ACCESS AND USAGE OF FAMILY TRAINING MATERIAL BY WOMEN ATTENDING FAMILY PLANNING CLINICS IN HOSPITALS IN KADUNA STATE OF NIGERIA
Abstract
This study investigated access and utilization of family planning information by women attending family planning clinics in hospitals in Kaduna State. To achieve the objectives of the study, four research questions were raised, among which are; what factors influence seeking for family planning information by women attending family planning clinics in hospitals in Kaduna State, what types of family planning information are accessible to women attending family planning clinics in hospitals in Kaduna State. A quantitative research methodology using survey design was adopted while structured questionnaire was the instrument used for data collection. The responses from the population of 17,029 with total of 3,406 (20%) sampled women attending family planning clinics in hospitals in Kaduna State were studied and analyzed descriptively; using frequencies, percentages, mean scores and standard deviations. The findings revealed that prevention of unplanned pregnancy and improvement on child and maternal care were the most important factors influencing women seeking for family planning information. Information on birth control was the accessible type of family planning information to women in the hospitals in Kaduna State. The type of information sources utilized by women for accessing family planning information were doctors, nurses and mid-wives. While information on birth control and information on healthy timing and spacing of pregnancy were considered to be highly utilized by the women. The study concluded that women who attend family planning clinics in hospitals in Kaduna State generally accessed and utilized family planning information. However, they did not fully explore information resources or sources such as radio, television, friends/relatives, visual photographs, posters, audio (tape/CDs, video (tape/DVDs), newspapers/magazines, library and/or information centres. The study recommended among others that hospitals should encourage women attending family planning clinics in hospitals to seek for current awareness on contraceptive use, avoiding daily premature death and healthy timing and spacing of pregnancy and hospitals should provide the various types of family planning information such as information on birth control, information on healthy timing and spacing of pregnancy, antenatal information and postnatal information on a wider scale to the women.
TABLE OF CONTENTS
Title Page…………………………………………………………………………………………..i
Declaration…………………………………………………………………………………………ii
Certification………………………………………………………………………………………iii
Dedication…………………………………………………………………………………………iv
Acknowledgement…………………………………………………………………………………v
Abstract……………………………………………………………………………………………vi
Table of Contents…………………………………………………………………………………vii
List of Tables………………………………………………………………………………………x
List of Abbreviations……………………………………………………………………………..xi
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study…………………………………………………………………1
1.2 Statement of the Problem…………………………………………………………………..6
1.3 Research Questions………………………………………………………………………7
1.4 Objectives of the Study…………………………………………………………………..8
1.5 Significance of the Study…………………………………………………………………..8
1.6 Scope of the Study……………………………………………………………………….9
1.7 Operational Definition of Terms…………………………………………………………..9
References………………………………………………………………………………11 CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.1 Introduction………………………………………………………………………………13
2.2 Concept of Information…………………………………………………………………..13
2.3 Concept of Family Planning Information……………………………………………….16
2.4 Information Seeking Behaviour…………………………………………………………17
2.5 Types of Family Planning Information Accessible……………………………………..21
2.6 Type of Information Resources Utilized………………………………………………..24
2.7 Extent of Utilizing Family Planning Information………………………………………26
2.8 Summary of the Review…………………………………………………………………28
References………………………………………………………………………………30
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Introduction………………………………………………………………………………36
3.2 Research Methodology adopted for the Study…………………………………………….36
3.3 Population of the Study…………………………………………………………………..37
3.4 Sample Size and Sampling Technique…………………………………………………….38
3.5 Instrument for Data Collection…………………………………………………………….40
3.5.1 Questionnaire…………………………………………………………………………….40
3.6 Validity of the Instrument…………………………………………………………………41
3.7 Reliability of the Instrument………………………………………………………………41
3.8 Procedure for Data Collection……………………………………………………………43
3.9 Procedure for Data Analysis………………………………………………………………43 References…………………………………………………………………………………44 CHAPTER FOUR: DATA PRESENTATION, ANALYSIS AND DISCUSSION
4.1 Introduction…………………………………………………………………………….46
4.2 Response Rate………………………………………………………………………….46
4.3 Data Analysis…………………………………………………………………………..48 References………………………………………………………………………………54
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1 Introduction…………………………………………………………………………….55
5.2 Summary of the Study………………………………………………………………….55
5.3 Summary of the Findings………………………………………………………………..56
5.4 Contribution to Knowledge…………………………………………………………….57
5.5 Limitations of the Study………………………………………………………………..57
5.6 Conclusion………………………………………………………………………………57
5.7 Recommendations………………………………………………………………………58
Bibliography……………………………………………………………………………..59
Appendix A……………………………………………………………………………..67
Appendix B……………………………………………………………………………..70
Appendix C……………………………………………………………………………..71
LIST OF TABLES
| Table 3.1: | Sample Size of the Respondents…………………………………………………39 |
| Table 3.2: | Split-half Test of the Pilot Study…………………………………………………42 |
| Table 4.1: | Questionnaire Returned Rates……………………………………………………47 |
| Table 4.2: | Factors Influencing Seeking for Family Planning Information by Women
Attending Family Planning Clinics in Hospitals in Kaduna State………………………………………………………………………………48 |
| Table 4.3 | Types of Family Planning Information Accessible to Women Attending Family
Planning Clinics in Hospitals in Kaduna State…………………………………..50 |
| Table 4.4: | Type of Information Resources Utilized by Women Attending Family Planning
Clinics in Hospitals in Kaduna State…………………………………………………51 |
| Table 4.5:
|
Extent to which Women Attending Family Planning Clinics in Hospitals in
Kaduna State Utilize Family Planning Information…………………………………..52 |
LIST OF ABBREVIATIONS
| AV | Audio Visual |
| CC | Cronbach‟s Coefficient |
| CDs | Compact Discs |
| DVDs | Digital Versatile Discs |
| eHealth | Electronic Health |
| FP | Family Planning |
| FPI | Family Planning Information |
| H1 | First Test |
| H2 | Second Test |
| HIV | Human Immunodeficiency Virus |
| HTSP | Healthy Timing and Spacing of Pregnancy |
| ICPD | International Conference on Population and Development |
| ICTs | Information and Communication Technologies |
| IRs | Information Resources |
| ISB | Information Seeking Behaviour |
| UNFPA | United Nations Population Fund |
| WHO | World Health Organization |
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
The family which starts as a group of husband and wife and their children living together as a unit is the building block of society. The family is the principal institution for socialization which metaphorically creates more inclusive categories such as community, nations, humanism and in modern age global village. According to Abbot and Wallace (1992), the family prepares people for the rest of their lives and it is women that run it. Therefore, women health concerns must be prioritized to ensure that the society is a place for all. Family Planning (FP) is one of the greatest public health achievements in human history because it has pooled together male and female partners to support the well-being of women of child bearing. For instance, it allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their children. It protects the health of the mother and the outcome of each pregnancy. FP also allows parents the time and space to determine if they are able to care for more children; increasing the likelihood that any further children they have will be able to access healthcare, education, and other services.
FP, in its basic meaning, is defined as the use of various methods of fertility control that will help individuals (men and women) or couples to have the number of children they desire and when they want them in order to ensure the wellbeing of children and the parents (Oluwole, Kuyinu, Goodman, Odugbemi & Akinyinka, 2016). Nigeria is not left behind in the support of women‟s healthcare, among the black nations in the world today; it is the most populous and recent estimates indicate a total population of 177 million people with a growth rate of 3.2% and a total fertility rate of 5.5 lifetime births per woman (Salami & Oladosu, 2016). To cater for the wellbeing of its people, Nigeria adopted its first population policy in 1988 titled “National Policy on Population for Development, Unity, Progress and Self-reliance” (Federal Republic of Nigeria, 1988). An important goal of this policy is to make Family Planning Information (FPI) accessible to every household in the nation. FP programmes exist in virtually every nation (Babalola, Babalola & Oladimeji, 2012). According to Seltzer (2002), as at 1998, 179 countries with 99 percent of the world‟s population had some form of FP programmes, however, very little progress has been achieved ever since. Women do not subscribe to the policy, and mothers of child bearing age give birth to children every other year, subjecting at times mother and child to high risks.
The reasons are that the policy targets are not being met and influenced by numerous factors that include poor diffusion of information, weak programming, inadequate resources, weak institutional framework and a lack of strategic planning (Babalola et al., 2012). Despite their pervasiveness, FP programmes have caused controversy and drawn criticisms from a variety of perspectives, primarily for two reasons. Firstly, they deal with a sensitive subject: birth control. Secondly, concern about the negative effects of rapid population growth and high fertility in developing world. Seltzer (2002) asserts that there was widespread optimism that establishing FP programmes to distribute contraceptives on a large scale would help achieve several policy objectives: especially those aimed at reducing population growth and (unwanted) high fertility and thus boosting standards of living; improving women‟s health and quality of life by helping them avoid unintended pregnancies and abortion; and advancing the right of women to plan their families. These three distinct but interrelated objectives, or rationales have furnished the legitimating premise for FP programmes from the beginning:
Demographic rationale: concerns reducing high fertility rates and slowing population growth provided the dominant rationale for FP programmes in the 1960s and 1970s. This rationale was based on concerns over the potentially negative effects of rapid population growth and high fertility on living standards and human welfare, economic productivity, natural resources and the environment in the developing world (Seltzer, 2002).
Health rationale: during the 1980s, a different set of concerns became paramount; the public health consequences of high fertility for mothers and children. High rates of infant, child and maternal mortality, as well as abortion and its health consequences, were pressing health problems in many developing nations and had also become of greater concern to international development agencies. High maternal mortality was associated with high-risk circumstances that FP could help to address. These included a high number of pregnancies, births to older and younger women and pregnancies that were unintended. In addition, closely spaced births were associated with higher rates of infant morbidity and mortality. This rationale extended to issues of equity: Government-sponsored FP programmes could provide poor women with the same access to services that wealthier women already enjoyed through private physicians.
Human rights rationale: this rationale became pre-eminent in the 1990s, in part because of reactions to excesses under the demographic rationale. The human rights rationale rests on the belief that individuals have a fundamental right to control reproductive decisions, including family size and the timing of births. This rationale found its strongest articulation at the International Conference on Population and Development (ICPD), held in Cairo, Egypt, in 1994. All the three rationales that is demographic, health and human rights have existed from the early days of FP programmes, but they have been given different emphasis over time. FP helps women decide when to have a baby in such a way that both the mother and baby stay healthy. FP is more than just birth control. It includes screening services that help find serious health problems, such as low blood iron, high blood pressure and infections sooner (Seltzer, 2002).
Khan (2015) notes that information in the present-day context is not merely a „piece of data‟ but rather the “life blood” of the scholarly world. Information is power; it is the great national and international resource. Information is the result of processing, manipulating and organizing data in a way that adds to the knowledge of the receiver. Information, which is a catalyst for change, has become as important as life itself. Information is substantially different from data in that data are raw unevaluated messages. Information is the increase in knowledge obtained by the recipient by matching proper data elements to the variables of a problem (Ochai, 2007). Information, being awareness on a given situation or phenomenon which propels one into action must be valid and usable. According to Chimah and Nwokocha (2013), if information is valid but not usable it is (outdated or obsolete) and if usable but not valid it is (gossip or grapevine). On the contrary, if the sourcing variables are greater than its usability the information is said to be invalid. We survive as human beings, because we accurately record the sound, sight, smells, tastes and texture of our environment which are information (Aina, 2004).
FPI is that information that is collected and organized in a specialized way by subject field, type of source material, persons served, location, or type of services. According to
University Research Company (n.d.), FPI is defined as health communication and behavior change strategies to enable individuals, families, communities and societies to increase control over and improve their health. For better health outcomes, the strategies include: Advocacy which aims at securing leaders’ commitment to policies and programs that support health and promote changes in social conditions that contribute to disease and vulnerability; Eduentertainment, based on tradition and popular culture and specific to the geographic context, entertains and engages while it transmits important messages and encourages dialogue and interaction. Edu-entertainment includes popular theater, puppetry, music, dance, pageants, festivals and more; ICTsand eHealth strategies range from health data collection and storage to information-based and interactive web and mobile applications for health.
These strategies leverage the increasing access to ICTs to improve decision-making and performance by providers and clients and facilitate communication in remote areas where infrastructure is less developed; Information, education and communication strategies rely on job aids, interpersonal communication and other methods to improve health workers’ performance, remind caregivers to perform frequently omitted tasks, encourage individuals to make positive changes in healthcare seeking and behaviors, and create demand for health services; Mass media, such as radio, television, billboards and newspapers, complement other media to raise awareness and increase knowledge of health concerns, stimulate audiences to seek services and promote social norms that favor healthy practices; Social and communitymobilization engages civil society and community organizations to promote social norms that support collective health objectives and challenge harmful practices.
1.2 Statement of the Problem
Women in Kaduna State are expected to access and maximally utilize family planning information in hospitals as one of their major information resources. Family planning information is an important factor in having a meaningful life both for the individual family and the nation as a whole as it is rightly said that a healthy nation is a wealthy nation (Chukwuji, Tsafe, Sayudi, Yusuf & Zakarriya, 2018). It is only with the right information that women can make an informed decision. The woman that has the right information and use it well will always be ahead of the woman that does not have the right information. Family planning information is right information every citizen that is of age should have. According to Asghar, Maann, Zafar and Ali (2010), rightly pointed out that access to family planning information have been identified as a reproductive health right of women to be informed of appropriate healthcare services that will enable women to go safely through pregnancy and childbirth and provide them with the best chance of having a healthy infant.
However, lack of access to family planning information remain as a major barrier to knowledge-based healthcare in hospitals especially on family planning programmes; since the knowledge of family planning enables women to control their family size as is popularly held. It was assumed that women could be experiencing problems in accessing information resources; coupled with lack of knowledge and awareness of the resources will as a result void utilization of family planning information on the part of the women attending family planning clinics in
hospitals.
Seeking for information, is as a result of a felt gap that exists in the information needs of women. Therefore, women seek information to add knowledge they lack or to confirm or disconfirm their current state of beliefs, and they use that information for strategic purposes. Scholarly investigations and reportage on the nature and sources of family planning information and utilization are hard to find because scholars have not been keen at taking up these challenges
(Etukudo, 2015). It is in the light of this that the women‟s inadequate access and utilization of family planning information in family planning clinics in hospitals in Kaduna State was singled out as the cause that needed investigation in this study.
1.3 Research Questions
The following research questions guided the research:
- What factors influence seeking for family planning information by women attending family planning clinics in hospitals in Kaduna State?
- What types of family planning information are accessible to women attending family planning clinics in hospitals in Kaduna State?
- What type of information resources are utilized by women attending family planning clinics in hospitals in Kaduna State?
- To what extent do the women attending family planning clinics in hospitals in Kaduna
State utilize family planning information?
1.4 Objectives of the Study
The following were the objectives of the study:
- To identify factors that influence seeking for family planning information by women attending family planning clinics in hospitals in Kaduna State.
- To identify the types of family planning information accessible to women attending family planning clinics in hospitals in Kaduna State.
- To identify the type of information resources utilized by women attending family planning clinics in hospitals in Kaduna State.
- To identify the extent to which women attending family planning clinics in hospitals in
Kaduna State utilize family planning information.
1.5 Significance of the Study
The findings of this study will benefit Kaduna State Government and the Ministry of Health, in knowing the factors that influence the women attending family planning clinics seeking the types of family planning information. This will help the government and the ministry concerned to determine how best to provide family planning information in respective hospitals in the state. It will also help to understand the type of information resources women attending family planning clinics in the state hospitals utilize so that adequate provision can be made in order to make the family planning clinics more responsive.
The findings of the study will offer an opportunity to the women population under study realize whether the knowledge acquired would be useful to them and thus take the right decision concerning their health and that of their children. It will also encourage them to appreciate and to always pursue valid information services that will reduce uncertainty in the minds of the women in order to scale up safe motherhood and hence reduce maternal and neonatal mortality rate.
The findings of this research work will assist in delivering quality information in the field of Library and Information Science, particularly medical librarians as the study hinged on family planning information by women attending family planning clinics in hospitals in Kaduna State.
Moreover, it will add to the existing literature on Family Planning Information in Nigeria.
1.6 Scope of the Study
The study covered family planning clinics in the hospitals located in Zone I, Zone II and Zone III in Kaduna State. The study also covered only those registered women attending family planning clinics in both public and private hospitals.
1.7 Operational Definition of Terms
The following terms are defined as used in the study:
Clinic: refers to health programmes conducted in venue in hospitals to address certain medical challenges e.g. family planning clinics, antenatal and postnatal clinics etc.
Family Planning: is the control of birth by women using appropriate contraceptive methods.
Family Planning Information: refers to the various sets of information and messages that are relevant to family planning.
Healthy Timing and Spacing of Pregnancy: is an approach that helps women delay, space or limit pregnancy.
Information: refers to the classified messages according to how they are focused.
Utilization: relates to the use or converting into action the accessed family planning information to perform family planning activity.
References
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Aina, L. O. (2004). Library and Information Science Text for Africa. Nigeria: Third World Information Services Ltd.
Asghar, K., Maann, A. A., Zafar, M. I., & Ali, T. (2010). Practicing of Women Reproductive Health Rights: A Road Map for HIV Prevention. Pakistan Journal of Nutrition, 9(3), 250–254.
Babalola, D. A., Babalola, Y. T., & Oladimeji, A. A. (2012). Assessing the Use of Family Planning Information Among Farming Households in Nigeria: Evidence from Ogun State. Asian Journal of Rural Development, 2(2), 40–46.
Chimah, J. N., & Nwokocha, U. (2013). Information Resources, Retrieval and Utilization for Effective Research in Tertiary and Research Institutions. Asian Journal of Humanities and Social Sciences, 1(3), 43–50.
Chukwuji, C. N., Tsafe, A. G., Sayudi, S., Yusuf, Z., & Zakarriya, J. (2018). Awareness, Access and Utilization of Family Planning Information in Zamfara State, Nigeria. Library Philosophy and Practice (e-journal), Paper 1771. Retrieved April 26, 2019, from http://digitalcommons.unl.edu/libphilprac/1771
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