Family Planning: Breaking the walls of misconception and creating confidence
By Augustina Armstrong-Ogbonna
When Taiwo Ogunfayo, a 33-year old interior decorator visited a private hospital for her family planning treatment, she was told that she would not conceive in the next three years.
But five months after undergoing the Depol family planning method, she became pregnant.
“I gave birth to my second child through caesarean section and wanted to space so as to heal from the operation. I took Depol family planning method which is meant to last for 90 days, but I guess the nurse did a calculation of 84 days and I got pregnant,” she said.
Fifteen months later she was a patient at one of Planned Parenthood Federation of Nigeria (PPFN) facility in Ibadan, the Oyo State capital in southwest Nigeria.
Oyo state was chosen due to its high performance of the previous family planning project. The just concluded Expanding Sexual and Reproductive Health Project was a 9months pilot targeted at five local government area in the Ibadan Municipal
The PPFN facility is located on Liberty Stadium road same as the PPFN Southwest Regional Office in Ibadan, Oyo state. It is behind the Sports Stadium.
The reception was filled with about 30 women of different age group waiting turns. It can be called a women’s center. It has one room that serves as an operating theater, another room for counseling, a place that seems like a kitchen as medical equipment were sterilized for different operations. With some adjoining rooms. Within the 5hours I was at the facility, about fifty women have gone in and out of this small space that I believe can be expanded to accommodate more women.
Taiwo narrated her encounter with PPFN:
One day, I was in the market when I came across a PPFN outreach. The way the Community Health Extension Workers were explaining the different family planning methods was very simple to understand. I had my fears because of my last experience at the private hospital. But a friend, who has benefitted from PPFN services encouraged me to give it a trial. I trust their judgment that is why I am here (at PPFN)” Taiwo said profoundly as she blamed her second attempt at family planning on inexperience of nurses at the private clinic.
The calculation they gave before administering the method, is different from what I was told here at PPFN. I have come across a lot of women since my first visit to this place and they all assured me that family planning works and it won’t fail like the previous one.
I gave birth to my second child through caesarian section operation and the doctor advised me on spacing before my next pregnancy. So you can imagine how devastated I was when I discovered I was pregnant 5-months after receiving the Depol family planning method. But I am glad; I didn’t allow that experience shut the door to family planning method for me. If not I won’t be here today.
Lack of adequate information is creating misinformation and wrong perception about family planning as affirmed by Taiwo who claims that “a lot of women have all sorts of beliefs and perception about family planning, with some tied to religion and culture”, hence the need for more PPFN outreaches.
The campaign for some non-communicable diseases like polio is believed to have received more awareness level than family planning. Though Polio is not an issue in Ibadan but Taiwo believes the campaign for Polio is more intensified in the media than family planning.
Taiwo is of the opinion that if the level of awareness for family planning is intensified, it will record a high level of success.
“The outreach that was carried out was the avenue I used in coming in contact with them. The interesting thing about the Planned Parenthood Federation of Nigeria project in Oyo state is that all the family planning methods are free. At no cost to the patient. I paid at the private hospital and it still failed but here it free” she lamented.
Since its launch in Ibadan, the PPFN regularly holds public outreach across the state with its well trained and professional Community Health Extension Workers (CHEW). These outreaches enable direct contact with women on the need to plan their family.
It was launched in January 2015 to improve on a cluster system that already existed, but the cluster only had focused medical agenda during outreaches. Like if an outreach was upcoming, it could focus only on cervical cancer screening. But with the launch of the pilot phase of the cluster model plus system, outreach can best be described as a one-stop shop for integrated services.
These services include; breast and cervical cancer screening, counseling and administration of all family planning methods. Also when a woman is detected to have an early stage of cervical cancer, she is immediately scheduled for cryotherapy. There was also treatment like Bi-Lateral Tubal Ligation BTL which is performed on women who have decided to stop bearing children.
Dr. Adebisi Olasunkani who is the Medical Director of Ramoth-Gilead Hospital is one of the ten facilities involved in the cluster model project of the PPFN in Ibadan.
He explained with delight the success of a BTL operation he performed during an outreach:
A mid-aged woman was in one of our outreaches at Apata area of Ibadan in Oyo state. After counselling, she decided she wanted to close her womb as she had no plans to bear children any longer. The operation lasted about 30 minutes. The woman was so surprised at how fast the surgery took place.
Dr. Adebisi said that was one of his best moment during the 9months pilot project of the PPFN.
The cluster plus model of the Expanding Sexual and Reproductive Health was able to conduct outreaches in the five local government area that was selected for the pilot phase of the project.
The PPFN Community Health Extension Workers (CHEW) that were engaged for the outreaches, in different public places like markets, motor parks also go from house to house to educate women and girls on the need to undertake family planning.
Omolara Afolabi a 32-year old CHEW who has been working with the PPFN project for over a year said their work involves breaking down the meaning of family planning to people in rural communities.
“On the field, I discovered lots of misconception and misinformation, fears and rumors about family planning. But my job is to educate them on the benefits of family planning and allay their fears.”
According to Omolara, “some people just have this belief that they won’t get pregnant again if they start using planning method.”
“I discovered that some women prefer to use the injectable family planning method more than the implants. And this is due to fear that for implants they will under surgical operations, but this is not the case. We keep educating them and breaking the walls they have built around family planning methods”.
Omolara further explained that the outreach period is the best times for her. “I so much look forward to it. It is a time to help women make better choices that will help them plan for their family and future. The fact that the family planning method is administered free has contributed to its high level of acceptance by the people. In some of our communities, the people are so poor that they can’t feed properly. Let alone to have money for family planning. Poverty is real and not planning your family, escalates the challenges of having a quality life. No money should mean fewer children. But the reverse is the case in the midst of poverty, ignorance and low level of education.”