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SPOUSAL COMMUNICATION AND CONTRACEPTIVE USE AMONG MARRIED COUPLES IN RURAL AREAS OF AKWA IBOM STATE
1.1 Background of the study
The institution of marriage is as old as the creation of man. According to Munroe (2003) marriage is a religious duty and is consequently a moral safeguard as well as a social necessity. It depends on many different things to be successful; trust, love, time, friendship, understanding, honesty, loyalty, sincerity and above all effective communication. Communication is the life-wire of marriage relationship or any meaningful relationship (Esere, 2002; 2006). It is the elixir for ailing marital relationship (Olagunju and Eneniyi, 2002). It is also the key to a successful marriage (Jolin, 2007).
Communication isconceived as a process in which people share information, ideas and feelings which involves not only the spoken and written word but also body language, personal mannerism and style (Hybels and Weaver, 2001). It is the imparting or interchange of thoughts, opinions or information by speech, writing or complex signs. It is the way humans create and share meaning, both verbally and non-verbally (Olson and Defrain, 2000). According to Axxin and Barber (2001), it can be referred to as the process used by people to create and manage relationships. In fact the ability and willingness to communicate have been found to be among the most important factors in maintaining a satisfying relationship.
Interaction between spouses is of great importance and interest as many studies have observed that contraceptive use vary considerably between couples who reported discussionrelative to those who did not. Although demographic studies on fertility historically focused on women, researchers of fertility behaviour are recognizing increasingly that decisions regardingchild bearing do not lie exclusively with women but rather on both spouses (Cynthia, 2011).
The importance of spousal communication is often emphasized in family planning programmes and research. In some analysts view, it is the first step in a rational fertility decision making process. Thus, communication intervention programmes have been developed and implemented to encourage couples to talk about the number of children to have, birth spacing and contraceptive use, but spousal communication concerning contraception remains low especially in developing countries.
A contraceptive could be defined as a device, drug or chemical agent that prevents conception. Lack of communication about contraceptive use and family planning may be associated with misconceptions about a spouse’s view of family planning which in turn may inhibit mutual decision making. Men and women who do not communicate with their spouse about family planning may not be aware that their spouses view contraceptive use positively (Biddlecome and fapohuna,1998). Thus in settings where contraceptive use is a sensitive issue and overt spousal communication is uncommon, men and women perceive such exchange differently and these perceptions guide their negotiation strategies with their partners (Kamal, 1999).Other factors that may inhibit spousal communication could be household crowding fatalism and perceived worthlessness of such discussions, dominance of other relatives (such as mother-in-law) in reproductive decisions and embarrassment about discussing contraceptive usage (Blanc,1996).
The population of any society depends primarily on the territory or physical environment for sustenance, but unfortunately, while population increases overtime, the land masses of which this population depends on for sustenance are relatively fixed. This results in food shortage, poverty, scarcity of land, hunger and environment degradation, political and social instability. About 70% of Nigeria’s population live and work in the rural areas with a very high fertility rate. High fertility has a negative impact on the health status of mothers, infants and children and contributes to the high morbidity and mortality situation in the country. The introduction and acceptance of modern birth control are of great importance in controlling the population growth in these areas as the rate of usage of contraceptives in these areas is relatively low (Asa and Daniel,2015).
Socio-demographic factors such as education, occupation, income have been shown to be significantly associated with contraceptive use (Gubbaju, 2009; Axxin 1993, Axxin and Barber, 2001). Also socio-psychological factors like knowledge of varieties of modern contraceptives, perceived consequences of contraceptive have been highly associated with contraceptive attitude of married couples. In a national assessment of reproductive health needs, it was reported that even among women with a fairly broad knowledge of contraceptive methods, many gave fear of spousal disapproval as the reason for non-use. While empowering spouses is undoubtedly important for using contraceptives, in a traditional or rural area, it is unclear yet what type of communication is more crucial for taking a decision in the selection of appropriate technology. Understanding the role of communication is crucial to this process because of the centrality of communication in contexts in which gender power differences about sexual and reproductive health matters are extremely salient.
1.2 Statement of the Problem
The Trading Economic Report of 2012 stated that the population of Nigeria in 2012 was 166.2 million people as against 4.2 million in 1960, representing a change of 268 percent during the last 50 years. This figure is likely to hit 389.615 million people in 2050, (Food and Agriculture organization (FAO), 2012). This high population growth has brought about high food demands, triggering tremendous hike in food deficit and high import bills with 991 billion naira being spent on cereals and 97 billion naira on fish in 2010 (Thisday Live, 2012).
In Akwa Ibom State, according to the 2006 National Population Census, the population figures stood at 3,920,208 people; 2,044,510 male and 1,875,698 female, thus representing 2.8% of the total population of the country which was recorded as 140,003,542 at the period (National Population Commission, NPC, 2006). This number has also been projected to increase to 5,344,149 by the UNFPA report, (November 2010) representing an increase of 3.41 percent.
Rapidly increasing population may result due to the effect of three important factors, viz: birth rate, death rate and higher net immigration. The population of Akwa Ibom State and Nigeria could be increasing mostly due to the effect of increasing birth rates. For instance crude birth rate (CBR) was 39.0 and 44.60 in 1990 and 1991 respectively (NPC, 2002), it was 42.0 in 2003 (NPC, 2003) indicating a high CBR in the state.
Increasing population threatens food security. Adetiloye (2012) conceives food security as access to enough food by the people at all times that can make them active and healthy and at a minimum cost while the Wikipedia (2010) defines the term as a measure of the ability to ensure access to nutrition while food insecurity refers to a country’s inability to provide and secure high quantity and quality of food to its people as a result of high demand, shortage in supply of agricultural commodities and low purchasing power (Abdurahaman, 2013). Adebayo (2010), Abu (2012) and Adeniyiet al (2009) confirmed the existence of food insecurity in Nigeria.
The impacts of rapid population growth in the state are already seen through non-renewable resource consumption and depletion, land degradation and waste disposal, weather modification, rapid urbanization, water, air and soil pollution and desertification among others (Oramah, 2006). Hughes et al (1997) argued that population growth has been responsible for 45% of humanity’s environmental problems. Rapid population growth could have also retarded economic development in Akwa Ibom State. Jhingan (2005) opines that the effect of population growth on per capita income is unfavourable. He further stated that population growth retards capital formation. It increases the population on land, rise in cost of consumables goods and decline in accumulation of capital as increase in family members’ increases expenses.
Population growth has been identified as one of the principal causes of poverty in Africa (WHES, 2012). Poverty in Africa has been noted to be prevalent in the rural areas where greater population lives with poorly developed human resources and poor access to basic amenities of life (IFAD, 2012). In Akwa Ibom state where 72.3% of its population lives below the poverty line (Umoh, 2002) poverty is more prevalent in the rural areas than in the urban areas. Rapid and uncontrolled birth rate amongst low income earners has contributed to rural poverty level in the state.Oye-Adeniranet al (2004) opined that large number of Nigerian women experience unwanted, un-intended and ill-timed pregnancies and births. The 2003 Demographic and Health Surveys (NDHS) found that of live births to women in the previous three years, 15% were reported to be unplanned. Thus population control is seriously needed if people are to live sustainably in Akwa Ibom State.
The use of birth control methods and contraceptives could help check population growth in the state and in the rural areas. But there exist low level of contraceptive usage in developing countries especially in the rural areas. According to Drenann (1998), Couples in urban areas are generally more likely to discuss fertility desires than their rural counterparts. Lack of husband/wife communication about family planning could be one of the factors raising this gap.
Husbands play dominant role in most family matters and as bread winners also have a major say in the families. Regrettably, available researchers on family planning and contraceptives usage have traditionally focused on women over the years to raise contraceptive prevalence and usage (Bawah, 2002; Sharan and Thomas, 2002) with the exclusion of husband’s reports, but with the male dominated societies, it is unlikely that women bring sexual and contraceptive issues to the surface and initiate discussions with their husbands.
Studies on spousal communication demonstrate a strong positive association between contraceptive use in Bangladesh, Ghana and Kenya (Kamal, 1999; Salway, 1994; lasee and Stan, 1999) but information on the effect of spousal communication on contraceptive use in Akwa Ibom State is limited. This study will attempt to fill this gap by assessing spousal communication and contraceptives use among married couples in rural areas ofAkwa Ibom State. Although there have been so many family planning programmes in Nigeria, the level of use, especially of modern contraceptives methods is still low (Asa and Daniel, 2015). This low level of use in spite of various programmes points to the need for more research in that area .Also understanding the determinants of contraceptive use in Nigeria is still very crucial to the achievement of population and development goals.