Factors Affecting Family Planning Services In Rural Areas Among Women
[A CASE STUDY OF NSIT IBOM]

The cultural and national traits of women of some geo- political regions of the world do influence their family planning decisions to the extent that the family planning preferences of these women even in the developed nations reflect what obtains in their home regions as revealed by Woollett, Matwala and Hadlow ( UN, 2009). Human reproductive behaviour which is the result of a complex interplay of economic, social, cultural, religious and biological factors influence the family planning decisions of women in the developing world (Caldwell, 2009). Family planning decisions within the traditional family system are based on factors such as children as old age security for parents, prestige attached to large family size, labour force for agricultural practices, as security against high infant mortality and the social benefits of having children and grandchildren. Children are, therefore, cherished as sources of labour in the agrarian and traditional societies. This has led many women into having many children as a result of many child births which have effects on the mother, children in such families and the nation at large. The effects include: maternal, neonatal and child mortality and morbidity; over population, social ills, poverty and lack of community development hence the family is the building block of the community. The low status accorded to women made them desire for larger family sizes. They felt secure in the number of children they had, as a woman’s value and status were linked to her reproductive efficiency and this also give them support in the event of unexpected vicissitudes of life such as widowhood, divorce and physical incapacitation. How applicable are these global gender inequalities with respect to child bearing decision-making of women in the 21st century Nigeria especially in Nsit Ibom-North Local Government, Akwa Ibom state. This is what the researcher seeks to investigate.

STATEMENT OF PROBLEM

 More than half a million women, nearly all of them in developing world die each year in pregnancy or childbirth, amounting to one death every minute (Ronsmans & Graham, 2006). Another million suffer serious, and sometimes permanent pregnancy – related injuries such as – vesico vaginal fistula etc. Much of this suffering and death could be prevented through appropriate maternal and child health services including ANC, labour and delivery services as well as family planning services. 4 In Nigeria traditional attitudes towards gender relations have affected the power of decision- making both within and outside the house hold. Buor, (2004) observed that women, especially in traditional families were subservient to the man in marital relationship, so the man assumes a key position in decision making which is evidenced in the area of Family planning. Some of the result of such subservient role in decision making include; a situation where a pregnant woman’s life is in danger on presenting to the hospital required immediate surgical intervention but will refuse to give her consent until the husband comes. This was observed severally by the researcher and most times when the husband comes, he might decide to take the woman out of the hospital putting the woman’s life in great danger and many others scenario that the researcher personally observed in Nsit Ibom – North LGA hence the women cannot solely make decision on their own even on issues that affect their health during Family planning which sometimes result to maternal death due to delay in decision making. It was suggested that traditional attitudes towards gender relations might reduce effective communication between couples and restrain a wife’s freedom to make chilbearing decisions (May, 2014). 

The effect of the inferior role of women in decision- making is that they have traditionally been suppressed in taking decision even on matters that affect them such as childbirth. The National Population commission (2014) reported that Akwa Ibom State in Nigeria demographic and health demographic and survey (NHDS, 2013) recorded a total fertility rate of 5.7 and there existed fertility differentials between the rural and urban communities of the state of 7.0 and 4.7 respectively. The researcher also observed a similar trend in the Family planning pattern of women in Nsit Ibom  LGA which was recorded to be 5 based on the findings from the research study. Women’s non involvement in their Family planning decisions affects their health and could lead to high frequency of childbirth among women which could result in serious health risk like; maternal, neonatal and child mortality and morbidity; over population, social ills, poverty, lack of community development hence the family is the building block of the community, economic stagnation, marital  burden and inability of families to educate most of their children resulting in high illiteracy rate in the rural communities of the State . Consequently the question that comes to mind are: Is the large family size the choice of the woman or women have no role in decision making with regards to controlling their fertility ? If family planning is women’s rights do these rights apply in family decisions? To what extent do women exercise reproductive right by participating in issues that directly affect their well beings ? Do women have any control over decision - making issues that relate their child bearing ? To answer these questions and many others the study seeks to assess the child bearing decision of women in Nsit Ibom  Local Government Area, Akwa Ibom State. Hence the need for this study cannot be overemphasized, especially in an environment with high fertility and low contraceptive use.