Despite the gain, contraceptive use is still low and needs high usage in some of the world’s poorest and most populous places, including Nigeria. At least, three in 10 pregnancies are unintended in some regions, and millions of couples are still unable to effectively choose the number and timing of their children.
Moreover, some developing countries (such as Bangladesh) that have not substantially reduced their fertility levels in recent decades are in danger of seeing their development or progress halted or slowed. These challenges are immense, but not insurmountable. The past 50 years demonstrate that successful family planning programmes can be developed even under difficult circumstances. For example, the one child per family policy in the Peoples Republic of China, however draconic has helped to check birth rate and population explosion and the country is arguably better for it.
The use of safe, voluntary contraception is also accepted worldwide. In 1994, representatives from 179 nations met in Cairo, Egypt at the international conference on population and development and agreed to provide reproductive health care to all people by the year 2015- a goal that called for countries to “meet the family planning needs to their population” and provide “universal access to a full range of safe and reliable family planning methods” (Population Reference Bureau, PRB 2004).
Diachronically, family planning methods, among other social issues have engaged the interest of media researchers. Aikhenomia (1999) remarks that:
Researchers in the field of mass communication at one time or the other have conducted researches to study the influence of a given idea or practice via the mass media, through a sociocultural structure. Also systematic inquiries have been conducted about the attitudes of receivers or audience towards such practice.
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