Maternal, infant mortality: Experts recommend FP interventions
Maternal, infant mortality: Experts recommend FP interventions
NAN-HG-3
Planning
By Reporters
Abuja, July 11, 2017 (NAN) Family Planning experts have recommended interventions in the use of Family Planning (FP) methods as the most cost effective ways to prevent maternal, infant and child mortality in Nigeria.
They spoke in separate interviews with the News Agency of Nigeria (NAN) in Lagos to mark this year’s World Population Day (WPD).
The event is celebrated annually on July 11, and the 2017 theme is: “Family Planning, Child Spacing: Empowering People, Developing Nations’’.
The experts also called for improvement in maternal and child healthcare services in the nation’s health facilities, as well as enlightenment of the public on the meaning and use of birth control or FP.
The experts include Dr Olawale Oba, a Senior Registrar, Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital (LUTH); and Mr Oladeji Adeyemi, the Project Co-ordinator, Association for Reproductive and Family Health (ARFH).
Dr Edun Omasanjuwa, the Lagos State Team Leader of an NGO, Nigerian Urban Reproductive Health Initiative (NURHI), also fielded questions on the subject.
Adeyemi described FP as one of the most cost effective ways to prevent maternal, infant and child mortality.
He said FP helps to save women and children’s live and preserves their health by preventing untimely and unwanted pregnancies.
Adeyemi advised couples to make use of available FP methods to promote small family sizes and avoid effect of population growth.
According to him, achieving the desired population growth rates will require expanded access to FP, especially in some rural areas.
He said that most women in the rural areas do not know of FP due to lack of awareness and access to family planning services.
“The lack of family planning which led to an increase in Nigeria population is as a result of lack of women education and poverty.
“The only way to prevent this is by enlightening the public on the meaning and use of birth control or family planning.
“It is important to know that family forms the society and population which can determine the growth and development of the country,” Adeyemi said.
He said that this would also prevent women’s exposure to health risk of child birth and abortion.
“The most appropriate or best method to recommend to families or couples will depend on certain medical eligibility which can be determined after consultation with a medical officer,” he said.
Adeyemi said that there were different modern FP methods including the use of contraceptives such as pills, injections, intrauterine devices and sterilisation.
He said that different FP methods had made it possible for women and couples to space the births of their children which also help to reduce the overpopulation rate in Nigeria.
Adeyemi listed the benefits of different FP methods to include pills which he said were highly effective if used correctly and suitable for all reproductive age groups.
“It offers some protection against cancers of the endometrium and reduces the risk of ectopic pregnancy.
“Injections have minimal client dependence, make sickle cell crises less frequently and less painful and reduce symptoms of endometriosis.
“Intraceptive implant are effective immediately if inserted within the first seven days of menstrual cycle and very safe for majority of women.
“Intrauterine contraceptive device are reversible, independent of intercourse, have no effect on lactation, but do not protect against sexually transmitted diseases,” he said.
Adeyemi said that child spacing was very important due to the country’s socioeconomic and for a better living.
He said that the recommendation of having two or three children with spacing of three or four years would help the families and population growth.
A Senior Registrar, Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital (LUTH), Dr Olawale Oba, said that FP play a vital role in developing the nation’s economy and women’s health.
Oba said that the use of contraception was beneficial to the society in improving both the economic and psycho-social wellbeing of a family.
According to him, FP is a way of reducing fertility and family size such that there can be sufficient economic power.
“Family planning is important because it allows us to have a small family that can be taken care of and also build economic capability.
“When there is limited family size, we will have limited responsibility and increased financial capability that will improve the economy at large.
“When financial capability is improved, our social and psyche will also improve, which are components of good health because health is not just the absence of diseases, but it’s encompassing.
“Mentally, physically, socially, economically, a lot of things are imbedded in good health and wellbeing, this is why we cannot exhaust the importance of contraception,” he said.
Oba said that natural methods include the withdrawals style or using the calendar to calculate safe and unsafe periods.
“This is the period of fertility and that during this period of safety, couples can copulate safely without the anticipation of pregnancy.
“However, there are a lot of things that may preclude the use of these natural methods.
“For instance, in the withdrawal method, many men are not in total control of their ejaculation during intercourse.
“So, they cannot accurately do the withdrawal method, even before the feeling of ejaculation, there are seminal fluids already that would have been released.
“Which in actual fact is what contains the sperm cells that lead to pregnancy; so, it is a bit difficult to use this method very effectively.’’
Oba said that the use of calendar to calculate the safe periods was sometimes inaccurate for many women who thought they knew their safe period and avoid sexual intercourse for the latter part of the period.
“The drawback of this method is that many women do not have a stable cycle length; some have elongated cycle length, while some have shortened cycle length and in that way, it creates some imbalance within this calculation.
“But, with the help of trained health personnel or family planning experts, they will be able to tell precisely what and when are these periods depending on the cycle length of every woman.
“Beyond that, there are hormonal methods that varies in administration, some are taken by mouth, injection and patch.
“By applying things that look like gum on the skin and it releases the hormone during the period of the menstrual cycle, creating contraception or giving cover against pregnancy,’’ he said.
The expert said that for the Oral Contraceptive Pills (OCPs), women took them everyday of their cycle for 28 days.
He said that this method was actually good in young women who do not have any serious medical condition that could contradict its usage.
“It is important to always speak with a family planning expert before using any of these hormonal methods in order to be properly guided in which is better for them.
“Because, there are different criteria used for different patients to determine what is best; there is no one perfect contraceptive method for every individual,” he said.
Oba urged the government and non-governmental organisations to create more awareness about the importance of FP.
He said that this would increase the uptake of the use of contraceptives and acceptance of family planning in the society.
“Right now, there is an issue of unmet needs that is the number of women who actually need contraception, but are not getting them.
“This is not because the contraceptives are not available, but information may not be reaching them and also limitations to getting to them.
“With a wide range of advocacy, there will be improvement in the use of contraception, which will eventually give us a better living,” he said.
The expert also said that there should be adequate awareness on the reversal methods in the use of contraceptives.
“It is very important for women to know that different contraceptive have a degree of time after discontinuing, reversal for fertility is almost like you never used it before.
“For example, women that had hormone based contraceptive for two or three months and stop, within a month, they are reversed and can get pregnant.
“However, some women sometimes have delay; it is not because of the contraceptive they have used in the past, this should be clearly stated such that it won’t be a point of withdrawal from women in using contraception,’’ he said.
Another expert, Mr Oma Sanjuwa, said: “According to the 2013 National Demography and Health Survey Report, Nigeria has continued to report very high maternal deaths.
“This is arising from complications of pregnancies and child birth. Currently, 576 women per 100,000 lives birth die every year from complications of pregnancy and childbirth.
“Among those things we can do to drastically reduce the number is the promotion of FP, because evidence has shown that FP alone can reduce the number by at least 30 per cent.
“When you add that to a robust and healthy system, you will see that number crashing drastically.
“So, while we advocate for the use of FP, we also advocate for the improvement of maternal and child healthcare services in our health institutions.
“By the time we combine these interventions, you will see that our maternal mortality and also infant and under five-year-old mortality will reduce drastically.
“This is cost-effective and not too expensive interventions.’’
The expert said that apart from saving the lives of women, FP would empower women to be financially stable.
According to him, such empowerment automatically translates to the health of the family.
“Once a woman is empowered and financially stable, automatically, the family becomes stable as well.
“So, that is even better outcome, not just for the woman, but also for the family in general.
“We can get it right by getting lots of women who naturally want to space their births or stop having children.
“Once we can do that, first of all, we will be reducing the risks associated with pregnancy, helping the mothers to recover properly before they become pregnant next time.
“Also, the period when the woman has stopped having children, she can be engaged in a trade, business or job.
“She can generate income for the family and overtime she can save and pull her family away from poverty,’’ he said.
Sanjuwa said from the surveys that had been carried out, awareness and knowledge of at least one form of FP in the country was generally high.
He said that the knowledge of not transferring to actual use was relatively low.
“Our organisation is making effort to re-educate people on what exactly what FP is; lots of people have erroneous beliefs about FP.
“So, it is going to take a bit of work to begin to change their beliefs and then change their attitude which will then change their behaviour.
“We know the impact of culture and religion on the attitude and behaviour of people.
“So, we preach the message of FP coming from the cultural perspective and religion angle.
“We explain to them how our culture in the past had supported FP; we also use biblical passages and passages from the Qur’an.
“All these have been pushed into the community to make people understand that their religion actually supported FP and we also educate the traditional and community leaders,’’ he said. (NAN)
AOI/OKG/EEI/GOK/MST
Edited by Olagoke Olatoye/Muhammad Suleiman Tola