Health Facility-Based Versus Community-Based Family Planning Education and Utilization of Modern Contraceptives in Rivers State, Nigeria

The use of modern contraceptives by rural women of childbearing age in Nigeria is low. The aim of this study is to compare a community-based family planning education and text message reminder with the conventional health-facility based approach to promotion of modern contraceptive use among rural women of childbearing age in Rivers State, Nigeria.

Place and Duration of Study: This is a quasi-experimental before and after comparative study conducted in Etche (intervention group) and Tai (control group) local Government Areas (LGAs) in Rivers State Nigeria between August 2013 and January 2014.

Methodology: A total of 196 and 184 rural women of child-bearing age, recruited into the intervention and control groups respectively through multi-stage sampling, were followed up for six months. Data was collected on socio-demographics, parity condition, awareness and sources of information on modern contraceptives, method used, problems encountered in the use of methods as well as reason for non-use and discontinuation of use. Data analyses was done with SPSS version 15. Level of statistical significance was set at P < 0.05.

Results: Respondents in both groups were similar in socio-economic characteristics except for age. All (n = 196, 100%) in the intervention group and nearly all (n =182, 98.9%) in the control, were aware of modern contraceptives. Respondents who consistently used a method increased from 37 (18.9%) to 75 (38.3%; P < 0.001) in the intervention group but decreased from 49 (26.6%) to 41 (22.2%; P = 0.33) in the control. Respondents in the intervention group were more likely to be late users (RR 1.67, 95% CI 0.98 – 2.83); less likely to discontinue use (RR 0.58; 95% CI 0.32 – 1.07).

Conclusion: Community-based family planning education and text message reminders is a more effective approach for promoting modern contraceptive use among rural women.