Factors determining the choice of contraceptive methods at the Family Planning Clinic, University College Hospital, Ibadan, Nigeria

Abstract

In a study of 2000 women volunteers seeking contraceptive services at the Family Planning Clinic (FPC), University College Hospital, Ibadan, Nigeria, 66.2 per cent chose the intrauterine device (IUD) making it the most common method of contraception. Factors influencing choice of contraceptive methods were advice from friends and family members, intended duration of use and information from the media. Ignorance, fear and unfounded cultural beliefs were factors responsible for the delay in seeking contraceptive advice. The mass media was an important source of information for most of the women. We conclude that the IUD is the contraceptive of choice in our clinic because of the highly selective nature of our clients. In order to provide a service with a broader clientele, we suggest the incorporation of other priority reproductive health services such as cervical and breast cancer screening, prevention and treatment of reproductive tract infections and sexually transmitted diseases including HIV/AIDS.

PIP: Studies conducted in Nigeria consistently find that, while oral contraceptives (OCs) are the most popular fertility control method on a national level, the IUD is the method most frequently selected by women who obtain contraception from a family planning center. The possibility that this phenomenon reflects family planning provider bias in favor of the IUD was investigated in a survey of 2000 women seeking contraceptive services at the Family Planning Clinic of University College Hospital in Ibadan, Nigeria, in 1986-90. The mean age of acceptors was 31.5 years; mean parity was 4.4. 63.2% of these women sought contraception to delay or postpone pregnancy. Clients were offered a choice of the standard range of barrier and hormonal methods as well as sterilization. The four most frequently selected methods were IUDs (66.2%), OCs (10.4%), injectables (7.9%), and sterilization (5.8%). IUDs were a popular choice among women who had not obtained their husbands' support for attending the center. Only 9.1% of IUD acceptors did so on the advice of family planning center staff. Information from the mass media (television and radio) and friends were most influential. Although this finding would seem to refute the hypothesis that the preponderance of IUD users at family planning centers reflects provider bias, an indirect association may be operating. Most material on contraception in the mass media is provided by family planning workers and many family planning center clients who are satisfied IUD users refer their friends to the clinic.