THE IMPACT OF EDUCATION AND OCCUPATIONAL CHOICE ON THE

ATTITUDE OF WOMEN TOWARDS FAMILY PLANNING IN SELECTED AREAS

OF IKENNE LOCAL GOVERNMENT AREA

By

AYOKA, ELIZABETH OGECHI

14/4435

BEING A DISSERTATION SUBMITTED IN THE DEPARTMENT OF EDUCATION,

SCHOOL OF EDUCATION AND HUMANITIES, COLLEGE OF POSTGRADUATE
STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
AWARD OF MASTERS DEGREE BABCOCK UNIVERSITY ILISHAN-REMO,
OGUN STATE, NIGERIA

SUPERVISORS:

DR. ADEOYE, A.
DR. BELLO, A.

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 CHAPTER ONE

1.1 Background to the Study

As the number of children per family in rural areas increases, Nigeria’s population continues

to grow. It is not uncommon to find families with seven or more children, and thus, making

children attain a larger proportion of this population. Families within the society should have

the right to decide the number of children they will have and the space between each child,

without any form of coercion, violence and oppression, as long as they can take care of the

children. However, the need to regulate and plan these process appropriately should not be

taken for granted.

According to Idang (2005), siting (Ndiga 1992, Muazu, 1994, Dogo, 1998 & Onwuzurike

2001), family planning is the most underestimated but most practiced culture of today as it

helps to reduce many family challenges, such as miscarriage, abortion. unwanted pregnancy,

child mortality, etc. Generally, the problem of too many children is associated with low

contraceptive use among married women of reproductive age in the country as a whole.

Nazli, Yasemin, Selcuk, Mehmet, Canan and Bilge (2017) define family planning as a couple

or an individual, having the freedom and responsibility define the number of children they

want, having the right knowledge and education as well as tools they need for this purpose. In

other words, family planning is a preventive service that allows couples to raise the number

of children they need and determine the interval between pregnancy based on their economic

opportunities and personal wishes. Ensure that the distance between childbirth is reasonable

to ensure the health of mother and baby.

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Family planning can save life and improve the health of women, children and society in

general. According to Bernstein, Cleland, Ezech, Farnds, Grassier, and Innis (2006),

controlling a person’s reproductive choices and fertility is healthy for both the mother and the

baby. In 2000, women who wanted to delay or stop childbirth could have used effective

contraceptive measures to prevent 90% of abortions and 20% of deaths and disease-related

births worldwide (Daulaire, Leidl, Mackin, Murphy, and Stark, 2002).

Family planning does not mean limiting the number of people in a family, rather, the goal is

to prevent and reduce the health risks of women related pregnancy issues, such as unsafe

abortion and infant mortality. Maternal health, pregnancy risks and maternal mortality rate

will increase significantly if the gap between each birth is less than 2 years. In addition,

babies born at frequent intervals may not be fully developed (low baby Weights), the

incidence of disability increases, care becomes difficult, and the infant mortality rate

increases in mother’s womb (Family Planning/Contraception, 2017).

Low contraception rates among women of childbearing age are also associated with

occurrence of illegal abortions and maternal mortality (Bankole, 2006). Countries with low

contraceptive prevalence rates have high maternal mortality rates. Nigeria with only 15%

contraceptive prevalence rates has the second highest maternal mortality rate in the world,

with an estimated 760,000 abortions each year, which is not surprising. On the other hand,

the total incidence of common contraceptives among Nigerian women is 16%, and the use of

family planning methods has increased with age from 6% between 15-19 years old to 21%

between 35-39 years old. Then it drops to 12% of women aged 45-49 (NPC and ICF

International, 2014).

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Overall, 15% of married women in Nigeria use contraceptives, an increase of only 2%

compared to 2003 NDHS (Nigerian Population Health Survey, 2003). Most women using

contraceptives depend on modern methods (10% of married women now) and 5% use

traditional methods. In addition, the report states that the total fertility rate in rural areas is

much higher than in urban areas (6.2% compared to 4.7% over the same period). Currently,

married women in urban areas use some form of contraception (27%) more than women in

rural areas (9%) (NPC, 2013; NPC and ICF International, 2014). In contrast, the prevalence

of contraceptives among Nigerian women is 16% among women age 15-19 to 21% among

women age 35-39 Among women aged 45-49, after which it deteriorates to 12% among

women age 45-49 (NPC and ICF International, 2014).

According to Akokuwebe (2016), studies have shown that family planning save and enhance

the lives of women, children and families (Conde-Agudelo and Belizan, 2000; Rutstein,

2005; White and Speizer, 2007; Agbo, Chikaike and Okeahialam, 2013). The World Health

Organization (WHO) has identified family planning as one of the six basic measures needed

to achieve the safe role of mothers, and the United Nations Children’s Fund (UNICEF) also

identified it as one of the seven child survival programs (Hyeladi, Gyang and Chuwang,

2014). The report shows that despite signs of the critical role of family planning,

contraceptive use rates in sub-Saharan Africa remain low. Sub-Saharan Africa accounts for

only 10% of women in the world using contraceptives, causing 12 million unplanned

pregnancies worldwide each year, accounting for about 40% of all deaths (WHO, 2004; Utoo

and Araoye, 2012).

Family planning can be achieved through higher levels of education, better job opportunities,

higher socioeconomic status and empowerment (World Health Organization, 2012).

4
Education in family planning services can help rural women understand the situation, prevent

unintended pregnancies and related maternal and infant mortality, and provide help and

consultation for every family, no matter how many children they want or want. Family

planning services will improve the decision-making ability of family members and recognize

that they can freely choose whether to have children. Family planning services play an

important role in "basic health services" and must be made public (World Health

Organization, 2012).

Fewer uptake of family planning programs in rural areas, are blamed on many factors, such

as women’s education and career choices. The education and occupation of couples also

affects their knowledge and decision-making ability on family planning. According to Malini,

Narayanan and Unmet (2014), some women are aware of available family planning but do

not properly understand the various types of family planning services and the way they work.

In rural areas, some of these women complained about insufficient counselling on the side

effects of certain family planning methods.

Education is recognized as the corner stone for sustainable development and a fulcrum in

which quick development of economic, political, sociological and human resources could be

resolved. According to Kabeer (2001), education is a critical resources for women’s

empowerment, enabling them to make strategic decisions. The introduction of modern family

planning methods in developed countries in the mid-20th century was initially aimed at

liberate women from unintended pregnancies and enable them to pursue education and to

participate in economic activity. These family planning programs were initially sought to

slow down rapid population growth. Regardless of the aims, empirical research on the effects

of contraceptives has largely focused on the impact of contraceptive use (particularly the pill)

5
on women’s education and career choices in the United States rather than in developing

countries (Cleland, Bernstein, Ezeh, Faundes, Glasier and Innis, 2006).

Also, the occupations of husband and wife influences their level of knowledge of

contraceptive practices as occupation is key factor for their socioeconomic status. Financial

status of family is of paramount importance in deciding family size and uptake of

contraceptive method. Thus, decision to investigate the factors that influence the uptake of

family planning services in rural areas is imperative as very little is known about the factors

that influence the decision of people to go for family planning services.

1.2 Statement of the Problem

Nigeria is classified among one of the most developed African country with a high rate of

corruption which has continuously enveloped citizens in low income, chronic food deficiency

and poor infrastructures. With these, there is a need for families to keep up and maintain their

socio-economic status, maintain a healthy and safe environment within this region through

some practices such as family planning, in order to regulate the number of children within

each family. Educating families will create a knowledge of at least a modern form of

contraceptive to be used in other to practice family planning.

Although socio-cultural characteristics play an important role in this situation (Tuladhar, &

Marahatta 2008), women’s educational level will increase their awareness of specific family

plans. Education has greatly improved women’s quality of life. Improving women’s access to

education and encouraging continued contact will greatly increase the use of family planning

and reduce unmet needs.

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The knowledge of these contraceptive methods is almost universal (over 90%), but compared

with countries with changing fertility rates, high-fertility countries (especially Nigeria) have a

much lower rate of using modern contraceptive methods among married women (Darroch

and Singh, 2013). This is partly related to attitudes, insufficient knowledge of family

planning, and partly related to higher fertility desire (Bongaarts 2003). Despite significant

investments in family planning programs in recent decades, knowledge of contraception does

not necessarily mean the use of contraceptives (Cleland, Ngugwa and & Zulu, 2011).

Also, the occupational choice of women in the rural communities has been seen as a factor

affecting their use or practice of family planning. The women are seen to engage in petty

trading which may grant them the opportunity to stay around and take care of the children, no

matter the number. This study therefore sets to find out the Influence of level of Education

and occupational Choice of Women towards Family Planning in Selected Areas of Ikenne

L.G.A.

1.3 Objective of the Study

The main objective of this study is to examine how factors such as level of education and

occupational choice of women influence women towards family planning and to recommend

strategies for improving family planning services, while the specific objectives are:

1. To identify Ikenne Local Government Area women’s level of awareness of family

planning services

2. To identify Ikenne Local Government Area women’s source of information on family

planning

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 3. To identify the type of contraceptive method adopted by Ikenne Local Government

Area women

4. To identify the factors that mitigate the utilization of family planning methods among

women in Ikenne Local Government Area

5. To establish Ikenne local Government Area women’s level of acceptability of family

planning

6. To establish the influence of occupational choice on the attitude of Women in Ikenne

Local Government Area.

1.4 Research Question

1. What is the Ikenne Local Government Area women’s level of awareness of family

planning services?

2. What is Ikenne Local Government Area women’s source of information on family

planning?

3. What are the type of contraceptive method adopted by Ikenne Local Government

Area women?

4. What factors that mitigate the utilization of family planning methods among women

in Ikenne Local Government Area?

5. What is Ikenne local Government Area women’s level of acceptability of family

planning?

6. What is the influence of occupational choice on the attitude of Women in Ikenne

Local Government Area?

1.5 Research Hypothesis

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 1. H1: There is no significant relationship between the level of awareness of family

planning services and the acceptability of family planning among women in Ikenne

Local Government Area.

2. H2: There is no significant relationship between the sources of information (such as

radio, television, friends, spouses, etc.) and knowledge of rural women on family

planning methods.

3. H3: There There is no significant relationship between utilization and knowledge of

rural women on family planning methods.

4 H4: There is no significant relationship between factors militating against the

utilization of family planning methods and knowledge of rural women.

5 H2: Occupational choice does not have any significant influence on the attitude of

women in Ikenne Local Government Area.

1.6 Significant of the Study

Notwithstanding the availability of scholarly work family planning, there is little or

inadequate attention from writers and practitioners on the Influence of level of Education and

occupational Choice of Women towards Family planning in Nigeria. This study will enhance

the understanding of family planning and the services in areas not yet fully covered.

The study of family planning will be improved upon, as the findings of this study will

contribute immensely to the expansion of knowledge based on the information and education

the will be provided for families within Ikenne Local Government area of Ogun state. The

study will inform and educate women on the benefit of family planning, the need to enrol in

family planning services around Ikenne Local Government area as well as creating a platform

to provide answers to some of the many questions being asked concerning family planning.

9
The study will also provide insight for the Government and other policy makers with regards

to taking appropriate measures towards designing strategies for improving efficiency in their

programs on family planning and making services available for women in Nigeria.

The society will also take part as recipients of the benefits of this study. This implies that the

society will become a better place when the findings and suggestions from this study are

properly applied by organizations especially in the consumer goods sector so as to produce

healthy products for members of the society.

1.7 Scope of the Study

The study focused on the evaluation of the Influence of level of Education and occupational

Choice of Women towards Family Planning in Selected Areas of Ikenne L.G.A. considering

the role of family planning services within the area. The study adopted a quantitative

methodology, the design was cross-sectional survey design. The population of the study

comprise of married women within Ikenne Local Government area of Ogun State. They will

be selected, because they are found to be the most appropriate to study. A self-developed and

validated questionnaire will be used to collect data for the study. The data collected will be

diagnosed using the appropriate tools and hypotheses will be tested using descriptive tools

and regression tools. The study will go through ethical approvals to confirm authenticity.

1.8 Operational Definition of Terms

Level of Education: Level of education in this study refers to the basic understanding of

women on Family planning. How well they know about family planning and family planning

services available. In all, the general knowledge of women on family planning. For example,

to inform the women about family planning and their level of acceptance of it.

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Impact: Impact in this study refers to the effect of level of education and occupational choice

on the acceptance or rejection of family planning among women in Ikenne Local Government

Area.

Occupational Choice: In this study, occupational choice refers to the women’s choice of job.

i.e. trading, office work etc.

Family Planning: In this study, family planning is the freedom and responsibility of all the

couples and the individuals to decide the number of children they desire and having the

knowledge, education and tools for this purpose.

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 CHAPTER TWO

LITERATURE REVIEW

2.0 Introduction

This chapter details the basic theories amd models underlying the subject of The Impact of

Education and Occupational Choice on the Attitude of Women Towards Family Planning. It

also contains the review of similar and related literatures of other scholars with regards to

family planning in Nigeria and beyond. Detailed explanation of concepts and theories will

also be included to drive the understanding of the study.

2.1 Conceptual Review

The socio-demographic history in developing countries shaped early conceptions of Family

Planning. As a result, the term takes on a strictly practical interpretation in the western

context. The decision to limit fertility was left to the particular person, and the consequences

of such a decision or inaction were left to be suffered solely by the family who took the

initiative, regardless of whether or not such decisions caused costs or provided advantages to

other families. Nonetheless, the favourable socioeconomic climate (i.e., industrialization,

urbanization, prosperity, and so on) enabled the individual's voluntary practice of birth

control quite worthwhile. Furthermore, birth rates in developed countries had already fallen

to low levels, indicating that drastic shifts in reproductive behaviour had occurred over time.

As a result, in developed nations, the idea of a need for sustained governmental action or

involvement in this area appeared far-fetched.

Individuals in developed nations, on the other hand, were forced to display their fecundity by

resolve and hardship. The value of speaking favourably regarding pregnancy was emphasized

in the subtlest and overt ways (i.e. proverbs prayers, sanctions, and taboos), with the overall

effect of keeping birth rates up. Fertility was not only the responsibility of the man or his kin,

12
but rather of community as a whole. As a result, the idea of carrying a burden into the

universe was alien to the practice of child-bearing. A creation was born solely for the good of

the family and, eventually, culture, and any negative effects of fertility behaviour were borne

by society. So, creating a balance between these two very opposite conceptions of fertility

behaviour becomes a challenge.

Though, with the way the world's population is growing, it is possible that one day we could

have a severe lack of food and housing, or if we continue the trend of actively clearing

jungles and providing food for the inhabitants of the world, we could overwhelm nature,

resulting in a severe natural catastrophe that could destroy thousands of citizens. The whole

planet is now concerned with ways to preserve the world from the chaos and damage that will

result from overpopulation. Individually, many countries across the world are taking steps to

restrict and regulate their populations, but in most cases, the laws are not strict and the

counter-actions are not severe, because the interventions have either not been applied well or,

in some instances, have not been pursued properly. Family planning has been a crucial word

in the development race that the third world has been proposed time and time again, but their

lack of infrastructure to distribute knowledge in these countries has enabled conditions to

deteriorate. Here, the study will look at various definitions of the concept Family planning

from various scholars accros the world.

2.1.1 Family Planning

The World Health Organization (1971) defined Family Planning as the practice that helps

individuals or couples to attain certain objectives such as avoiding unwanted pregnancies,

bringing about unwanted babies at the right time, regulating the interval between pregnancies,

controlling the time at which birth occurs in relation to the ages of the parents and

determining the number of children in the family. Family planning is also regarded as

reproductive health. Reproductive Health is a state of complete physical, mental and social

13
wellbeing, not merely the absence of disease, in all matters relating to the reproductive

system and to its functions and processes. Reproductive health therefore implies that people

are able to have a satisfying and safe sex life and that they have the capacity to reproduce and

the freedom to decide if, when and how often to do so.

Organized family planning programming in the developing world since the 1960s has

primarily focused on women, with less attention to involving men. Efforts for an improved

gender balance grew as a result of the 1994 International Conference on Population and

Development (ICPD), but since then the need has persisted to reinforce male involvement

and engage them as users of family planning as well as supportive partners for its use by

women (IGWG, 2009).

A restricted definition of the family planning that the researcher adopted in her study was that

it is a conscious effort to determine the number and spacing of births. It is therefore the right

of individuals and couples to freely and responsibly decide the number and spacing of their

children having good information, education and ability to do so (world population

conference, 2015).

Despite the fact that men constitute about 50% of the sexually active adult population, they

feel excluded from these services and hence are reluctant to use them. Reasons that men have

for opposing family planning vary, some want more children, while others worry that their

wives might be unfaithful if protected from pregnancy (khasiani, 2017).

According to Caldwel, (2002), the challenge has been on how to sustain contraceptive use.

Current trends demand that both men and female take part in family planning. Lawrence &

Wylie (1977) states that a man and woman are partners in the act of conception; however, in

the development of contraceptive technology and in the design of facilities for family

14
planning. It has been argued that this unbalanced emphasis has been related to the

comparative lack of proper male participation in family planning activities.

Family Planning was introduced to Zambia in 1972 by the Planned Parenthood Association

of Zambia with an aim of trying to motivate the people of Zambia to accept family planning.

In 1982, the ministry of health under primary health care integrated family planning into

Maternal and Child Health services (MCH). All people of the reproductive age group have

the right to access family planning services with different varieties being provided throughout

the country. In 1989, the Zambian government adopted a National population policy as an

integral component of its fourth National Development plan (FNDP) (1989- 1993) (MOH &

CBH 1997). In the year 1990, Zambia adopted a population policy which had targets such as

making family planning services accessible by women, available and affordable by at least

30% of all adults in need of the services by the year 2000 (Zambia National Population

policy, 2009)

Although contraception use in Zambia has since increased from 15% in 1992 to 26% in 1996

and further to 34% in 2001, only women have been targeted thereby sidelining men (CSO,

2001).

According to the World Health Organization (WHO, 2021), “family planning helps

individuals and families to predict and achieve their target number of offspring, as well as the

positioning and timing of their births.” That is accomplished by the use of contraception and

the prevention of unwanted infertility. The desire of a woman to space and restrict her

deliveries has a significant effect on her wellbeing and well-being, as well as the result of

each pregnancy.” In other words, family planning is a personal choice, and accessible

contraceptives (formerly known as birth control) may be tailored to meet specific preferences

using a variety of approaches that are both suitable and reliable when used properly. Unmet

15
need for family planning extends only to married people and suggests some women who

claim they want to postpone a baby but are not utilizing some form of contraceptive. The

figure is a stunning 215 million women worldwide.

2.1.2 Methods of Family Planning

1. Hormonal Contraceptive Methods: Hormonal contraceptive methods include oral

contraceptives pills, injectables, and implants. They all prevent pregnancy mainly by stopping

a woman’s ovaries from releasing eggs. hormonal methods contain either one or two female

sex hormones that are similar to the hormones naturally produced by a woman’s body.

Hormonal methods are highly effective in preventing pregnancies, and nearly all women can

use them. All hormonal methods work by preventing the woman’s ovaries from releasing an

egg every month. Without an egg, there is nothing for sperm to join with — known as

fertilizing the egg — so pregnancy cannot occur. They also cause the mucus produced by the

cervix to become very thick which prevents sperm from entering the uterus.

Hormonal methods include oral contraceptive pills, injectables, and implants. Each is used

differently, has somewhat different side effects, and has slightly different advantages and

limitations. It is helpful if a woman talks with a health care provider to make sure she has no

health conditions that may make a method unsuitable, to learn the specifics about the method,

and to choose one that is right for her. Some hormonal methods are shortacting, and some are

long-acting. The short-acting hormonal methods require either taking a pill every day or

getting repeat injections as scheduled. They are very effective when used correctly. They are

somewhat less effective when women forget to take a pill or to return for an injection on

time. Implants are long-acting hormonal methods, and they are highly effective because, once

inserted in the woman’s arm, the woman will not require further action for 3 to 5 years

depending on the implant being used.

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 2. Combined Oral Contraceptive: The most commonly used oral contraceptive pills

combine two synthetic hormones — estrogen and progestin. These oral contraceptives are

often referred to as combined pills or simply “the Pill.” If a woman remembers to take the Pill

every day, the method is close to 100% effective in preventing pregnancy. However, since

some women forget, on average over the course of a year, 8 pregnancies will occur among

every 100 women taking the Pill. Some women experience side effects when first taking the

Pill, such as nausea or mild headaches, but the side effects are not dangerous and usually go

away after the first few months. Breastfeeding women should delay starting the Pill until the

baby is at least 6 months old because the estrogen in the Pill might reduce the amount of

breast milk.

3. Injectable Contraceptives: Injectable contraceptives are given by injection into a

woman’s arm or buttocks in either the muscle or under the skin in the fatty tissue, depending

on type of injectable. After the injection, the hormone is released slowly from the injection

site into the bloodstream. Different injectables require a woman to return for a repeat

injection once every 1, 2, or 3 months. When women always remember to come for re-

injection on time, injectable contraceptives are close to 100% effective. However, some

women occasionally are late for re-injection. On average, over the course of a year, 3

pregnancies will occur among every 100 women using injectables. The most common side

effects of injectables are bleeding changes. At first, injectables may cause irregular, heavy, or

prolonged bleeding, but after

2.1.3 Attitudinal Factors Affecting Family Planning

Attitudes

Attitudes have long been considered a central concept of social psychology. The initial

definitions of attitudes were broad and encompassed cognitive, affective, motivational, and

17
behavioural components. Attitude has several definitions as Allport defined, an attitude as " a

mental and neural state of readiness, organized through experience, exerting a directive and

dynamic influence upon the individual's response to all objects and situations with which it is

related” [10]. Later, Kerch and Crutchfield defined attitudes as "an enduring organization of

motivational, emotional, perceptual, and cognitive processes with respect to some aspect of

the individual's world” [11]. These definitions intensified the constant and stable nature of

attitudes and their relationship to individuals' behaviour [12]. Attitude strength is very

important to understand. As several researchers considered attitudes are variable in their

strength. Moreover, the strongly held attitudes are more constant, continual over time and less

likely to be changed by disguised messages. In addition, they are better predictors of

behaviour than weak attitudes.

2.1.3.1 Educational Factor

Education

Education is the main catalyst, which can propel the desired greater rural women’s

participation, especially in skilled and highly productive jobs. In addition, it is known that

education is one of the most important basic human rights and should be made available to

everyone in society, regardless of gender, race or region (Allport, 2006). Women’s education

is a corner stone in family education, while a man’s education is merely educating one

human. The importance of women’s education in a society, especially a rural one, is the key

to solving many problems. In Egypt, the governorate counts on female education to solve

existing problems like female circumcision, population growth, addictions and education

dropouts (Krech, & Crutchfield, 2010).

level, as well as participation in the labour force. The number of children was inversely

proportional to the level of education.

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2.1.3.2 Socio-cultural Factor

2.1.3.3 Socio-economical Factors

Empowerment of rural women

The empowerment of women is a dynamic, economic, socio-cultural, family, legal, political

and psychological process (Roushdy, 2004; Malhotra, Schuler, & Boender, 2002), The

United Nations Millennium has committed countries to increasing gender equality and

empowering women to tackle four major issues, namely illiteracy, poverty, hunger and

illness, in a supportive and sustainable manner. These and other issues occur mostly in rural

regions (Millennium Project, 2005). The empowerment of women in rural regions depends on

many variables like land ownership and land control; access to different kinds of work,

education, health care training and political life possibilities. (French, & Burg, 2004).

(French). However, at various levels, this half confronts many difficulties. At the

unemployment level in 2010, women accounted for 24% of the work force, nearly 23% of

which were 4.3 times the rate of males. This prevalence among young women reached 54

percent (aged 15-24 years). In the non-agriculture sector, the proportion of women in the

wage employment sector was extremely low; almost half of the working women were in the

informal sector. There is still a gender gap and pay inequalities. The public sector supported

this disparity for women, while the private sector did not (UNDP and Ministry of Economic

Development, 2010). The ideal approach for empowering rural women requires the

dissociation of many opinions, institutions and processes that perpetuate discrimination and

subordination against women, preventing them from accessing political, social and political

facilities. For this process, education is the essential and crucial livelihood approach. Though

insufficient, research have shown that women's education is a strong and significant method

of decreasing poverty. The increasing data suggests that women need to get training in

various areas such as marketing, rural enterprise, farms and human and community welfare

19
funding (Millennium Project, 2005). In 2000, the fact that women gain much less than males

from social and economic possibilities may be explained by the inequalities in education and

skill development. The cause for women's analphabetism is sex discrimination in rural

regions. The training of men in rural regions is considerably higher than that of women.

Some 60% of all the Analphabet individuals worldwide are women, with just 69% of women

aged 15 and older being educated, compared to 83% of men (Roudi-Fahimi, &

Moghadam,2003). In Egypt, many research projects have examined the relationship between

female empowerment and demographics. El-Sheneity studied the relationship between status,

fertility and family planning and the findings of his investigation revealed a negative

relationship between fertility and education and involvement in the workforce. The children's

number was inversely related to educational level (UNDP and Ministry of Economic

Development, 2010). In this research, the empowerment of women was represented by many

factors that are supposed to influence the autonomy of women. This covers education for

women, health care and jobs.

Health facilities

Egypt has a large primary care network, which has a strong health system infrastructure.

Around 5,000 main public services and 1,100 public hospitals are in operation. An significant

part in providing health care and running private clinics as well as specialist hospitals Egypt's

private sector network of generalised professionals, labs and pharmacies Egypt (Sweetman,

2000). Most Egyptians reside in the vicinity of an accessibility health clinic; even in remote

regions most women live in a state hospital within 30 km.

Less physical access and greater socio-economic, educational or cultural variables are the

reason for under-use of health services. More than 1/3 of all mother fatalities in Egypt in

2000, for example, were caused by a lack of prenatal care (ANC), or inadequate ANC, in

20
particular among the least educated and mostly rural people (Roudi-Fahimi & Moghadam,

2003).

Health care for rural women

Two key variables influencing the decision-making of a person in the field of health care

have been examined for studying the attitudes of rural women: Social factors and access to

resources. First, social influences are the societal pressures perceived by the person in

deciding on a certain behaviour. This behaviour may be impacted by friends, family or

community members. Second, the availability of resources indicates access to

comportemental resources. This covers resources such as time, health insurance, and El-

Sheneity monetary resources (2009). The absence of health insurance substantially decreases

the use of health services. Medical treatment or recruitment opportunities for insured

individuals are higher than for uninsured peers even those suffering from chronic diseases of

health (WHO, 2014). Even uninsured households are less likely than insured families to seek

health care, even if income is consistent. Minister of Population and Health of Egypt (2000).

Some scientists have observed that low-income women typically have poor health conditions,

limited access to health and often suffer from chronic disease, particularly when they are not

insured (World Bank, 2015). In addition, certain issues such as mental and physical condition

are more reported by jobless women than employees, which is due to higher incomes, more

trust and self-confidence, and of course health insurance (Ross, Mirowsky, & Goldsteen,

2010). In order that educated women are able to comprehend the significance of healthcare

better than uneducated women, education also influences attitudes towards health. They are

thus generally healthier and physically more effective (Siefert, Heflin, Corcoran, &.

Williams, 2001). Moreover, age has not been shown to be the most important factor of

healthcare, but the knowledge and experiences of healthcare have been shown to be the most

effective determinant (Ross & Mirowsky, 2000). In general, rural society individuals in their

21
ideas and beliefs are classical, conventional and outdated. Rural communities are tiny and

have limited and poor resources, therefore developing a close link between families, urging

them to conform with the cultural convictions, structure and values of society (Rosen, Anell

and Hjortsberg) (2001).

Attitudes

A fundamental notion in social psychology has long been believed to be attitudes. Attitudes

were initially wide and covered by cognitive, emotional, motivational and behavioural

aspects. Attitude has many meanings, as described by Allport, an attitude "a state of

readiness, structured by experience and having an impact and dynamic influence on the

behaviour of the person to all its objects and circumstances" (Krech, & Crutchfield, 1948).

Krech and Crutchfield subsequently described attitudes as "a permanent arrangement of

motivational, emotional, perceptive and cognitive processes in some element of the

environment of the person" (Allport, 1935). These definitions have stepped up the consistent,

stable attitudes and relationships between them and the behaviour of the person (Bohner,

Moskowitz, & Chaiken, 2005). Because the views evaluated by different studies are varied.

Moreover, strong attitudes are more stable, are more consistent across time and are less prone

to be altered by covert signals. Moreover, they are better behaviour predictors than weak

behaviour.

Education

Education is the primary catalyst to foster the desired increased involvement of rural women,

particularly in skilled and highly productive professions. Furthermore, one of the most

essential human rights is education, which should be accessible to everyone in society,

irrespective of gender, ethnicity or location (Heise, Ellsberg, & Gottemoeller, 2010)

Education of women is the corner stone for education in the home, whereas education of a

man is just a human being. In a community, particularly rural, the significance of women's

22
education is crucial to addressing many issues. The Governorship of Egypt relies on

education for women to address issues such as women's circumcision, population increase,

addiction and loss of education (Hussain, Zakaria, Hassan, Mukhtar, & Ali, 2003).

Work Outside the Home:

In the past, rural women in Egypt participated in subsistence farming, including the planting,

weeding, harvesting, transport and selling of agricultural products. They were also

responsible for domestic chores and childcare. Small-trading remains a non-formal task for

rural women, since it is regarded an essential business activity in rural community in

developing countries such as Egypt (Hussain, et al, 2003).

2.2 Theoretical Frame Work

2.2.1 Health Belief Model

2.2.2 Diffussion Theory

2.2 Empirical Review

This part of the review will focus on a review of the methodologies and findings of related

studies.

2.2.1 Women Level of Awareness of Family Planning Services

The awareness drive should be for both couples as they are the ones to jointly take the

decision of accepting the need for family planning and what method(s) to adapt from

available options. According to Gage and Zomahoun (2011) information given to clients

refers to information imparted during provider-client interactions that enables clients make

informed choice and derive satisfaction. Modern methods of contraception include pill,

23
injection, implants, female sterilization, male sterilization, female condom, male condom,

intrauterine device, diaphragm, foam/jelly, and emergency contraception. Choice of methods

refers to both the number of contraceptive methods offered regularly and the extent to which

methods offered meet the needs of significant subgroups (Gage and Zomahoun (2011).In

their study (Alege, Matovu, Ssensalire and Nabiwemba, 2016) reported that Knowledge of

FP methods was nearly universal with (98.1%) and that method-specific knowledge was

highest for short-term methods (e.g. male condoms (98.3%), pills (97.9%) and injectables

(97.6%) while Knowledge of long-term FP methods (implants (91.7%); intra-uterine devices

(89.1) was equally high as was knowledge of permanent methods (female (79.3%); male

sterilization (77.6%)). with knowledge of lactational amenorrhea and emergency

contraceptives being the lowest at 71.9% and 40.1% respectively.

In a case study conducted in Ghana by Eliason, Awoonor-Williams, Eliason, Novignon ,

Nonvignon, and Aikins, (2014), it was reported that a little over 90% of both cases (93.8%)

and controls (91.5%) knew at least a method of modern contraceptive of which Injectable

was the most known modern method of family planning amongst both cases (93.1%) and

controls (82.6%), followed by the pill (cases-86.9%; controls-65.9%). The diaphragm was the

least known method amongst the cases (3.1%), while vasectomy or male sterilization was the

least known amongst the controls (0.4%).

2.2.2 Women’s Source of Information on Family Planning

Various studies in the six geopolitical zones of Nigeria have indicated that the main sources

of information about contraception, in descending order of frequency, include friends/

siblings, radio/television/newspapers/magazines, school lectures/workshops/seminars, and

health workers (Abiodun & Balogun, 2009). Oye-Adeniran, Adewole, Odeyemi, Ekanem &

Umoh, 2005, the poor contribution of health workers to dissemination of contraceptive

24
information is worrisome. More reliable information should emanate from health workers at

the family planning clinics but, in Nigeria, the family planning clinics are not young women-

or adolescent-friendly.The main reason for this unfriendliness is rooted in the cultural fabric

of Nigerian society where many still regard family planning services as the preserve of

married people (Otoide, Oronsaye & Okonofua, 2001).

In addition, discussions on sex and contraception with young persons is still considered

inappropriate in Nigeria, even among health workers (Abiodun & Balogun, 2009).)

Therefore, there is a great need in Nigeria to promote youth-friendly reproductive services to

encourage sexually active young people to increase their contraceptive use. However, this

must begin by mass education of the adult population in Nigeria to change the cultural norms

about sex education in adolescence. Recent observations in some centres and communities

indicate staff in health centres are becoming an important source of information, especially in

southern Nigeria ( Abasiattai, Bassey & Udoma, 2008) This is probably because of the

increased level of education among women and mothers in southern parts of Nigeria

(Abasiattai, Bassey & Udoma, 2008)

Among the health facility sources, the availability of contraceptives is higher at private

clinics than at government family planning and maternal health clinics or hospitals. In

addition, more married than single women receive contraceptives from the government-run

health facilities, including hospitals (Okpani & Okpani, 2000). Studies in Ghana and Kenya

have also shown that these commodities are obtained mainly from the private sector. In

contrast, in countries like Zimbabwe and Tanzania, where there is strong government

involvement in the provision of family planning services, the majority of users obtain oral

contraceptives and condoms from the public sector (Chen & Guilkey, 2003). This public

sector-driven commodity source of contraceptives is also seen in India and Indonesia. Mize &

Byrant (2006), the trend of the patent medicine shop being the most important source of

25
contraceptive commodities in Nigeria is worrisome. The type of information obtained on

contraception from a patent medicine shop is likely to be incorrect because these shops are

managed by traders who themselves may have little or no knowledge of contraceptives.

Unfortunately, the pharmacy shops which are managed by qualified pharmacists are few in

number and are limited to the urban areas.

The patent medicine dealers, however, are more numerous and found in the vast number of

rural and peripheral villages, where 60%–70% of the population resides. It is also in these

rural areas that there are no practising pharmacists or doctors to advise on contraceptive

choices. In most communities in Nigeria, single women are therefore more likely to obtain

contraceptive information and commodities from patent medicine dealers, because single

women are not culturally accepted at conventional family planning clinics, especially those

run by the government, (Oye-Adeniran, Adewole & Umoh, 2005) Religion and Christian

denomination have also been shown to have an influence on contraceptive usage. Research

by Oye-Adeniran et al has shown that while the Roman Catholics get their contraceptives

mostly from patent medicine shops, the majority of Christians get theirs from general

hospitals. Catholic patronage of patent medicine shops and market places may be connected

with a religious objection to the use of modern contraceptive methods. Muslims in the same

study also patronized the patent medicine shops more often because of the reported high

disapproval by Muslims of contraceptive use.30 In the same survey, the age of the respondent

was also important in the source of contraceptive commodity. Most adolescents used patent

medicine shops, but from the age of 25 years there is a greater tendency to obtain

contraceptives from the private/general hospitals. This finding is largely due to societal

disapproval of sex before marriage, the group to which most adolescents belong. Adolescents

are also most likely to obtain condoms and OCPs over the counter at patent medicine shops

where these cultural inhibitions are less evident. Unwanted pregnancy and unsafe abortions

26
are more common among young persons (15–24 years), yet it is this same age group that

Nigerian cultural forces have prevented from benefiting from adequate information regarding

contraception.

Sources of information on family planning include television, radio, posters, hospitals,

friend/relatives, communities, religious orgnaisations, seminars, talk show, and even social

Medias among others. Msovela, Tengia–Kessy and Mubyazi (2016) in their study reported

that overall - close to half of their respondents (45.7%) reported to have obtained FP

information from their spouses. The other half received such information through other

sources including mass media (27.6%); health facilities where they attended for care seeking

(18.1%); community health meetings (12.6%), and others from neighbours, friends,

campaigns, and billboards. While on actual access by mediums Msovela, Tengia– Kessy and

Mubyazi (2016) discovered that Majority of respondents were exposed to at least one type of

mass media with 82.7% of them reported to have listened to radios at least once per week.

One third (38.4%) of those that listened to radios also watched television while a slightly

lower proportion (28.1 %) claimed to have received FP information by additionally reading

newspapers. Out of those who listened to the radio, 78.1% confirmed to have heard FP

messages as compared to more than half (65.7%) of respondents who got such messages by

watching TVs. Moreover, about half of respondents (48.4%) reported to have had access to

newspapers through which they could get FP messages. For those reporting to have had seen

or heard of FP messages through the mass media, they specified that the contents of the

messages were related to such issues as child spacing, types of recommended FP methods,

importance of using the methods, their safety and male involvement in FP services. However,

the above study is for male and there is much likelihood that male tend to be more media

friendly than women.

2.2.3 Type of Contraceptive Method Adopted

27
Studies on the use of contraceptive method among Ghanaian women were assessed by

Govindasamy and Boadi (2000) using data collected in the Ghana Demographic and Health

Surveys that were conducted in 1988 and 1998. According to their results, a significant

number of women mentioned fertility-related reasons (infrequent sex, menopausal/subfecund,

postpartum/breastfeeding, and wanting more children) as principal reasons for nonuse.

Methodrelated reasons, particularly fear of side effects for method use, were also cited as

reasons for nonuse. In Uganda, community mobilization in family planning programs has

also been difficult and has been hindered by opposition to family planning on the part of

some religious and community leaders (Okwero, Ssempebiva, Okwero, & Kipp 1994).

Another report presented a review of literature on male attitudes and behaviors concerning

family planning and male initiatives in Africa. The results indicated that men often have

positive attitudes toward family planning, but women believe that their husband disapproves

of family planning. The report further noted that spousal communication was positively

associated with family planning method use (Toure, 1996). However, another study

conducted by Ezeh (1993) in Ghana showed that spousal influence, rather than being mutual

or reciprocal, is an exclusive right of the husband. According to the Demographic and Health

Surveys, many married women who want to avoid pregnancy are not using contraception

because their husband objects. Nearly one in ten married women with unmet need cited

husband’s disapproval as the principal reason for nonuse of contraception (Drennan, 1998).

A similar study of family planning programs in India’s rural Bihar state indicated that

improved access to services, expanded choice of available methods, and increased knowledge

of family planning were important for the acceptance of contraception. However, opposition

from husbands and in-laws, the desire for at least two sons, and lack of trust of voluntary

health workers from a different caste or religion were obstacles to the acceptance of

contraception (Rudranand, Bachan, Khan & Patel,1995) As indicated in the previous

28
subsections of this analysis, the unmet need for family planning is high (about 36 percent) in

Ethiopia. Therefore, this study looks at whether the factors that have been mentioned are

associated with the prevailing high level of unmet need for family planning in Ethiopia.

There have been numerous research endeavors on factors associated with the use of family

planning methods in most parts of Africa and Asia. However, such studies are limited in

Ethiopia, but there are a few fragmented descriptive studies that have been carried out by

scholars, mainly dealing with the reasons for nonuse of contraceptive methods. To fill these

gaps, this study assesses the socioeconomic and demographic factors, as well as individual

attitudes and perceptions, influencing use of family planning in Ethiopia. It is hoped that this

study will contribute to the improvement of family planning services in the country through

appropriate service delivery approaches and strategies.

Likewise, the majority of currently married Ethiopian women want to control their future

fertility. According to the 2000 Ethiopia Demographic and Health Survey report, nearly

onethird of Ethiopian women do not want to have any more children, a figure that rose from

onequarter in the 1990 National Family and Fertility Survey (NFFS). In the 1990 NFFS,

unmet need for family planning to limit childbearing was less than 1 percent among currently

married women, whereas this figure was 14 percent in the 2000 Ethiopia DHS survey. This

implies that there is an increasing demand for fertility control (CSA, 1993; CSA and ORC

Macro, 2001). Thus, meeting the unmet need for family planning may play an important role

in slowing the pace of population growth, improving maternal and child health, and

minimizing problems with natural resources and the environment that prevail in Ethiopia. In

many countries, the stated targets of population policies, i.e., increasing contraceptive use and

decreasing fertility levels, could be achieved by eliminating the unmet need for family

planning (Ross and Mauldin, 1994; Westoff & Bankole, 1995).

2.2.4 Factors that Mitigate the Utilization of Family Planning Methods

29
Osemwenkha (2004) stated that it is likely that the utilisation of family planning services can

alter the population growth rate, reports have shown that contraceptive knowledge, and usage

is very low in Nigeria, hence the reason for the high fertility and increased population. The

underutilisation of family planning methods in these regions is attributed to low literacy and

low socio-economic status of women, Oyedokun (2007) and spousal communication on

family planning has also been found to influence contraception use, Narary (2001). Again, a

study by Chacko (2001), found that the number of living sons a woman has also influences

her contraceptive use. The resultant effect of underutilisation of these services is a leading

cause to the high prevalence of teenage pregnancy and maternal deaths in Africa.

According to Cleland, Bernstein, Ezeh, Faundes & Glasier (2006) family planning services

are necessary for the widespread of adoption of preconception care for planning pregnancies

and counseling. The potential of family planning services is to promote preconception care

which is limited by underutilisation of these services and adequate attention to preconception

care during the reproductive years is dependent on the woman and man planning their

pregnancies, not only in respect to their timing but also on health-related factors that would

maximize their chances for a healthy pregnancy and healthy infant.

Child spacing, which is one of the benefit of utilising family planning services have been

identified as a means of reducing maternal deaths Campbell & Graham (2006). Globally,

99% 0f maternal deaths and disability occur in the developing countries, and Nigeria alone

accounts for 10 percent Ekpenyong & Ekpenyong (2011). In addition, utilisation of family

planning helps to prevent women from participating in unsafe abortion practices, Godwin

(2009). This is because in Nigeria, like many other African countries, abortion is illegal and

the United Nation Population Fund (UNFPA) 2009 reported that 74,000 women were

estimated to die because of unsafe abortion. This report further explains that 50 million

induced abortions were performed each year of which 20 million are performed in unsafe

30
conditions or by untrained providers. Thus, the use of family planning services reduces the

number of unintended pregnancies, thereby promoting women reproductive health by

decreasing the number of times a woman is exposed to the risk of pregnancy and child

bearing in adverse conditions World Population Department (1996). Family planning saves

lives and can improve the health of women, children and society as a whole.

The National Survey of Family Growth (NSFG) (2002) reported that 41.7% of women 15 to

44 years of age received at least one family planning service from a medical care provider.

This percentage is not as alarming as it might appear at first glance, because some of the

women who did not seek family planning services already were pregnant, seeking to become

pregnant, or infertile because of sterilization or other reasons. Nevertheless, this rather low

percentage suggests that some women are not either planning their pregnancies deliberately

or because they are experiencing problems, obtaining family planning services, Klerman

(2006). The growth rate in Nigeria is estimated to be between 2.5-3.0% increasing per annum

currently estimated to 190million persons and is expected to reach 338million persons by

2050, which pose various problems for economic growth and development in the country,

UNFPA (2005).

Utilisation of family planning services need to be increased and the content of such services

expand to achieve the reproductive health of women. Hence, it becomes expedient to conduct

this research to understanding the factors influencing utilisation of family planning services is

critical to the efforts of programmes targeted at meeting the demand for contraception.

2.2.5 Women’s Level of Acceptability of Family Planning

Studies have revealed that there is a high level of awareness and knowledge of family

planning methods in Nigeria but ample evidence from literature indicated that low

contraceptive prevalence and non-use of contraceptive is associated with high maternal

31
mortality ratio (Okonofua, 2003; Oye-Adeniran, Adewole, Odeyemi, Ekanem and Umoh,

2005). Similarly, findings from this study illustrated that majority of the women (96.4%)

have heard about family planning and only few (35.0%) accepted the use of family planning

methods that were available on their immediate community as this corroborates the work of

Igbodekwe, Oladimeji, Oladimeji (2014). This implied that high prevalence of awareness

among women of reproductive age is indicative, but the use of it is still low. Family planning

services can be made to reach a large number of people if it is well-marketed, and this can

break barriers such as cultural obstacles.

Similarly, more than half of the respondents (61.5%) have positive attitude towards family

planning from the influence of the promotion of family planning from organisations that

comes to promote family planning services in the community. Though, very few (1.5%)

women view that couples having three children were many and they reported that they were

comfortable with a fewer number of children. A quarter number of the respondents (21.0%)

mentioned that their husbands would not approve of the use of family planning in controlling

the number of children they desired to have. These findings support the works of Malhotra,

Reeve and Sunita (1995) and Nwachukwu and Obasi (2008). Majority (65.0%) declined the

acceptability of the use of family planning methods with reasons such as excessive bleeding

(34.2%), husband’s disapproval (16.2%), high cost of family planning methods (12.3%) and

fear (36.9%). These reasons has been similarly reported by previous studies (Barrett and

Buckley, 2007; Nwachukwu and Obasi, 2008; OlugbengaBello, Abodurin and Adeomi, 2011;

Igbodekwe Olademiji, Olademiji et al., 2014). Notably, spouse approval and acceptance of

the use of family planning method is a major hurdle hindering the use of family planning

methods by rural women in Nigerian communities. If their spouses approve their acceptance

of family planning methods, the women will tend to accept and practice family planning

methods. This was also corroborated by Ekani-Bessala and Carre (1998), Malhotra,

32
Vanneman and Sunita (1995) and Makinwa-Adebusuyi (2001) in their studies carried out in

India and sub-Saharan Africa. This pattern should be expected in the light of fertility

dimensions and non-use of family planning methods as a result of spousal refusal to use

family planning methods. This is an ongoing issue on family planning in Nigeria, especially

at grassroots level.

CHAPTER THREE

METHODOLOGY

3.0 Introduction

33
The emphasis of this chapter is on the methods, instruments and procedure that will be used

in the data gathering and information analytic process. It will also elaborate more on the

research methodology that will be adopted in conducting this study. The importance is to find

the suitable approach in addressing the research objective, the research design, the process

and tools used for data analysis and some ethical consideration. This methodology includes;

the research design, population of the study, sample size, sampling technique, instrument of

data collection/research instrument, reliability of the research instrument, validity of the

research instrument, administration of research instrument and the method of data analysis.

3.1 Research Design

The Survey research design will be adopted to generate the necessary information needed in

this study. According to Asemah’ (2012), survey research design is used to derived responses

through the administration of structured questionnaire to the respondents. Asemah explained

that survey is useful in trend studies; survey is also useful in panel studies. It is a procedure

used in obtaining information from a sample or relevant population that is familiar with the

ideas relating to the objectives of the study. Survey design is one which studies large or small

population by selecting and analysing (sample) data collected from the group through the use

of questionnaire, telephone or personal interview. In other to gather quantitative data, this

study will adopt a survey method with the use of a questionnaire.

3.2 Population of the Study

34
Population of a study refers to the totality of items or objects under a researcher’s focus and

about which a conclusion can be drawn on a phenomenon. According to Asika (1991) as

cited in Umar and Usman (2015), population is made up of all conceivable elements, subjects

or observations relating to a particular phenomenon of interest to the researcher. Therefore,

the population of this study will consist of the 119,117 registered residents of Ikenne Local

Government Area of Ogun State (Population Censors, 2006)

3.3 Sample Size

A sample size is referred to as the selected fraction of a population which stands as a

representation of the entire population. Sample size is a selected portion of population

representing an entire population which would produce data that would have been generated

from the total population. Therefore, the sample size of the population is gotten using the

Krejcie and Morgan sample size determination table, the Krejcie and Morgan table was

formulated by the statisticians Krejcie and Morgan (1970) to determine the sample size from

a given population and the sample size determination table allow the researcher to use a

sample size of 384 for any population more than 75,000 but less than 1,000,000.

35
Therefore, the sample size is 384.

3.4 Sample Technique

The study participants will be recruited using the purposive sampling technique, which will
be predetermined by the researcher’s criterion for inclusion and exclusion, these requirements
were set to determine eligible and ineligible participants for the research.

The inclusion criteria:

1. The respondents must be between 20 – 45 years of age

2. The respondents must be married
3. They must be willing to participate in the study
4. They must have prior knowledge of Family Planning

36
3.5 Research Instrument

Since the method of research to be adopted is the survey research method, the research

instrument for conducting this study is a self-structured questionnaire. The questionnaire will

be used in collecting relevant information from respondents. The questionnaire items were

generated from the research objectives and questions. However, the questions will be made

unambiguous and simple. The questionnaire will consist of five sections: A, B, C, D, and E.

The demographic details of the respondents will be covered in Section A, while the questions

aligned with the study priorities and research questions will be covered in Sections B to E.

Closed ended questions in a Likert scale style of five alternatives (SD=Strongly Agree,

A=Agree, D=Disagree, SD=Strongly Disagree, and U=Undecided) make up the framework

questions of the questionnaire. This will be used in order to get equal answers on the topics of

the researcher's concern.

3.6 Validity of research instrument

Validity of a research instrument is when a particular research instrument works for the

purpose for which it is made, but will not give the same result if conducted over and over

again. The face and content validity will be used to cross check the questions in the

questionnaire alongside with the research objectives. The content validity will be used by

cross checking with the operational definition of terms and the content of the research work.

Empiricism is one major characteristic of scientific research. However, this study adopted

this scientific method in order to ensure that before conclusions are drawn, everything must

be verified and tested before accepting it as evidence.

37
3.7 Reliability of Research Instrument

In order to prove the reliability of the instrument that will be used for this study, a pilot study

will be conducted at first with a convenient sample of 10% of the respondents from a

different location. The information gotten from the Pilot study will be subjected to Cronbach

alpha analysis to decide the reliability of the research instrument. The coefficients of

Cronbach alpha reliability test ranges from 0.00 to 1.00 with any value above 0.7 indicating

that the research instrument is reliable. The result of the Cronbach alpha shows that the

instrument used in generating responses from each of these categories of consumers

measured what it intended to measure, so the findings from it can be depended upon. The

pilot test will be dependent on the validation of questionnaire by supervisor.

3.7 Administration of data collection

In order to meet the intended respondents, the researcher and four other qualified research

assistants will administer the research instrument. This is due to the fact that the study must

be done within a certain amount of time. The researcher will instruct these research assistants

on how to administer the questionnaires to respondents. To ensure a high return rate, the

researcher and research assistants will wait for respondents to read, understand, and complete

the questionnaire before collecting it. The researcher and assistants will meet the respondents

in their offices, shops, market place and lots more.

3.9 Method of data analysis

The study used descriptive statistics to analyse the responses from the structured

questionnaire. It involves descriptive analysis such as frequencies, percentages, mean and

standard deviation. To test the formulated hypothesis, multiple regression analysis was used

with the aid of SPSS (26.0).

38
Reference

A Roadmap to Achieve Social Justice in Health Care in Egypt. International Bank for
Reconstruction and Development, (2015). pp. 52-59.
Akokuwebe, M. E. (2016). Factors influencing acceptability of family planning among
women in rural communities in Ife Central Local Government Area, Osun State,
Nigeria See discussions, stats, and author profiles for this publication at:
https://www.researchgate.net/publication/292141723,

Allport (1935), Attitudes. In C. Murchison (Ed.), Handbook of social psychology.

Worcester, Mass: Clark University Press,193

Allport, G.W. (2006). Attitudes. In C. Murchison (Ed.), Handbook of social psychology.

Worcester, Mass: Clark University Press,2006
Bankole, A., Oye-Adeniran B.A., Singh, S., Adewole, I.F, Wulf, D. Sedge, G., and Hussain,
R. (2006) Unwanted pregnancy and induced abortion in Nigeria: Causes and
consequences. New York, NY: Allan Guttmacher Institute, 2006

Bernstein, S., Cleland, J., Ezeh, A., Faundes, A, Glasier, A., & Innis, J. (2006). Family
Planning: the unfinished agenda. Lancet 368:1810-27

Bohner, G. Moskowitz, G. and Chaiken, S. (2005), The interplay of heuristic and systematic
processing of social information. European Review of Social Psychology, 1995, pp. 33-68

Bohner,G., Moskowitz,G. and Chaiken S. (2000). The interplay of heuristic and systematic
processing of social information. European Review of Social Psychology, 1995, pp.
33-68.
Bongaarts, J. (2003). ”Completing the fertility transition in the developing world: The role of
educational differences and fertility preferences.” Population Studies. Vol. 57, No. 3:
321-335.

Bushy,A.(1998). Health issues of women in rural environments: An overview. JAMWA,

1998, vol 53, no 2 , pp. 53-56.

Canning D, Schulz TP, (2012). The economic consequences of reproductive health and
family planning. Lancet. 2012;380:165-171. DOI: 10.1016/S0140-6736(12)60827-7.
PMID: 22784535

Cleland, J., Ngugwa, R. P. and Zulu, E. M. (2011). “Family planning in sub-Saharan Africa:
Progress or stagnation?” Bulletin of the World Health Organization. Vol. 89, No. 2:
137-143.

Cleland, J., S. Bernstein, A. Ezeh, A. Faundes, A. Glasier, and J. Innis. 2006. Family
planning: The unfinished agenda. The Lancet 368(9549):1810–1827

Conde-Agudelo, A. & Belizán, J.M. (2000). Maternal morbidity and mortality associated
with interpregnancy interval: Cross sectional study. BMJ, 321: 1255-1259

39
Darroch, J. E. and Singh, S. (2013). “Trends in contraceptive need and use in developing
countries in 2003, 2008, and 2012: an analysis of national surveys.” The Lancet. Vol.
381, No: 9879: 1756-1762.

Daulaire, N., Leidl, P., Mackin, L., Murphy, C., & Stark, L, MSc. PhD. (2002). Promises to
Keep: The Toll of Unintended Pregnancies on Women’s Lives in the Developing
World. Global Health Council: 1-46.

Dogo, B. (1998) A survey of the knowledge, attitude and practice of family planning among
the military personnel in the Ribadu Cantonment of Kaduna. J Environ Sci. 1998;
1(2): 124–132.

Egyptian Ministry of Health and Population (2000). Directorate of Maternal and Child Health
Care. National Maternal Mortality Study. Cairo: Ministry of Health and Population,
2000.
El-Sheneity S. (2009) Work and Women’s Empowerment in Egypt. Unpublished Report.
Social Research Center, The American University in Cairo, 2009.

El-Sheneity, S. (2009). Work and Women’s Empowerment in Egypt. Unpublished Report.

Social Research Center, The American University in Cairo, 2009.
Family Planning/Contraception, (2017). Available from: htp://www.who.int/mediacentre/
factsheets/fs351/en/ [Accessed: 2017/10/20]

Heise, L., Ellsberg,M. and Gottemoeller M. (1999). Ending violence against women:
population reports. Population Information program, Centre for Communication
Programs, The Johns Hopkins University, 1999.

Heise, M. Ellsberg, and Gottemoeller, M. (2010) Ending violence against women: population
reports. Population Information program, Centre for Communication Programs, The
Johns Hopkins University

Hussain, M. Zakaria, Y. Hassan, Y. Mukhtar, and Ali, S. (2003) Parents Attitude Towards the
Education of Their Daughters: A Case Study of Faisalabad–Pakistan, International
Journal Of Agriculture & Biology, 2003, vol 5, no 3, pp. 306–307.

Hussain, S., Zakaria, M., Hassan,Y., Mukhtar, Y. and Ali S. (2003). Parents Attitude
Towards the Education of Their Daughters: A Case Study of Faisalabad–Pakistan,
International Journal Of Agriculture & Biology, 2003, vol 5, no 3, pp. 306–307.
Hyeladi, A., Gyang, J.D. & Chuwang, N. (2014). Family Planning Practice and Factors
Influencing Family Size among Mwaghavul Ethnic Group of Plateau State. The
International Journal of Humanities & Social Studies, 2(3): 106-109

Idang, P.E. (2005). Knowledge, attitude and use of family planning methods among married
women in Odogbo Military Barracks, Ibadan. Unpublished Master of Public Health
dissertation, submitted to the Department of Public Health, University of Ibadan,
Nigeria, 2005, pp. 54–81

40
Kabeer, N. 2001. Reflections on the measurement of women’s empowerment. In Discussing
Women’s Empowerment: Theory and Practice. SIDA: Swedish International
Development Cooperation Agency

Krech, & Crutchfield, R.S. (1948) Theory and problems of social psychology. New York:
MacGraw-Hill.

Krech, D. and Crutchfield, R.S. (2010). Theory and problems of social psychology. New
York: MacGraw-Hill, 2010
Lauria, L., Donati, S., Spinelli, A., Bonciani, M., and Grandolfo, M.E. (2014) The effect of
contraceptive counselling in the pre- and post-natal period on contraceptive use at
three months after delivery among Italian and immigrant women. Ann Ist Super
Sanita. 2014;50(1):54-61.

Malhotra, A. Schuler,S.R. and Boender, C. (2002), Measuring Women Empowerment as a

variable in International Development. Gender and Development group of World
Bank. Social Dvelopment Group, 2002.

Malhotra,A. Schuler, S.R. and C. Boender (2002). Measuring Women Empowerment as a

variable in International Development. Gender and Development group of World
Bank. Social Development Group, 2002.
Malini B., and Narayanan E. (2014) Unmet need for family planning among married women
of reproductive age group in urban Tamil Nadu. Journal of Family & Community
Medicine. 2014; 21(1): 53-5

Mead,H., Witkowski,K., Gault,B. and Hartmann,H. (2001). The influence of income,

education, and work status on women’s wellbeing. Women’s Health Issues,
2001,11(3): pp. 160-172
Millennium Project (2005), Investing in Development: A Practical Plan to Achieve the
Millennium Development Goals, United Nations Development Programme, Earth
scan in the UK and USA, 2005.

Millennium Project (2005). Investing in Development: A Practical Plan to Achieve the

Millennium Development Goals, United Nations Development Programme, Earth
scan in the UK and USA, 2005.
Momsen, J. Townsend (2012), Geography of the Gender in the Third World, University
Press, State University of New York

Momsen, J.H. Townsend, J. (2015). Geography of the Gender in the Third World, University
Press, State University of New York, 2015
Muazu UA. (1994) Fertility pattern in Dalet Barracks, Kaduna. B.Sc. dissertation, submitted
to the Department of Geography, Nigerian Defence Academy, Kaduna
State, Nigeria, 1994

41
National Population Commission (NPC) [Nigeria] and ICF International, (2009). Chapter 5:
Fertility. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria, and
Rockville, Maryland, USA: NPC and ICF International. Pp. 45-55.

National Population Commission (NPC) [Nigeria] and ICF International, (2014). Chapter 5:
Fertility. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and
Rockville, Maryland, USA: NPC and ICF International. Pp. 65-66.

National Population Commission (NPC) [Nigeria] and ICF International, (2014). Chapter 7:
Family Planning. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and
Rockville, Maryland, USA: NPC and ICF International. Pp. 93-94

Nazli, Yasemin, Selcuk, Mehmet, Canan and Bilge (2017) Factors Affecting the Attitudes of
Women toward Family Planning. Additional information is available at the end of the
chapter http://dx.doi.org/10.5772/intechopen.73255

Ndiga S.R. (1992) Fertility pattern in Nigerian barracks: A case study of 241 Recce Battalion,
Kaduna. B.Sc. dissertation, submitted to the Department of Geography, Nigerian
Defence Academy, Kaduna State, Nigeria, 1992

Onwuzurike B.K, Uzochukwu BSC. (2001) Knowledge, attitude and practice of family
planning amongst women in a high density low income urban of Enugu, Nigeria.
Afr. J. Reprod. Health 2001; 5(2): 83–89

Parveen,S. and Leonhäuser, I. (2004). Empowerment of Rural Women in Bangladesh: A

Household Level Analysis. Conference on Rural Poverty Reduction through Research
for Development and Transformation. Deutscher Tropentag- Berlin, 5-7 October
2004.
Parveen,S. and Leonhäuser, I. (2004). Empowerment of Rural Women in Bangladesh: A
Household Level Analysis. Conference on Rural Poverty Reduction through Research
for Development and Transformation. Deutscher Tropentag- Berlin, 5-7 October
2004.
Paulin,G. D. and Dietz, E. M. (1995). Health insurance coverage for families with children.
Monthly Labor Review, 1995, pp. 13-23.

Rosen, P. A. Anell, and Hjortsberg C. (2001), Patient views on choice and participation in
primary health care. Health Policy,2001; 55: 121-128
Ross,C. E. and Mirowsky, J. (2000). Does medical insurance contribute to socioeconomic
differentials in health? The Milbank Quarterly, 2000, vol 78 no 2, pp. 291-321.
Ross,C. Mirowsky,J. and Goldsteen K. (2010). The impact of the family on health: The
decade in review. Journal of Marriage and the Family, 2010, vol 52, pp. 1059-1078.
Roudi-Fahimi F., and Moghadam V.M. (2003), Empowering Women, Developing Society:
Female Education in the Middle East and North Africa Population Reference Bureau,
New York, 2003.

42
Roudi-Fahimi, F. and Moghadam, V.M. (2003). Empowering Women, Developing Society:
Female Education in the Middle East and North Africa Population Reference Bureau,
New York, 2003.
Roushdy, R. (2004), Intrahousehold Resource Allocation in Egypt: Does women’s
empowerement led to greater investment in children. Population Council- West Asian
and North Africa Region, 2004.

Roushdy, R. (2004). Intrahousehold Resource Allocation in Egypt: Does women’s

empowerement led to greater investment in children. Population Council- West Asian
and North Africa Region, 2004.
Schwarz, and Bohner, G. (2001), The Construction of Attitudes in A. Tesser and N. Schwarz,
Intrapersonal Processes (Blackwell Handbook of Social Psychology), Oxford, UK:
Blackwell, 2001, pp. 436-457

Schwarz, N. and G. Bohner (2001). The Construction of Attitudes in A. Tesser and N.

Schwarz, Intrapersonal Processes (Blackwell Handbook of Social Psychology),
Oxford, UK: Blackwell, 2001, pp. 436-457
Siefert,K. C. M., Heflin, M. E. Corcoran, and Williams, D. R. (2001). Food insufficiency and
the physical and mental health of low-income women. Women & Health, 2001, vol
32, no1, pp. 159-177.
Sweetman, C. (2000) Gender in the 21st Century, United Kingdom of Great Britain and
Northern Ireland, Oxfam, 2000.

Sweetman, C. (2000). Gender in the 21st Century, United Kingdom of Great Britain and
Northern Ireland, Oxfam, 2000.
Tuladhar H, Marahata R. (2008) Awareness and practice of family planning methods in
women attending gene OPD at Nepal Medical College Teaching Hospital. Nepal
Medical College Journal. 2008;10(3):184-191
UNDP and Ministry of Economic Development (2010), “Egypt Progress Toward Achieving
the Millenium Development Goals”, 2010.

UNDP and Ministry of Economic Development (2010), “Egypt Progress Toward Achieving
the Millennium Development Goals”, 2010.
Utoo, P.M. & Araoye, M.O. (2012). Awareness and utilisation of family planning methods
among mothers of under-fives in Gindiri, North-Central Nigeria. Journal of
Community Medicine and Primary Health Care, 25(1): 23-30

WHO (2014). Country Cooperation Strategy for WHO and Egypt: 2010-2014. (World Health
Organization, Geneva). Document EM/ARD/037/E/R/12.10 Design and layout by
Pulp Pictures Printed by WHO Regional Office for the Eastern Mediterranean, Cairo.

WHO, (2021). The Partnership for Maternal, New-born & Child Health.

43
World Health Organization (WHO), (2012). Cutting-edge global research on family planning
and improving adolescent sexual and reproductive health. Department of
Reproductive Health and Research, World Health Organization, 2012, WHO, Geneva.

World Health Organization; (2012). Trends in maternal mortality: 1990 to 2010. Geneva:
Available
from:htp://www.unfpa.org/webdav/site/global/shared/documents/publications/2012/
Trends_in_maternal_mortality_A4-1.pdf. [Accessed: 2017/10/26]

Wyn,R. and Solis, B. (2001). Women’s health issues across the lifespan. Women’s Health
Issues, 2001, vol 11 no 3, pp. 148-159.

44