ABSTRACT

This study was designed to identify the factors associated with the use of family planning methods among women in Enugu State, with particular reference to Aji in Igbo-Eze North Local Government Area (LGA). The researcher assessed the acceptance of the different family planning methods in Aji, examined how aware the people of Aji are of the existence of family planning methods, evaluated the effect of family planning on the well-being of the family, and examined the relationship between family planning and family well-being. Data were obtained from primary and secondary sources. Primary data were collected through questionnaires and oral interviews, while secondary data came from journals and other relevant materials, and an extensive review of direct and indirect literature on books, journals and past works was carried out. The questionnaire was structured and contained both closed and open-ended questions. The data were analysed using simple tables and percentages. The study found that the methods of family planning used in the Aji community are traditional methods, contraceptive measures, conventional methods and withdrawal. The people of Aji are aware of the existing methods, and family planning has a positive effect on the well-being of the people. A significant relationship was also found between family planning and the well-being of families in the community. Based on these findings, the study recommends that couples plan their families according to the practices advised by the Planned Parenthood Federation of Nigeria, whose services are available free of charge in family planning clinics across the country. It also recommends that sex education be encouraged in the community and in society at large in order to reduce teenage pregnancy and child dumping.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

The family is a social institution that brings individuals together in cooperative groups responsible for bearing and raising children and socialising them into society. Families exist in every society, although their forms vary. A family usually consists of a husband, a wife and their children, who live together, share resources and work together. Because the stability of a nation depends largely on the stability of its families, the future of any society depends on the health and development of the young people raised in them.

Family planning is the practice by which couples and individuals decide whether to have children, how many to have and when to have them. It allows people to space or limit births so that each child is wanted and can be given a good start in life, and it enables individuals and couples to realise their potential and contribute more fully to social and economic development. Its benefits are especially important for women who are very young or who are approaching the end of their childbearing years, and for rural communities such as Aji, where services and amenities are often limited.

In Nigeria, family planning is closely connected with the pace of population growth. Fertility has declined over time, with the total fertility rate falling from 6.3 children per woman in the 2008 Nigeria Demographic and Health Survey (NDHS) to 4.8 in the 2023–24 NDHS, but it remains much higher in rural areas (5.6) than in urban areas (3.9) (Federal Ministry of Health and Social Welfare [FMoHSW], National Population Commission [NPC], & ICF, 2024). Such growth places pressure on the country's ability to provide the services that raise the quality of life, including food, health care, education, housing and employment.

The NDHS shows that use of family planning has risen but is still low. Among currently married women aged 15 to 49, 20% used any contraceptive method and 15% used a modern method in 2023–24, compared with 6% and 4% in 1990. About 21% of married women had an unmet need for family planning, total demand stood at 41%, and only 37% of that demand was met with modern methods (FMoHSW, NPC, & ICF, 2024). Use differs sharply by place and education. Modern use among married women was 22.4% in urban areas against 10.2% in rural areas, and contraceptive use of any kind rose from 7.4% among women with no education to 41.3% among women with more than secondary education (FMoHSW, NPC, & ICF, 2024).

The pattern in Enugu State differs from the national one in a way that is important for this study. Among married women in Enugu, 25.9% used any method but only 11.2% used a modern method, and 14.6% relied on traditional methods, mainly withdrawal (13.0%). Unmet need was 23.6%, and only 22.6% of the demand for family planning was satisfied by modern methods. The South East zone as a whole shows a similar pattern, with 29.8% of married women using any method, of whom nearly half relied on traditional methods (FMoHSW, NPC, & ICF, 2024). This is consistent with the methods reported in Aji, where traditional methods and withdrawal are prominent.

Research across Nigeria has identified many reasons for low uptake of modern methods. In a systematic review, Akamike et al. (2020) grouped them into client-related factors, such as fear of side effects, religious beliefs, partner disapproval, education and marital status, and health-service factors, such as difficulty in accessing services, cost, stock-outs and providers who restrict access by age, parity or marital status. Provider knowledge and attitudes also matter. Adigwe and Onavbavba (2025) found that more than half (58.1%) of community pharmacy staff surveyed in the Federal Capital Territory had poor knowledge of contraceptive use, and they noted that biased attitudes, inadequate training and poor communication about methods can limit access. Ayamolowo et al. (2026) similarly identified user-related, provider-related and health-system barriers to family planning in rural south-west Nigeria.

Igbo-Eze North LGA in Enugu State is largely rural. Government and non-governmental agencies, including the Planned Parenthood Federation of Nigeria (PPFN), have supported family planning services through information, education and communication activities, counselling and outreach. The NDHS reports results for states but not for individual LGAs, so little is known about how women in Aji use family planning, and why. The consequences of low use of modern methods, especially for the health of mothers and children, make this a matter of concern, and it is the reason for this study.

1.2 Statement of the Problem

Unmet need for family planning is a major obstacle to the well-being of women and children in developing countries. Many factors affect women's access to services and their decisions about contraception, and although scholars have examined them extensively, they have not been resolved. In Nigeria, use of family planning has improved over time, but many women who want to space or limit births still cannot obtain or do not use an effective method. Non-use affects the health and well-being of the woman and her children. Unplanned and unintended pregnancies contribute to poor health outcomes for mothers and children, and the risks of HIV and other sexually transmitted infections are greater where access to quality care is limited, as in many rural areas.

In Enugu State, married women rely heavily on traditional methods, and less than a quarter of the demand for family planning is satisfied by modern methods (FMoHSW, NPC, & ICF, 2024). Aji, in Igbo-Eze North LGA, is a rural community where the factors behind this pattern have not been documented. This study therefore examines the factors associated with the use of family planning methods among women in Aji.

1.3 Rationale of the Study

Unplanned and unintended pregnancies account to a large extent for the poor health of women and children in many developing countries. Women's ability to control their own health and that of their children is limited by social and environmental factors that restrict their power to decide freely on reproductive and sexual matters. Some questions about local conditions remain unanswered, and they continue to affect the choices that vulnerable women are able to make about childbearing.

This study was conducted to provide local, context-specific information from women in a rural community. This information can be used in the design, administration and implementation of family planning programmes in Igbo-Eze North LGA and in similar rural areas. It also examines how knowledge, socio-economic characteristics, service-delivery factors and staff attitudes are connected to the use of contraception.

1.4 Research Questions

1. How does the background of women in Igbo-Eze North LGA influence their knowledge of contraceptive use and choice?
2. To what extent do the socio-economic characteristics of women influence their decisions on contraceptive use in Igbo-Eze North LGA?
3. What factors account for the low patronage of family planning methods in Igbo-Eze North LGA?
4. What effect does staff attitude have on women's access to family planning services at public service points in Igbo-Eze North LGA?

1.5 Objectives of the Study

1.5.1 General Objective

The general objective is to assess the extent to which prospective users perceive, and are influenced by, local factors in using contraceptives, and to examine the contextual factors that have contributed to the consistently low use of contraception in Aji, Igbo-Eze North LGA.

1.5.2 Specific Objectives

The specific objectives are to:

1. determine respondents' knowledge of contraceptive use and choice in relation to their social backgrounds;
2. assess the extent to which the socio-economic characteristics of women in Aji, Igbo-Eze North LGA influence their decisions on the use of family planning methods;
3. identify the factors that account for the low patronage of contraceptive methods in Igbo-Eze North LGA and assess their correlates among the women;
4. examine the extent to which staff attitude at public service centres affects women's decisions to access family planning; and
5. make recommendations to major stakeholders and suggest areas for further research.

References

Adigwe, O. P., & Onavbavba, G. (2025). Knowledge, attitudes, and practices regarding contraception amongst community pharmacy staff: A cross-sectional study in Nigeria. Frontiers in Reproductive Health, 7, Article 1488707. https://doi.org/10.3389/frph.2025.1488707

Akamike, I. C., Okedo-Alex, I. N., Eze, I. I., Ezeanosike, O. B., & Uneke, C. J. (2020). Why does uptake of family planning services remain sub-optimal among Nigerian women? A systematic review of challenges and implications for policy. Contraception and Reproductive Medicine, 5, Article 30. https://doi.org/10.1186/s40834-020-00133-6

Ayamolowo, L. B., Rall, N. N., & James, S. S. (2026). Perspectives among postpartum women, men, and healthcare providers on barriers to family planning services in rural Nigeria. African Journal of Reproductive Health, 30(11). https://doi.org/10.29063/ajrh2026/v30i11.4

Federal Ministry of Health and Social Welfare [Nigeria], National Population Commission [Nigeria], & ICF. (2024). Nigeria Demographic and Health Survey 2023–24: Key indicators report. NPC and ICF. https://dhsprogram.com/pubs/pdf/PR157/PR157.pdf