Abuja: Bethel Goddey’s rapid sequence of pregnancies was unplanned, with her second child born just eighteen months after her first, and a third pregnancy occurring only six months later. The mother of three from Edo State desired to space her children, but faced opposition from her husband regarding family planning. “I found myself having children in succession because he didn’t allow me,” Goddey explained. “But now, his perception has changed due to the economy and conviction through outreaches,” she added.
According to News Agency of Nigeria, Goddey’s husband was not present when she visited Iwogban Primary Health Centre in Ikpoba-Okha Local Government to receive a contraceptive implant. However, his attendance at a mobile outreach months prior had played a crucial role in altering his views on family planning. During the outreach, healthcare professionals addressed his fears and misconceptions about contraception, which, along with economic pressures related to raising children, ultimately secured his consent.
Goddey’s experience highlights a broader issue faced by women in making decisions about reproduction. In Nigeria, particularly in regions like Edo, male influence significantly impacts whether married women use modern contraception. The 2024 Nigeria Demographic and Health Survey (NDHS) reveals that 32 per cent of married women reported their husbands as the primary decision-makers regarding family planning, with only 37 per cent making the decision independently.
In Edo, where the Modern Contraceptive Prevalence Rate (MCPR) for married women is approximately 19 per cent, male opposition poses an additional barrier to family planning. This opposition is often rooted in socio-cultural myths, concerns about female infidelity, fears of side effects, and misinformation about contraceptive safety. Women in remote communities face compounded challenges due to limited access to health facilities and accurate information.
To address these issues, mobile outreach initiatives are being deployed, bringing family planning services and counseling to underserved communities. Non-Governmental Organizations like MSI Reproductive Choices, in collaboration with the Edo health sector, implement mobile outreach programs that integrate clinical services with community engagement and male-inclusive counseling. The approach aims to make contraceptive services accessible while addressing beliefs and fears influencing partner decisions.
Mrs. Omeche Enemaku, Regional Manager for MSI Reproductive Choices, South-South, emphasized the organization’s focus on maternal and child health, ensuring women in underserved areas access quality reproductive health services. “Through our outreach programs, we want to ensure that we go to the last mile, the last community, wherever it is, to make sure that women of all communities deserve quality sexual and reproductive health services,” she stated.
Enemaku noted that MSI collaborates with the Edo Ministry of Health and other coordinators to develop an annual outreach workplan. Community-provided locations, such as health centers, town halls, or private homes, facilitate the implementation of outreach services, allowing the program to operate where conventional health facilities are unavailable.
The mobile outreach model involves healthcare professionals, including doctors, nurses, and community health officers, visiting riverine, rural, and underserved communities. They utilize existing community structures to provide modern contraceptive methods and organize community dialogues to address family planning concerns. This male-inclusive approach is vital in communities where men significantly influence reproductive decisions.
Mrs. Aja Abieyuwa, Reproductive Health/Family Planning Coordinator for the Edo Ministry of Health, explained that the state collaborates with MSI Nigeria to identify areas lacking family planning services. “At the state level, we work with MSI Nigeria to conduct medical outreach as one of the ways of increasing uptake of Family Planning in Edo State by taking the services closer to the people,” she said.
The outreach model emphasizes dialogue alongside service delivery, ensuring that fears and misconceptions are addressed collectively. This approach has proven effective for women like Blessing Ikpomwosa, who overcame her hesitance toward contraception after receiving counseling from healthcare professionals during an outreach session.
Edo’s experience demonstrates that providing contraceptive services alone is insufficient where partner opposition exists. The outreach model, combining service delivery with community engagement, effectively addresses access and information barriers. However, persistent patriarchal resistance and supply-chain challenges remain, necessitating continued efforts to engage male stakeholders and ensure consistent access to contraceptive methods.
Dr. Coulson Osoikhia, Executive Secretary of the Edo Primary Health Care Board, highlighted the importance of involving traditional and religious leaders in changing community perceptions. “We hold quarterly Primary Health Care Summits where we invite traditional rulers, including the Oba of Benin, alongside Imams and pastors,” Osoikhia explained, emphasizing their influence in promoting accurate family planning information.
As Edo continues to expand family planning services, the combination of mobile outreach, counseling, and collaborative efforts with the state health system offers a promising model for challenging misconceptions and empowering couples to make informed reproductive choices.