|Year : 2013 | Volume
| Issue : 2 | Page : 113-116
Contraceptive choices amongst women in Kano, Nigeria: A five (5) year review
Ibrahim A Yakasai, Abubakar M Yusuf
Department of Obstetrics and Gynaecology Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
|Date of Web Publication||24-Dec-2013|
Ibrahim A Yakasai
Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano PMB 3452
Source of Support: None, Conflict of Interest: None
Background: Contraception has been identified as an effective means of combating the problem of unwanted pregnancy and unsafe abortion. It is equally an effective means of family planning and fertility control and therefore an important tool in promoting maternal and child health. The contraceptive prevalence in most developing countries remains very low.
Objective: To evaluate the trend of contraceptive usage the preferred method and the source of information on contraception among the new clients attending family planning clinic at Aminu Kano Teaching Hospital, Kano.
Materials and Methods: Records of the new clients attending family planning clinic of Aminu Kano Teaching Hospital, Kano from January 2005 to December 2009 were reviewed and analyzed. Information extracted included type of contraception, age, parity, and source of information. All information was analyzed using Epi- info 8.0.
Results: A total of 3484 new clients accepted various forms of contraceptive methods during the period of study. There was a steady increase in the number of new acceptors of contraceptives over the period of study from 449 (12.9%) in 2005 to 1096 (31.5%) in 2009. The mean age and parity were 28.0±5.8 years and 3.6±2.4, respectively. The most common method of contraception accepted by the clients was injectable 1451 (41.6%), followed by intrauterine device 1124 (32.3%), then oral contraceptive pills which was 749 (21.5%). Bilateral tubal ligation was the least accepted method of contraception, with only 2 (0.6%) women. The predominant source of information on contraceptive methods was through the clinic personnel (97.6%).
Conclusion: There was a steady increase in contraceptive acceptability in our center. The injectable methods of contraception were the most commonly accepted method, while bilateral tubal ligation was the least preferred method.
Keywords: Contraceptive choices, Kano, women
|How to cite this article:|
Yakasai IA, Yusuf AM. Contraceptive choices amongst women in Kano, Nigeria: A five (5) year review. J Med Trop 2013;15:113-6
| Introduction|| |
Contraception, which is the prevention of conception or implantation by methods other than abstinence from coitus, has been known and been in use since the early years of human existence albeit at a very primitive level.  With advancement in medicine and improved sociopolitical environment, there has been increased survival rates and long life expectancy with consequent population explosion.  Thus, in an effort to control population growth, contraception was introduced in the early 1950s. , Contraception witnessed revolution in the 1960s with the introduction of the pills. Despite the introduction of family planning services in developing countries over the years, the fertility rates in these countries are still high, as shown by a fertility rate of 6.1 in Nigeria. ,, It was estimated that about 113.6 million women in the developing countries have an unmet need for contraception. ,
The main aim of family planning is to improve the quality of life of the populace. Additional health benefits of contraception beyond pregnancy prevention include protection against sexually transmitted diseases, reducing the risk of cervical cancer, and minimizing the incidence of menorrhagia. According to the International Conference on Population and Development, should make reproductive health and family planning accessible to all individuals of appropriate ages as soon as possible, and no later than 2015.  Many developing countries have responded to this, by expanding their reproductive health and family planning programs, in accordance with the recommendation issued by the 1994 International Conference on Population and Development 
With the increase in publicity on the use of contraceptives, there has also been corresponding need to provide safe, effective, acceptable and affordable means of contraception. Different contraceptive methods are in use today ,,, and each has over time been undergoing development toward achieving the above goals.
This study was designed to evaluate the contraceptive choices together with the source of information on contraception amongst new clients attending Family Planning Clinic at Aminu Kano University Teaching Hospital (AKTH), Kano.
| Materials and Methods|| |
This was a review of the records of new clients that attended the family planning clinic of Aminu Kano Teaching Hospital, Kano from January 2005 to December 2009. The case records were retrieved from the central library and information pertaining age, parity, source of information on family planning and accepted method of contraception were sought. The data were collated and analyzed via Epi- info 8.0 and the results presented using simple percentages.
| Results|| |
A total of 3484 new clients attended the Family Planning Clinic of AKTH, Kano within the period under study. There was a steady rise in the number of new clients accepting a method of contraception over the period from 424 (12.2%) in 2005 to 1117 (32.1%) in 2009 as seen in [Figure 1].
The most common accepted method was progesterone only injectable contraceptives, 1451 (41.6%) while the least accepted method was BTL, 2 (0.6%) as depicted in [Table 1].
|Table 1: Yearly distribution of contraceptive methods between 2005 and 2009 |
Click here to view
The age range was from 15-49 years with a mean of 28±5.8 years. Women of the age group of 20-39 years constituted 93% of the new acceptors as seen in [Table 2]. Probably because this represents the reproductive age groups of most societies.
Women of low parity constituted 69.6% of the clients and the grand multiparous women constituted 28.1% as shown in [Table 3]. Injectables and intrauterine devices were the main contraceptive methods used by these clients. There was no male client during the period reviewed. The source of information was mainly through the clinic personnel (97.9%) as depicted in [Table 4].
| Discussion|| |
The age range of contraceptive users was from 15-49 years with a mean of 28 years. Women of the age group of 20-39 years constituted 93% of the new acceptors. Probably because this represents the reproductive age groups of most societies.
Women of low parity constituted 69.6% of the clients and the grand multiparous women constituted 28.1% as seen in [Table 3]. Progesterone only injectables and intrauterine devices were the main contraceptive methods used by these clients. This is similar to what was found by Mutihir and colleagues in Jos Northern Nigeria.  The acceptance of modern contraceptive methods by the new clients showed a steady rise over the period of study from 12.2% in 2005 to 32.1% in 2009. The reason for this may be due to increased contraceptive awareness campaigns and enlightenment programs by health workers and NGOs on the need for child spacing as a step in improving maternal and child wellbeing thereby reducing maternal and perinatal morbidity and mortalities.  Also the fact that family planning has been inculcated in our postnatal clinic, where women are referred to family planning clinic after the puerperium for advice on child spacing has contributed immensely in contraceptive awareness and acceptability among these clients. Other reasons could be due to the non-contraceptive benefits of these agents.
The progesterone only injectable contraceptives were the most accepted method of contraception in the clients, followed by intrauterine devices and OCPs. The findings in this study are different from that of Mutihir et al. in a suburban setting in Jos, north-central, Nigeria where OCPs was favored but closely related to a study by Ameh and co-workers  in Zaria where injectable accounted for 50.7% followed by intrauterine devices 22.5%. Factors that could be responsible for the choice of the injectable contraceptives among the clients in this study were probably due to convenience of the method, educational standard, compliance and the conservative nature of our society where women do not like exposure as required in other methods such as the intrauterine contraceptive devices  This study was also similar to the recently observed trend worldwide where many women are resorting to injectable contraceptives.  The reason for the increased use of the injectables from the studies were its long acting duration, which appeals to women living far away from the facility, convenience and effectiveness. The source of information for majority of the clients 97.9% was from the clinic personnel. This finding was similar to the findings of Boniface et al. This call for more community enlightenment on contraception. In a conservative society like ours, the husbands, religious and community leaders among others should be in the advocacy.
The contraceptive prevalence from the study (44.6%) is low when compared to the worldwide prevalence of 51%  as at 1991. However, the yearly trend showed progressive increase. This is probably due to the fact that modern methods of contraceptive are now increasingly being accepted in our community as a measure for child spacing. ,
The contraceptive needs of many communities especially in the developing countries and the world over are still unmet.  Worldwide, between 120 and 150 million women want to limit or space their future pregnancies but are unable to do so because family planning services are not available, inaccessible, unaffordable, and of poor quality or their use is restricted.  Contraceptive methods should be made available to women of all socioeconomic strata at affordable prices. Access to contraception must generally be improved upon. Health care providers should be trained on how to offer counseling services to all clients in order to improve their acceptance of contraceptives. Young persons should be targeted early in their lives to inculcate in them a positive attitude toward family planning including the use of emergency contraceptive pills to prevent unwanted pregnancy.
None of the subjects in this study was a male. This may be due to inadequate information available male methods of contraception. Outreach effort by the community health workers, targeting men with family planning messages is likely to be effective in initiating male contraceptive use. 
| Conclusion|| |
The acceptance rate of contraception in our environment is generally low though the prevalence is increasing and the commonest method of contraception was progesterone only injectables and the clinic personnel were the source of information in the majority of the clients
| References|| |
|1.||Emuveyan EE. Advances in contraception. Comprehensive gynaecology in the tropics. Accra, Ghana: Graphic Packaging Limited; 2005. p. 233-41. |
|2.||Nnatu S. Female sterilisation techniques update. J Obstet Gynaecol East Cent Afr 1984;4:187-91. |
|3.||Arkutu A. Family Planning in Sub-Saharan Africa: Present Status and Future Strategies. Int J Obstet Gynaecol 1995;2(Suppl 50):27-34. |
|4.||Mutihir JT, Dashala HL, Madaki JKA. Contraceptive pattern at a comprehensive Health Center in a Sub- Urban Setting. Trop J Obstet Gynaecol 2005;22:144-6. |
|5.||Ross JA, Winfrey WL. Un-met need for contraception in the developing world and the former Soviet Union: An updated estimate. Int Fam Plann Perspect 2002;28:138-44. |
|6.||Causes of maternal illness and death. In: Programming for Safe Motherhood, Guidelines for Maternal and Neonatal Survival, 1 st ed. United Nations Children's Fund, UNICEF Headquarters, Health Section, Programme Division, 1999. p. 16-25. |
|7.||Ross J, Stover J. Family Planning Programme Effort Index: 1999 cycle. Int Fam Plann Perspect 2001;27:119-29. |
|8.||Drife JO. New development in contraception. Progress in Obstetrics And Gynaecology. In: Studd, editor. 7 th ed. Edinburgh: Churchill Livinstone; 1989. p. 245-58. |
|9.||Ladipo OA. Contraception and Sterilisation. Textbook of Obstetrics and Gynaecology for Medical Students. In: Agboola A, editor. Vol. 1. Lagos: University Services Educational Publication Ltd.; 1988. p. 189-202. |
|10.||Akinkube A. Fertility regulation, contraception and family planning. Textbook of Obstetrics and Gynaecology. Vol. 40. Ibadan: Evans Brothers (Nigerian Publishers) Ltd.; 1996. p. 435-62. |
|11.||Ameh N, Sule ST. Contraceptive choices among women in Zaria, Nigeria. Niger J Clin Pract 2007;10:205-7. |
|12.||Bertrand JT, Seirber E, Escudero G. Contraceptive dynamics in Guatemala. 1978- 1998. Int Fam Plann Perspect 2001;27:112-8. |
|13.||Oye-Adeniran BA, Adewole IF, Umoh AV, Oladokun A, Ghadegsin A, Ekanem EE, et al. Community-based study of contraceptive behaviour in Nigeria. Afr J Reprod Health 2006;10:90-104. |
|14.||Emuveyan EE. Contraceptive update. National Revision Course. Lagos, 2010. |
|15.||Age of Consent - Nigeria. Action Health incorporated. Available from: http://www.siecus.org/inter/Nigeria/acti/acti0002.Html. access 20/06/13 |
[Table 1], [Table 2], [Table 3], [Table 4]