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Health Workers Encourage Child Spacing in Northern Nigeria

Health workers in northern Nigeria say a lack of information and awareness has led to poor family planning practices in the region. Voice of America English to Africa Service’s Isiyaku Ahmed in Kano explains that family planning is a way of limiting a family size and the intervals between childbearing either through natural methods or with modern contraceptives.

Many women have come to the Planned Parenthood Federation center in the northern Nigerian town of Kano. It’s one of many family planning centers in the town that provides counseling for couples on family planning methods.

Maryam Musa is a senior counselor at the center. This morning she is talking with married women. This is the first visit for some of them, and many are nervous. She describes the counseling process:

“There are steps that we take and there is an acronym that we use which will help the provider to be able to follow the counseling steps correctly—that is GATHER. G stands for greet, that is when the client comes, you greet her, create rapport, make her comfortable so that she will be able to explain whatever you ask her. A stands for ask. You ask the client why she is there and of course you will expect her to tell you why she is at the clinic. The T stands for tell. You tell her the kind of services that you render.”

Musa says other parts of the acronym GATHER are; H for helping the client to pick a child spacing method that suits her and her husband; E is for explaining how each method works, and its possible effects. Finally, R stands for referring people who need a more sophisticated planning method to specialized clinics or a hospital.”

Musa describes issues that prevent some couples in northern Nigeria from getting help with family planning, “Some women want it [family planning] but they don’t know where to access the service and another big challenge is the men; some of them don’t want it, and a woman cannot come out and access the service unless her husband permits it.”

Musa says people need to be educated in order to appreciate the benefits of family planning, or the methods, of which there are several.

She explains that breastfeeding delays menstruation. If a woman continues to breastfeed for several months, then she should have a little over a year before she ovulates and is ready to conceive again. The benefit of this delay is that it allows her body to recover from the previous birth.

Musa says this method is less familiar than another traditional way of preventing births in northern Nigeria – taking the woman to her maternal home to give birth. She stays there until the baby is weaned and then returns to her husband.

In addition to continued breastfeeding, couples can also use contraception.

She says there are contraceptive choices ranging from pills to tablets that a woman can swallow to ones that can be injected. Otherwise, like the IUD [Intrauterine device], is inserted into the woman’s womb.

Finally, men can also undergo a surgical procedure called a vasectomy which makes them sterile – an operation that can usually be reversed.

Musa says there’s another reason couples don’t know much about modern family planning methods in northern Nigeria, “The thing that killed family planning in the north was the translation given to it. When family planning [was advertised], they translated it as ‘Kaiyadde iyali’. Kaiyadde Iyali means limiting birth and when they brought it to the north, people frown[ed] at it. They said who are you to limit birth?”

Many northerners believe the Muslim holy book, the Koran, is against limiting birth. They refer to a verse that says Allah (God) will provide for all children.

Professor Oladapo Ladipo is the president of the Association for Reproductive Health and Family Planning in Nigeria. He says another issue is the widespread belief that modern family planning is a concept imported from the West. “The other reason is religious. [Strict] religions like Catholicism, for example, do not [embrace] any of these modern methods.”

He says countries that have adopted modern family planning methods are reaping the benefits and have reduced maternal deaths:

“I give you an example - the Islamic Republic of Iran that had a high national mortality rate after the revolution. They sought the [methods from] records across the globe. The only [scientific] method of reducing that mortality they found…was family planning. And they sold the concept of family planning to their citizens. So [the] government has to sell it, the health benefits ought to be promoted and there are many benefits other than just reducing maternal deaths.”

He says Nigerians enjoy large families. For example in the 2003 national demographic survey, it showed that the average Nigerian woman has between five and seven children.

The Planned Parenthood Federation of Nigeria sends health care workers from house to house and even to places of employment to educate men and women about their options.

The group says even if Nigerians prefer a number of children, with family planning at least the health of the mother and child can be ensured.