Influence Of Child-Spacing Campaigns On The Knowledge, Attitude And Practices Among Rural Women

Unplanned child birth generates serious health and financial problems for families, and results in a population explosion in the presence of inadequate infrastructure. In spite of the various awareness creation campaigns on family planning, many women are still ignorant of its importance; some believe that children are gifts from God and women should bear children without any restrictions. This study therefore sought to assess the influence of child-spacing campaigns on the knowledge, attitude and practices among rural women Osun State. A structured questionnaire was administered to 200 purposively selected women of child-bearing age attending the two largest infant welfare clinics in Osogbo.The mean age of the participants was 26.23 (SD ± 1.23) years. The majority (170; 85%) were married, had 3-4 children (114; 57%) and were Muslim (118; 59%). Most (130; 65%) of the participants had secondary level education. Almost all the participants (194; 97%) were knowledgeable about family planning and contraception and all of them practiced it. About 70% of the women had a good attitude to family planning. There was a significant relationship between education qualification (p < 0.000) and parity (p < 0.000) and women"s attitude tofamily planning. Likewise, there was a significant relationship between the family planning knowledge of women of child-bearing age as well as their practice of family planning (p < 0.000). The study showed that these women in the selected hospitals had good knowledge of and attitudes to family planning and applied good practices.

1.0 Introduction

1.1 Background To The Study

In 1948, the United Nations (UN) declared health, which is a state of human wellbeing, as a right (United Nations, 2010). Thus, striving for enhancement in health is a moral obligation for policy-makers at all government levels nationally and globally. Also, scholars have asserted to the significance of health to human capacity development. This indicates a shift in the development strategy meaning that enhancement of health standards is a means to achieve development in other areas (Kumar and File, 2010; World Health Organization (WHO), 2013; Bello and Joseph, 2014). Mortality in children under five years remains a factor that defines the wellbeing of any population and it is usually seen as one of the indicators of health development and socioeconomic status which go for quality life in a given population, as measured by the life expectancy rate (Buwembo, 2010).

According to the United Nation International Children Fund, child mortality is defined as the death of a child born alive between the day of birth and span of 12 months (UNICEF, 2013). The death rate among children is the scale of measurement of infants dying before they reach the age of one. Infant mortality includes deaths that occur between ages 1 and 5. Cases of infant and child death are largely inadequately reported and rarely documented in developing nations. Efforts for survival can be effective only if they are based on accurate information on the causing factors of diseases (Abhulimhen and Iyoha, 2012). The environment where the child is born and brought up is fast becoming unhealthy so that the life of the infant is constantly threatened by risk of morbidity (Chaudhari, Srirastava, Maitra and Desai, 2013). Another factor that affects infants and children survival has been identified to be the high depressing effect of HIV/AIDS. This threat has been a major global issue affecting the lives of families and eventually reducing the chances of survival of the infant (Baingana and Bos, 2013).

Many countries have shown a fair amount of progress in tackling infant death rate and it has been more advanced in Northern Africa, Eastern Asia, Western Asia, Latin America the Caribbean and Europe. It has set them on the track of achieving the SDG in opposition to many nations that still possess unacceptably high rates of child death. Sub-Saharan Africa accounts for one-fifth of the population of infants under 5years, and also accounts for about half (8.8 million) of deaths recorded in 2008 which indicates inadequate progress to meet the SDG 2020 target (WHO, 2014). In Nigeria, an examination of death levels across three successive five-year time periods indicate that mortality rate of under-five reduced from 199 deaths per 1,000 births during the middle to late 1990s to 157 deaths per 1,000 births in the middle part of the early 2000s and 128 deaths per 1, 000 births in 2013 (NPC and ICF Macro, 2013). These factors are attributed to poor family planning services and use, especially, inadequate child spacing. Lack of proper birth spacing serves as a causing factor of child malnutrition, deformities and health complications in adolescence and young adulthood (WHO, 2014).

The socio-demographic and economic factors of families play vital roles in determining survival of a child worldwide (Shawky and Milaat, 2011). For instance, mothers" education level has an inherent effect on the children"s health (Abuqamar, Coomans and Louckx, 2011). Early marriage has also been noted in various studies to have had significant effects on both the socioeconomic condition and infant mortality rate (Othman and Saadat, 2013). A study by Raj et al., (2010) in India indicated that children born to mothers who were married before the age of 18 were more prone to a higher risk of stunting and underweight when compared to infants of mothers who got married at the age of 18 or older.

The increase in mortality rates in Osun State seem to be firmly established and this would appear as the most striking demographic phenomenon of the last seven years. While, the pattern of mortality increase in Osun State bears similarities to the observed pattern in the early stage of the demographic transition, it is occurring now under quite different social, economic, and medical conditions. Child mortality rates are rapidly increasing as more infants are born with HIV and antropogenic factors. such as internal crises, malnutrition and climate change (MOH, 2014). Several health agencies both at the international and national levels, including non governmental agencies across the globe have striven towards combating the menace of under-five mortality. However, to the best of the knowledge of the researcher no study has been carried out on the trends and levels of awareness of inadequate child spacing on child health in Osun State, specifically Osogbo. Even where research exists on other parts of the country, very few of such works have placed emphasis on the socio-economic differentials. Studies in these areas have not clearly indicated the pattern or trends of infant and child mortality stemming from child spacing inadequacies as to whether the trend is increasing or decreasing in Osun State.

1.2 Statement Of Problem

Reports from systematic reviews and meta-analyses show that short- and long-term intervals between pregnancies are independently associated with high risk of negative maternal, infant, and child outcomes (CondeAgudelo, et al, 2016; Rutstein 2010). Inter-pregnancy spacing shorter than 18 months and longer than 59 months are greatly associated with high risk of negative perinatal outcomes. Moreover, short spacing are associated with high risk of premature membrane rupture, utero-placental bleeding and disorders including abruptio placentae and placenta, and uterine rupture in women using a vaginal birth after previous cesarean delivery session encounter; and long spacing (usually longer than 5 years) are associated with a high risk of preeclampsia (Conde-Agudelo, et al., 2017). Preceding inter-pregnancy spacing lesser than 36 months are relatively associated with a greater risk of child and under-five-years death rate, and spacing shorter than 24 months is significantly associated with a high risk of early neonatal, neonatal, and infant mortality levels (Rutstein 2013).

The means by which short and long spacing between pregnancies may affect maternal, infant, and child health have been the focal point of interest for much debate. Hypotheses usually adopt a biological or a behavioral orientation, yet no one framework has arisen as a dominant one (Erickson and Bjerkedal 2013; Winikoff 2013; Klebanoff 2013). In 2005, WHO conducted a technical consultation on birth spacing and it recommended the formation of a comprehensive framework to explain and evaluate the possible causal mechanisms of effective birth spacing (WHO 2016). Several health agencies at the national and international levels, including non-governmental agencies across the globe have striven towards combating the menace of spiking under-five mortality rates, via adequate birth spacing of children among a host of other factors. The study was therefore carried out to assess the influence of child-spacing campaigns on the knowledge, attitude and practices among rural women Osun State.

1.3 Objectives Of The Study

The broad objective of this study is to assess the influence of child-spacing campaigns on the knowledge, attitude and practices among rural women Osun State. However, the specific objectives are to:

Examine the knowledge, attitude and practices of inadequate child spacing (ICS) among rural women in Osogbo, Osun State

Identify factors responsible for inadequate child spacing (ICS) in Osogbo, Osun State

Examine the influence of child-spacing campaigns on the knowledge, attitude and practices among rural women in Osun state

1.4 Research Hypotheses

HO1: Child-spacing campaigns do not have significant influence on knowledge among rural women in Osun state

HO2: Child-spacing campaigns do not have significant influence on attitude among rural women in Osun state

HO1: Child-spacing campaigns do not have significant influence on practices among rural women in Osun state

1.5 Significance Of The Study

The results and findings of this study will fill the knowledge gap as a means of information to patients, healthcare professionals and providers, individuals and the society at large. This study generates information that could be found useful in the development and review of policies on family planning services, inadequate child spacing and its effects on health of children. The study will show the level of infant and child mortality, it"s implication to health effects and awareness among parents. Management and Regulatory Authorities will use the findings from this study as a basis for identifying strategies for community participation and the training of health personnel and providers with the aim of implementing effective intervention strategies.

1.6 Scope Of Study

This study was carried out to assess the influence of child-spacing campaigns on the knowledge, attitude and practices among rural women Osun State. Osogbo was chosen as the main area of study since the whole state could not be covered due to lack of resources and want of time.

• Mass Communication Project Topics and Materials