Influence of psychosocial variables on family planning among women of child bearing age in Obudu Local Government Area Cross River State.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Family planning (FP) remains one of the most effective strategies for improving maternal and child health globally. It refers to the practices that enable individuals and couples to anticipate and attain their desired number of children, as well as determine the spacing and timing of their births, through the use of contraceptive methods (World Health Organization [WHO], 2021). Access to and utilization of family planning services are critical for reducing maternal mortality, preventing unintended pregnancies, and enhancing socio-economic well-being. This is particularly important in developing countries like Nigeria where high fertility rates and poor maternal health outcomes persist (National Population Commission [NPC] & ICF, 2019).

Despite national and international campaigns to increase FP awareness, utilization of modern contraceptives remains relatively low in many Nigerian communities. According to the 2018 Nigeria Demographic and Health Survey (NDHS), only 17% of married women of reproductive age reported using modern contraceptive methods (NPC & ICF, 2019). This low prevalence highlights significant gaps between awareness, acceptance, and actual use. Factors such as cultural taboos, religious prohibitions, misinformation, and spousal disapproval contribute to the reluctance of many women to embrace FP. In rural areas such as Obudu Local Government Area of Cross River State, these barriers may be even more pronounced due to entrenched socio-cultural dynamics, low literacy levels, and inadequate health infrastructure.

Psychosocial variables have been identified as central determinants of FP utilization among women of childbearing age. Variables such as knowledge, attitudes, cultural beliefs, social norms, partner support, and perceived stigma strongly influence reproductive decisions. Women who are knowledgeable about FP and enjoy supportive relationships with their partners are more likely to adopt contraceptives compared to those constrained by cultural myths and male-dominated decision-making (Adelekan, Omoregie, & Edoni, 2014). On the other hand, misconceptions about side effects, religious objections, and fear of social stigmatization continue to discourage many women from embracing modern contraceptive options (Omo-Aghoja, 2013; Fayehun & Omololu, 2011).

Globally, research has shown that empowering women through education, autonomy in decision-making, and supportive social environments significantly improves FP adoption. In contexts where women’s voices are often subdued in family matters, cultural and psychosocial influences become decisive factors in reproductive health behavior. For instance, in Sub-Saharan Africa, FP uptake remains tied not only to service availability but also to the psychological readiness and social acceptance of contraceptive use (Oluwole et al., 2016). This underscores the importance of examining psychosocial variables beyond the traditional focus on access and availability of FP commodities.

In Nigeria, studies have revealed wide regional disparities in FP uptake. Southern Nigeria records slightly higher contraceptive prevalence than northern regions, largely due to differences in literacy rates, cultural openness, and access to services. However, rural areas such as Obudu still lag behind urban centers in awareness, accessibility, and acceptance. Women in these areas often face additional challenges such as pressure from extended families, limited exposure to health education, and reliance on cultural norms that may not favor contraceptive use. Thus, the interplay of psychosocial factors in shaping reproductive decisions requires context-specific investigation.

Family planning is not merely a health issue but also a developmental concern. Effective FP use has been linked to poverty reduction, improved educational outcomes for women, and enhanced household economic stability (United Nations Population Fund [UNFPA], 2020). For communities like Obudu, where traditional practices remain strong, addressing psychosocial barriers could contribute significantly to reducing unintended pregnancies, lowering maternal mortality, and promoting healthier families. By focusing on psychosocial determinants, this study highlights the need for interventions that go beyond medical supply to include cultural sensitivity, education, and male involvement.

Understanding the psychosocial determinants of FP uptake among women of childbearing age in Obudu is therefore crucial for designing context-specific and culturally appropriate interventions. By identifying the ways in which cultural beliefs, partner support, misconceptions, and perceived stigma influence contraceptive decisions, this study aims to provide actionable insights for policymakers, healthcare providers, and community leaders. Ultimately, the findings will help improve reproductive health outcomes and support sustainable development goals in Cross River State and Nigeria at large.

1.2 Statement of the Problem

Nigeria continues to face significant challenges in achieving optimal family planning coverage, a situation that has far-reaching implications for public health and socio-economic development. High maternal and infant mortality rates remain persistent despite concerted national and international efforts to expand access to contraceptive services. According to the 2018 Nigeria Demographic and Health Survey (NDHS), only 17% of married women reported using modern contraceptives, leaving a substantial proportion of women with unmet needs for family planning (NPC & ICF, 2019). This unmet need contributes to unintended pregnancies, unsafe abortions, and preventable maternal deaths.

Rural communities such as Obudu Local Government Area (LGA) in Cross River State are particularly vulnerable to these challenges. Anecdotal evidence suggests that women in Obudu face multiple barriers to contraceptive use, including inadequate awareness, entrenched socio-cultural disapproval, and persistent misconceptions about the safety and side effects of modern contraceptive methods. The rural context further compounds these barriers with limited health infrastructure, poor access to trained healthcare providers, and low literacy levels, making the uptake of family planning even more difficult.

Psychosocial variables have emerged as critical factors influencing family planning behaviors. Peer influence, religious teachings, cultural norms, and spousal disapproval shape women’s perceptions and decisions regarding contraceptives. For instance, in many traditional settings, male partners play a decisive role in reproductive decisions, and their opposition to family planning can severely restrict women’s autonomy. Similarly, religious prohibitions and cultural myths often perpetuate fear, stigma, and misconceptions surrounding contraceptive use (Oluwole et al., 2016). These factors combine to limit the effectiveness of existing family planning campaigns that focus mainly on supply and service delivery.

Despite the growing recognition of psychosocial influences on family planning, there is limited empirical research specifically addressing these factors in Obudu LGA. While national-level studies provide useful generalizations, localized investigations are necessary to capture the unique cultural and social dynamics of rural communities. Without context-specific evidence, interventions may fail to resonate with community values and beliefs, thereby undermining their effectiveness. The absence of such studies in Obudu represents a critical knowledge gap that this research seeks to fill.

Failure to address these psychosocial barriers has broader implications beyond reproductive health. Women who are unable to access or utilize family planning effectively often face repeated unintended pregnancies, which can strain household resources, disrupt educational opportunities, and limit women’s participation in economic activities. This, in turn, perpetuates cycles of poverty, gender inequality, and poor health outcomes, not only for women but also for their children and families. Thus, the neglect of psychosocial determinants of family planning contributes to wider social and developmental challenges.

Given these realities, there is an urgent need to investigate how psychosocial variables influence family planning practices among women of childbearing age in Obudu LGA. Understanding the role of cultural beliefs, partner support, peer influence, and perceived stigma is essential for developing culturally sensitive and community-based interventions. By providing empirical evidence from Obudu, this study will help bridge the gap between awareness and utilization, ultimately contributing to improved maternal health, women’s empowerment, and sustainable community development in Cross River State.

1.3 Objectives of the Study

The general objective of this study is to examine the influence of psychosocial variables on family planning among women of childbearing age in Obudu Local Government Area, Cross River State.

The specific objectives are to:

1. Assess the level of awareness of family planning methods among women of childbearing age in Obudu LGA.
2. Examine the influence of cultural beliefs on the utilization of family planning.
3. Investigate the role of spousal/partner support in family planning decision-making.
4. Determine the effect of misconceptions and perceived stigma on family planning adoption.

1.4 Research Questions

The research questions are buttressed below:

1. What is the level of awareness of family planning methods among women of childbearing age in Obudu LGA?
2. How do cultural beliefs influence family planning practices among women in the area?
3. What role does partner support play in the utilization of family planning?
4. How do misconceptions and perceived stigma affect family planning adoption?

1.5 Hypothesis of the Study

The study will test the following hypothesis:

H0: Psychosocial variables (cultural beliefs, partner support, misconceptions, and stigma) have no significant influence on family planning utilization among women of childbearing age

H1: Psychosocial variables (cultural beliefs, partner support, misconceptions, and stigma) have a significant influence on family planning utilization among women of childbearing age

1.6 Significance of the Study

The study is of great policy relevance, particularly for stakeholders in reproductive health and population management. By providing evidence-based insights into the psychosocial barriers affecting family planning uptake in Obudu Local Government Area, the findings will equip policymakers and health planners in Cross River State with the knowledge needed to design effective and culturally sensitive interventions. Such policies will not only focus on the provision of contraceptives but also address underlying psychosocial concerns such as myths, stigma, and spousal disapproval. In doing so, government agencies and development partners will be better positioned to implement context-specific strategies that resonate with community values and norms.

From a health perspective, the study carries significant implications for maternal and child survival. Family planning is a proven strategy for reducing maternal mortality by preventing high-risk pregnancies, limiting unsafe abortions, and promoting healthier birth spacing. In rural communities such as Obudu, where maternal and infant mortality rates are relatively higher, improved utilization of contraceptives will have a direct impact on the health and well-being of families. By shedding light on psychosocial factors that limit uptake, the study will contribute to designing interventions that can increase acceptance and usage of family planning services, thereby reducing preventable deaths.

The study also holds academic significance as it contributes to the growing body of literature on reproductive health, particularly within the Nigerian context. While numerous studies have examined family planning at national and regional levels, there is a paucity of localized research that explores psychosocial determinants in specific rural settings such as Obudu. By filling this gap, the study will provide empirical data that can serve as a reference point for future scholars, researchers, and students interested in public health, sociology, psychology, and gender studies. It will also advance theoretical discussions on how psychosocial constructs influence health behaviors in traditional communities.

At the community level, this research has the potential to influence behavioral change and collective awareness. By highlighting the psychosocial variables—such as cultural beliefs, spousal influence, and stigma—that hinder family planning, the findings can inform grassroots sensitization programs. Community leaders, religious institutions, and health educators can use the insights to develop targeted awareness campaigns that respect cultural values while correcting misconceptions. This, in turn, can foster a more supportive environment for women to make informed reproductive choices.

The study is equally significant for women’s empowerment and gender equality. Family planning empowers women by giving them control over their reproductive lives, enabling them to pursue education, participate in economic activities, and contribute meaningfully to community development. By addressing psychosocial barriers, this research will help create conditions where women can exercise autonomy in decision-making regarding their reproductive health. This empowerment has ripple effects on household welfare, children’s education, and overall community progress.

Finally, the study is relevant at the global development level, as it aligns with international commitments such as the Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being) and Goal 5 (Gender Equality). By investigating and addressing psychosocial barriers to family planning, this research supports efforts to achieve universal access to reproductive health services. The insights generated will not only be useful for Cross River State but can also inform interventions in other rural communities across Nigeria and Sub-Saharan Africa facing similar challenges.

1.7 Scope of the Study

The study focuses on women of childbearing age (15–49 years) in Obudu Local Government Area of Cross River State. It specifically examines psychosocial variables such as cultural beliefs, partner support, misconceptions, and perceived stigma as they relate to family planning awareness and utilization. Other factors such as economic status and availability of health services are beyond the scope but may be considered as background influences.

1.8 Operational Definition of Terms

Family Planning (FP): In this study, family planning refers to the deliberate actions and practices by which women of childbearing age in Obudu Local Government Area regulate the number and spacing of their children. It specifically relates to the use of modern contraceptive methods such as pills, injectables, intrauterine devices, implants, condoms, and other medically approved approaches to prevent unintended pregnancies.

Psychosocial Variables: These are social and psychological factors that influence the behavior and decision-making of women regarding family planning. In this study, psychosocial variables include cultural beliefs, spousal/partner support, peer influence, religious perspectives, misconceptions, and perceived stigma related to contraceptive use.

Cultural Beliefs: This refers to the traditional norms, values, and customs within the Obudu community that shape people’s attitudes toward family planning. Cultural beliefs may either support or discourage the use of contraceptives depending on community expectations, taboos, and perceptions about fertility and childbirth.

Partner Support: Partner support refers to the approval, encouragement, or disapproval of family planning practices by a woman’s husband or intimate partner. In this study, it captures the extent to which spousal involvement, communication, and joint decision-making influence women’s adoption of contraceptive methods.

Misconceptions: These are false beliefs, myths, or inaccurate information about family planning methods. Examples include fears that contraceptives cause infertility, lead to chronic illness, or reduce sexual pleasure. Within the context of this study, misconceptions act as barriers that discourage women from adopting modern contraceptive methods.

Perceived Stigma: Perceived stigma refers to the negative social judgment or discrimination that women expect or experience when they adopt family planning methods. This includes being labeled as immoral, promiscuous, or “anti-tradition” by peers, family members, or religious groups within the community.

Women of Childbearing Age: For the purpose of this study, women of childbearing age are defined as females between 15 and 49 years who are biologically capable of conceiving and bearing children.

Utilization of Family Planning: This term refers to the actual adoption and consistent use of one or more family planning methods by women of reproductive age. In this study, utilization will be measured by reported use of any modern contraceptive method in Obudu Local Government Area.