THE UNDERSTANDING AND PRACTICE OF NATURAL FAMILY PLANNING

PubMed, 2003

This study was carried out to document current trends in knowledge of, attitudes towards, and practices relating to traditional and modern child-spacing methods in a remote area in northern Burkina Faso. Information on sexual abstention, weaning, and contraception was elicited from 296 women of reproductive age, involving 413 postpartum intervals. A number of older women and key informants were also interviewed. The findings depicted significant diversity in that durations of individual postpartum sexual abstinence varied between 40 days and 3 years, with shorter durations associated with stricter adherence to Islamic beliefs and, possibly, a trend towards a less collective and, for the family unit, more labour intensive, agro-pastoral subsistence economy. Although durations of amenorrhoea were relatively short at between (median) 9 and 11 months, they determined the length of non-susceptible periods in almost 90% of cases. The median timing of weaning was stable at 24 months across all three main ethnic groups. However, changes in the frequency and type of complementary feeds may have impacted on the duration of amenorrhoea. Both demand for modem contraception and contraceptive prevalence (< 1%) were very low. The creation of new child-spacing norms and the promotion of modern contraceptive methods are likely to be successful in areas like this one only, if the population can be sensitized to the idea that Islam does not necessarily discourage contraception.

Social Science and Medicine, 1997

. 1997. “” Social Science and Medicine 45(12): 1789-1804. This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program , collective health action, and traditional leadership support for family planning behavior. !~ 1997 Elsevier Science Ltd. All rights reserved

International Research in Medical and Health Sciences, 2019

People everywhere have developed various means of family planning methods in fertility regulation for reasons such as ensuring better maternal and infant health, paternal care for children, reducing the burden of poverty, improving standards of living, quality education. The rate of population growth worldwide has caused political leaders to encourage national and regional fertility regulation project as vital support for regulation of individual fertility have been evident in all cultures at all-time even in those societies in which social and religious rules have favored the abundant production of children. The main objective was to assess the knowledge and practice of natural family planning among couples in Bamenda Health District. The descriptive cross-sectional study design was used in which the investigator collected data from couples on their knowledge in the practice of NFP methods and their findings analyzed. A sample size of 50 couples was recruited for the study; 50 questionnaires were administered to them within the study period. A random sampling technique was used, where three catholic churches were selected in the Bamenda Health District. Questionnaires were administered systematically to couples who practice NFP in the reproductive age group in the various churches. Results show that the high level of awareness of NFP methods did not give a corresponding encouragement to couples in practicing NFP methods. Culture and religion played a major role in a couple's decision to practice NFP methods and this is reflected in the husband's domination in most decisions taking by couples in reproductive health issues. Furthermore, women are found to be more involved in the practice of NFP than men. Both husbands and wives decide on the choice of family planning to be used and comparing following the man and the woman, the man-made the major decisions (26%) as to (24%) for the woman. Also following the decision on child spacing, the woman made the major decisions (34%) as opposed to the man (22%). On the decision concerning the family size, the man-made the major decisions.

American Journal of Health Research, 2014

Background: Optimal birth spacing plays a critical role in promoting perinatal health. However, in Ethiopia, many women still have shorter birth intervals than they would prefer and studies done to assess knowledge of couples were scarce. The objective of this study therefore was to assess perceived knowledge of couples about the disadvantage of short birth intervals in Arba Minch Zuria district, Ethiopia.Methods: Qualitative study design was conducted from February to April 2014 among women having at least two consecutive live births. Purposive sampling was employed to select information rich participants. Data were collected through focus group discussions using a semi-structured flexible discussion guide. Sixteen FGDs were conducted involving a total of 128 participants. Data were entered in to open code software and analyzed thematically.Result: Perceived disadvantage of short birth spacing, ultimate decision maker about birth intervals and reasons for experiencing short birth spacing were the major themes emerged from the discussion. knowledge of focus group discussants about the disadvantages of short birth pacing was high. Ultimate decision maker about birth spacing were couples in the optimal spacers groups. On the other hand, husbands had the right to say the final word among discussants that had short birth intervals. Index child being female, husband & religious influences, fear of side effects of contraceptive, lack of information about the benefit contraceptives, and inaccessibility of reproductive health services were noted as reasons to experience short birth spacing.Conclusion: Perceived knowledge of discussants was similarly high in both short and optimal birth spacers. The main reasons for experiencing short birth spacing were, husband influence, fear of side effects of contraceptives, lack of information about the benefits of contraceptives, and geographical inaccessibility of reproductive health care services. For women to achieve optimal birth spacing, they need the support of their significant family members. Hence, behavioral change communications should target all of those who have a direct or indirect influence on birth spacing decisions. Moreover, the district in collaboration with other stallholders needs to work hard to make reproductive health service accessible in all aspects.

Journal of Biosocial Science, 1994

SummaryPostpartum sexual abstinence may be a major determinant of fertility and of maternal and child health in sub-Saharan Africa. This study examines the relationship between ethnicity and abstinence using data from the 1988 Ghana Demographic and Health Survey. There is considerable diversity in the length of abstinence although only for one ethnic group, the Mole-Dagbani and other Ghanaians, is abstinence, both actual and ideal, very long. Respondents in most ethnic groups believe their abstinence to be adequate. A key motivation for abstinence is the unwillingness to have sexual intercourse with nursing mothers. Education, urbanisation, changes in marriage patterns and religious traditions are major factors shaping the ethnic differentials in abstinence. In comparison to breast-feeding, abstinence appears to have relatively little impact on the length of the birth interval and, for Ghana, has relatively few implications for fertility and child health.

Sexual and Reproductive Health Matters, 2019

Birth spacing has emerged since the early 1980s as a key concept to improve maternal and child health, triggering interest in birth spacing practices in low-income countries, and drawing attention to prevailing norms in favour of long birth intervals in West Africa. In Senegal, the Wolof concept of Nef, which means having children too closely spaced in time, is morally condemned and connotes a resulting series of negative implications for family well-being. While Nef and “birth spacing” intersect in key ways, including acknowledging the health benefits of longer birth intervals, they are not translations of each other, for each is embedded in distinct broader cultural and political assumptions about social relations. Most notably, proponents of the demographic concept of birth spacing assume that the practice of using contraception after childbearing to postpone births could contribute to “empowering” women socially. In Senegal, by contrast, preventing Nef (or short birth intervals) is also viewed as strengthening family well-being by allowing women to care more fully for their family. This paper draws on policy documents and interviews to explore women’s and men’s understanding of Nef, and in turn critically reflect on the demographic concept of birth spacing. Our findings reinforce the relevance of the concept of birth spacing to engage with women and men around family planning services in Senegal. Accounts of the Nef taboo in Senegal also show that social norms stigmatising short birth intervals can legitimise constraints faced by women on control of their body.

Inadequate birth spacing is perceived as riskier than all family planning methods, except sterilization and abortion, in a qualitative study among urban Nigerians, 2017

Background: Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians. Methods: A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach. Results: The ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items. Conclusion: Inadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants’ risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items’ perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing. Keywords: Nigeria, Contraception, Risk, Birth spacing

Social Science & Medicine, 1997

This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program, collective health action, and traditional leadership support for family planning behavior.

African journal of reproductive health, 2012

The persistence of early and closely spaced pregnancies in Northern Nigeria contributes to maternal and child morbidity and mortality. A technical working group to WHO recommended that following a birth, a woman should space her next pregnancy by at least 24 months, and following a miscarriage or abortion, a woman space her next pregnancy by at least six months. UNICEF, UNFPA and WHO also recommend that a woman delay her first pregnancy until 18. These recommendations comprise the concept of Healthy Timing and Spacing of Pregnancy. The Extending Service Delivery Project (ESD) partnered with the Federation of Muslim Women Association of Nigeria and religious leaders to educate communities about the benefits of using family planning to practice HTSP in five local government areas. Informal discussions with 148 women and 28 men found high recall of the HTSP recommendations and favorable attitudes toward spacing and family planning although many remain concerned about the side effects o...

Fertility religions are based on the birth, rebirth or rejuvenation of creation, especially the fertility of the land, which guarantees bountiful harvest and human fertility, ensuring the continuation of community. However, the emphasis on fertility, especially in Africa, has not only contributed in ruining marriages; it has also marginalized childless couples in church and community. This essay argues that there is an urgent pastoral need for the African church to develop a deeper and more nuanced understanding of fertility that goes beyond the biological and immanent view of the subject which I think dominates the understanding of marriage in both African Christianity and a significant document of Vatican II, Gaudium et Spes (Pastoral Constitution of the Church, 46-50). It argues that Christianity is not a fertility religion that is immanent and anthropocentric but is rather a theocentric religion that is transcendent in character, especially as demonstrated in the life, death, and resurrection of Christ. My original intention for this paper was to critique the immanent understanding of fertility that has come to characterize much of African Christianity. I intended to appropriate the debate on the difference between Baalism and Yahwism in twentieth century German biblical, and theological studies and the recent consensus on the perception of God as a fertile God, to call for a deeper and more nuanced understanding of fertility. This deeper and more nuanced understanding of fertility went beyond the biological and immanent view of the subject. This biological and immanent view of fertility, I think, dominates the understanding of marriage in both African Christianity and a significant document of Vatican II, Gaudium et Spes (Pastoral Constitution of the Church, 46-50). It seems to me that this immanent understanding of fertility and fruitfulness has negatively affected married life in Africa, especially for those couples who have not been able to bear children. The point of the paper was to argue that there is a crying