Asian Research Journal of Gynaecology and Obstetrics

A Qualitative Analysis of Contraceptive Use and Barriers to Uptake among Antenatal Clinic Attendees at a Tertiary Hospital in Port Harcourt, Southern Nigeria

Terhemen Kasso *

Department of Obstetrics and Gynaecology, University of Port Harcourt, Nigeria.

Dagogo Sementari Abam

Department of Obstetrics and Gynaecology, University of Port Harcourt, Nigeria.

*Author to whom correspondence should be addressed.

---

Abstract

Background: The use of modern contraceptives has been identified as one of the most cost-effective public health interventions for reducing fertility, improving maternal and child health outcomes, avoiding pregnancy and lowering maternal and child morbidity and mortality rates.

Aim: This study aimed at exploring the views of pregnant women attending the antenatal clinic (ANC) at the University of Port Harcourt Teaching Hospital (UPTH) on their use and barriers to contraceptive use.

Study Design: Qualitative study.

Methodology: A qualitative research design was used to collect data from pregnant women attending UPTH antenatal clinic. Four focus group discussions (FGDs) were conducted in August, 2021 with each group having 10 pregnant women. A total of 40 participants were purposely recruited from the antenatal clinic attendees every week. The interviews were audiotaped, transcribed and subjected to thematic analysis with the aid of NVivo 12.

Results: The FGDs revealed that many of the women used contraceptives mostly to prevent unwanted pregnancy, sexually transmitted infections (STIs) and for child spacing, while traditional methods (withdrawal, unproven concomitant mixtures and herbs) were in high use more than modern methods. The study also identified that the major barrier to contraceptive use among the women was fear of side effects while others included religion, misconception about contraceptives, search for a particular sex of child, partner’s disapproval and financial constraints.

Conclusion: Findings from this research confirm that traditional methods enjoyed more use than modern contraceptive methods. Fear of side effects was the main barrier to modern contraceptive uptake among the pregnant women. Hence, the need to intensify efforts towards enlightening the populace on the types, uses and benefits of modern contraceptives as well as making them more affordable and accessible.

Keywords: Antenatal attendees, barriers, contraceptive use, side effects

---

---

---

References

Handady SO, Naseralla K, Sakin HH, Alawad AAM. Knowledge, attitude and practice of family planning among married women attending primary health center in Sudan. International Journal of Public Health Research. 2015;3(5):243 – 247.

Akinwale DO, Okafor AN, Akinbade OM, Ojo CI. Determinants of Modern Contraceptives Utilization among Women of Reproductive Age in Rural Community, Osun State, Nigeria. International Journal of Caring Sciences. 2020;13(2):1173–1182

Wang W, Staveteig S, Winter R, Allen C. Women's marital status, contraceptive use, and unmet need in sub-Saharan Africa, Latin America and the Caribbean. Rockville, Maryland, USA: ICF. DHS Comparative Report. 2017;44.

Obwoya JG, Wulifan JK, Kalolo A. Factors influencing contraceptive use among women in the Juba city of South Sudan. International Journal of Population Research. 2018:1 – 7.

World Health Organisation. Contraception: Evidence brief, Department of Reproductive Health and Research. World Health Organisation, Geneva: Switzerland; 2019.

Yaya S, Ghose B. Prevalence of unmet need for contraception and its association with unwanted pregnancy among married women in Angola. PLoS ONE. 2018;13(12):e0209801 Available:https://doi.org/10.1371/journal.pone.0209801

Grindlay K, Dako-Gyeke P, Ngo TD, Eva G, Gobah L, Reiger ST, Chandrasekaran S, Blanchard K. Contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. PLOS ONE. 2018;13(8):e0201663.

Doi: 10.1371/journal.pone.0201663

Wang C, Cao H. Persisting regional disparities in modern contraceptive use and unmet need for contraception among Nigerian women. BioMed Research International. 2019;2019:1–9

United Nations, Department of Economic and Social Affairs, Population Division (2017). World Family Planning - Highlights (ST/ESA/SER.A/414). New York: USA; 2017.

Singh S, Sedgh G, Hussain R. Unintended pregnancy: Worldwide levels, trends, and outcomes. Studies in Family Planning. 2010;41(4):241–250. Doi: 10.1111/j.1728-4465.2010.00250.x

Frini HO, Nabag WOM. The knowledge and determinant factors of contraceptive use among married Sudanese Women. App Sci Report. 2013;4(3):247–51.

Saluja N, Sharma S, Choudhary S, Gaur D, Pandey S. Contraceptive knowledge, attitude and practice among eligible couples of rural Haryana. Internet Journal of Health. 2001;12(1):1-6.

Adeyemi AS, Olugbenga-Bello AI, Adeoye OA, Salawu MO, Aderinoye AA, Agbaje MA. Contraceptive prevalence and determinants among women of reproductive age group in Ogbomoso, Oyo State, Nigeria. Open Access Journal of Contraception. 2016;7:33 – 41

Kaniki FR. Factors influencing the use of modern contraceptive methods among rural women of child bearing age in the Democratic Republic of the Congo. Journal of Family Medicine and Primary Care. 2019;8(8):2582-2586.

Ajayi AI, Adeniyi OV, Akpan W. Maternal health care visits as predictors of contraceptive use among childbearing women in a medically underserved state in Nigeria. Journal of Health, Population and Nutrition. 2018;37(1):19

Dasgupta AN, Zaba B, Crampin AC. Postpartum uptake of contraception in rural northern Malawi: a prospective study. Contraception. 2016;94(5):499–504

Eko JE, Osonwa KO, Osuchukwu NC, Offiong DA. Prevalence of contraceptive use among women of reproductive age in Calabar Metropolis, Southern Nigeria. International Journal of Humanity and Social Science Invention. 2013;2:27–34.

Umoh AV, Abah MG. Contraception awareness and practice among antenatal attendees in Uyo, Nigeria. Pan African Medical Journal. 2011;10:53.

Asekun-Olarinmoye, EO, Adebimpe WO, Bamidele JO, Odu OO, Asekun-Olarinmoye IO, Ojofeitimi EO. Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria. International Journal of Womens Health. 2013;5:647–655

Ajong AB, Njotang PN, Yakum MN, Essi MJ, Essiben F, Eko FE, et al. Determinants of unmet need for family planning among women in urban cameroon: A Cross Sectional Survey in the biyem-assi health district, yaoundé. BMC Women's Health. 2016;16(1).4. Doi: 10.1186/s12905-016-0283-9

Kabir AD, Lukman OO, Olusegun E. Barriers to Contraceptive Uptake among Women of Reproductive Age in a Semi-Urban Community of Ekiti State, Southwest Nigeria. Ethiopian Journal of Health Sciences. 2017;27(2):121–128

Chatterjee S, Bangal VB. Awareness and acceptability of contraceptive methods amongst antenatal patients attending antenatal care clinic at Pravara Rural Hospital (PRH) Loni. Pravara Med Rev. 2020;12(04):97–105.

Sedgh G, Bankole A, Oye-Adeniran B, Adewole IF, Singh S, Hussain R. Unwanted pregnancy and associated factors among Nigerian women. International Family Planning Perspective. 2006;32:175–184.

Curtis S, Evens E, Sambisa W. Contraceptive discontinuation and unintended pregnancy: an imperfect relationship. Int Perspect Sex Reprod Health. 2011;37(2):58–66.

Bishwajit G, Tang S, Yaya S, Feng Z. Unmet need for contraception and its association with unintended pregnancy in Bangladesh. BMC Pregnancy and Childbirth. 2017;17(1).

Doi: 10.1186/s12884-017-1379-4

Campbell MM, Prata N, Potts M. The impact of freedom on fertility decline. Journal of Family Planning and Reproductive Health Care. 2013;39(1):44–50.

Doi: 10.1136/jfprhc-2012-100405

Batool Z, Sabahat H. Reasons for low modern contraceptive use, insights from Pakistan and neighbouring countries.; 2015. Available:http://www.popcouncil. org/uploads/pdfs/2015RH_LitReview-RAF.pdf.

Accessed on December, 2020

Alenoghena I, Yerumoh S, Momoh MA. Knowledge, attitude and uptake of family planning services among women of reproductive age group attending outpatient clinic at a tertiary health institution in Edo State, Nigeria. Journal of Public Health and Epidemiology. 2019;11(3):63–70.

Otoide VO, Oronsanye F, Okonofua FE. Why Nigerian adolescents seek abortion rather than contraception: Evidence from focus group discussions. International Family Planning Perspective. 2001; 27(2):77–81.

Gele AA, Musse FK, Shrestha M, Qureshi S. Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: A qualitative study. PLoS ONE, 2020;15(3):e0229916.

Doi:https://doi.org/10.1371/journal.pone.0229916

Adewole IF, Oye-Adeniran BA, Iwere N, Oladokun O, Gbadegesin A, Babarinsa AI. Contraceptive usage among abortion seekers in Nigeria. West African Journal of Medicine. 2002;21(2):112–114.