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Factors Affecting Family Planning Services In Rural Area Among Women
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However, making the rural issues concerning family planning more
understanding, Etukudo, (2014) opined that in rural areas of AkwaIbom
State where there is a high desire for large family size by couples and
lack of communication activities and behavior inventions to increase
knowledge and use of family planning, lack of access to family planning
services can be a barrier to women’s use of family planning services.
Besides that, Etukudo further said that, large number of Nigerian women
including some of those in NsitIbom Local Government Area of AkwaIbom
State do not see the need of family planning. And that a good number of
them see family planning as a taboo which is against their culture and
many refer to religion to support their argument and disapproval of
family planning (Etukudo, 2014). Similarly, Akpan, et al., (2011) in
addition said that, a critical look at the issue reveals that ignorant
peasant women living in NsitIbom and other communities in Nigeria want
to have large families. Hence, there is evidence that women are prepared
to have fewer children and adopt family planning if they are provided
with adequate information, service and supplies (Akpan et al, 2011).
Etukudo, (2014) concluded that urban women are more than twice as likely
as rural women to use a method of contraception (20 percent versus 9
percent). Majority of the women hardly gave birth in hospitals and
depended on their husbands to decide what ever method will be used to
space or limit the number of children they will have. This
notwithstanding, there still exist a great challenge of unmet needs
regarding family planning especially in the rural part of AkwaIbom State
like NisitIbom as the desired attitudinal and behavioral changes
towards family planning is yet to be achieved (Etukudo, 2014).
Theoretical framework
For the purpose of this study, one theory has been selected as guide.
1.2.2 Health Belief Model (Theory)
Health
Belief Model is a theory that was proposed by social psychologists
Hochbaum, Rosenstock and Kegels in the 1950. The theory uses constructs
that represent perceived threats and net benefits such as perceived
susceptibility, perceived severity, perceived benefits, perceived
barriers, cues to action and self-efficacy. The model asserts that these
constructs account for a person’s “readiness to act†(Rosenstock, et
al., 1988). According to the Rosenstock and colleagues explanations, the
health belief model (HBM) is a cognitive, interpersonal framework that
views humans as rational beings who use a multidimensional approach to
decision-making regarding whether to perform a health behavior. However,
the model is appropriate for complex preventive and sick-role health
behaviors such as contraceptive behavior and other family planning
methods as barriers against unwanted pregnancy. Its dimensions are
derived from an established body of social psychology theory that relies
heavily on cognitive factors oriented towards goal attainment (i.e.
motivation to prevent pregnancy). Its constructs emphasize modifiable
factors, rather than fixed variables, which enable feasible
interventions to reduce public health problems (i.e. unintended
pregnancy, spacing and limiting the number of children).
Rosenstock
and other scholars further brought to light that with the application of
health belief model,factors affecting family planning services would be
wisely fought against. They also put it clear that the reason for the
combatis that family planning is a dynamic and complex set of services,
programs and behaviors towards regulating the number and spacing of
children within a family. For that reason, they maintained that
contraceptive behavior is one form of family planning which refers to
activities involved in the process of identifying and using a
contraceptive method to prevent pregnancy and can include specific
actions such as contraceptive initiation (to begin using a contraceptive
method), continuation or discontinuation (to maintain or stop use of a
contraceptive method), misuse (interrupted, omitted or mistimed use of a
contraceptive method), nonuse, and more broadly compliance and
adherence (general terms often used to denote any or all of the former
contraceptive behavior terms).
In a more sense, these scholars
depicted that contraceptive behavior, viewed through the HBM, is
motivated by an individual’s: desire to avoid pregnancy and value placed
on not becoming pregnant; nonspecific, stable differences in pregnancy
motivations and childbearing desires; and perceived ability to control
fertility and reduce the threat of pregnancy by using contraception
amongst other safe methods.
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