The Important Of The Family Planning On Women Of Child Bearing Age (15-49)
[A CASE STUDY OF MOBA LOCAL GOVERNMENT AREA, OTUN EKITI, EKITI STATE.]

INTIMATE PARTNER VIOLENCE AND SEXUAL  VIOLENCE: current and past intimate partner sexual or domestic violence might impede the correct and consistent use of contraception and might be a consideration when choosing a method, for example, an IUD might be profiteered because it does not required the partner’s participation. The medical history might provide information on signs current or past violence, and if not, provider should ask client about relationship issues that might be potential barriers to contraceptive use. In addition client experiencing initiate partner  violence of sexual violence should be referred for appropriate care. (Grady W, Klepinzer D. Billy J. Cubbin L. Sci 2010, Jaccard J, 2009, pallito Cc,Campbell JC, o campo P. 2005).
•    MENTAL HEALTH AND SUBSTANCE USE BEHAVIOUR:- Mental health (e.g depression, anxiety disorders and other mental disorder and substance use behavior (e.g alcohol ) use, prescription abuse, and illicit drug use might affect a client ability to correctly and consistently use contraception. The medical history might provide information about the signs of such conditions or behaviours, and if not, providers should ask client about substance use behaviours or mental health disorder, such as depression or anxiety, that might interfere with the motivation or ability to follow through with conceptive use. If needed, clients with health disorder or risky substance use behaviours should be referred for appropriate care. (Grady. W, Klepinger D Billy J, Cubbins L. Sci 2010, Jaccard J. 2009, Pallito CC, Campbell JC O ’Campo P- 2005, Paterno MT, jordan ET 2012).
Step4:     Conduct a physical assessment related to contraceptive use, when warranted: Most women will need no or few examination, or laboratory tests before starting a method of contraceptive. Guidance on necessary examinations and tests relate to initiation of contraception is available. A list of assessments that need to be conducted when providing reversible contraceptive services to a female client seeking to initiate or switch to a new method of reversible contraception is provide clinical evaluation of a client electing permanent sterilization should be guided by the clinician who performs the procedure. Recommendations for contraceptive use are available. Key points include the following
•    Blood pressure should be taken before initiating the use of combined hormonal contraception
•    Providers should assess the current pregnancy status of clients receiving contraception, which provides guidance on how to be reasonably certain that a women is not pregnant at the time of contraception initiation.
    In most cases, a detailed history provides the most accurate assessment of pregnancy risk in a women about to start using a contraceptive method. Routine pregnancy testing for every women is not necessary (CDC. U.S 2013. MMW)
•    Weight measurement is not needed to determine medical eligibility for any method of contraception because all methods generally can be used among obese women. However measuring weight and calculating BML at baseline might be helpful for monitoring any changes and counseling women who might be concerned about weight change perceived to be associated with their contraceptive method.
•    Unnecessary medical procedures and tests might create logistical, emotional, or economic barriers to contraceptive access for some women, particularly adolescents and low- income women, who have high rtes of unintended pregnancies. For both adolescents and adult female clients, the following examinations and tests are not needed routinely to provide contraception safely to a health client (although they might be needed to address other non- contraceptive health needs) (CDC. US 2013, MMW) 
•    Pelvic examinations, unless inserting an intrauterine device (IUD)  or fitting a diaphragm.
•    Cervical cytology or other cancer screening, including clinical breast exam.
•    Human immune deficiency virus (HIV) screening
•    Laboratory tests for lipid, glucose liver enzyme and hemoglobin levels or thrombogenic mutation.
For male clients, no physical examination needs to be performed before distributing condoms.
Step5:    provide the contraceptive method along with instructions about correct and consistent use, help the client develop a plan for using the selected method and for follow-up, and confirm client understanding.
•    A broad range of FDA- approved contraceptive methods should be available onsite. Referrals for methods not available onsite should be provided for clients who indicate they prefer those methods. When providing contraception, provides should instruct the client about correct and consistent use and employ the following strategies to facilitate a client’s use of contraception.