Currenttrend In Contraceptive Demand In A Tertiary Hospital In Calabar, Nigeria

Background: The recent prevalence rate for contraceptive use in Nigeria is put at between 11%–13%. This rate however seems to be very low notwithstanding the high rate of sexual involvement and widespread awareness of various methods of contraception. Many women in Nigeria often discover that they are pregnant after a missed menstrual period. Many of these pregnancies are therefore unplanned and unintended, ending in majority of cases in illegal and unsafe abortions and thus contributing to a high maternal morbidity and mortality ratio. There however seems to be a large unmet need for contraceptive use or a deliberate attempt not to use any method for reasons known to those in need. Recent encounters suggest that adolescents and married women are becoming more aware of their reproductive rights and requesting for different forms of contraception, including permanent methods of contraception without the consent of their spouses. Aim: the aim of this study is to ascertain the level of awareness and reasons for the increasing desire for contraception in cross river state, Nigeria and by extension the country as a whole in keeping with the current economic hardship and high unemployment rate in Nigeria. Methodology: this was a one-year retrospective and prospective study at a tertiary hospital in Calabar, Nigeria. This study was commenced on 1st January, 2019 to December 31st 2019, while the retrospective period covered January 1st to December 31st, 2018. The records of the family planning unit of the hospital in the previous year were compared with those of the year under study. Women who had active counseling during their antenatal visits and proceeded to take up a method were captured in this study. The parity, age, educational status and occupation were captured in the questionnaires. The results were analyzed as frequencies and percentages and presented in tables. Result: A total of 1,380 pregnant women booked in 2018 and had antenatal care (ANC) in this facility. However, only 1086 of them (78.7%) delivered in the facility and 338(31.1.0%) requested for and had contraception. In 2019, 1648 women booked for ANC and 1,210 delivered at the facility and 544(50.0%) indicated interest and received contraceptives. Conclusion: Comparatively, there is a drastic increase in contraceptive awareness and uptake in this study. During routine visits clients are taught on issues involving pregnancy changes, optimum care of the pregnancy, labour and delivery, care of the baby, breastfeeding and the post-delivery care and family planning. This has been the traditional teachings at antenatal clinics. This sudden change is however not unconnected with the hardship majority of households pass through. There is increased unemployment in the country and the country is ranked the second poorest country in world, with a daily income of less than 1-2 US dollar a day. This situation currently does not encourage keeping large family size, coupled with the high inflationary rate of 12-15% without any corresponding increase in wages.