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EVALUATING THE EFFECTIVENESS OF COMMUNITY HEALTH CLINICS IN PROMOTING FAMILY PLANNING IN ASABA, DELTA STATE
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EVALUATING THE EFFECTIVENESS OF COMMUNITY HEALTH CLINICS IN PROMOTING FAMILY PLANNING IN ASABA, DELTA STATE

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ABSTRACT

 

Background: Family planning remains a critical yet underutilised component of reproductive health services in Nigeria, with contraceptive prevalence rates persistently low in many states including Delta State. Community health clinics, as primary points of contact between the formal health system and communities, have a strategic role in promoting family planning services and addressing the knowledge, attitudinal, and structural barriers that constrain uptake. This study evaluated the effectiveness of community health clinics in promoting family planning in Asaba, Delta State. Methodology: A descriptive cross-sectional research design was employed. The study population comprised women of reproductive age (15–49 years), men of reproductive age (15–59 years), nurses, and community health workers in Asaba. A structured questionnaire was administered to 120 respondents selected through systematic random sampling from the Federal Medical Centre Asaba and selected community health clinics in the Asaba metropolis. Data were analysed using simple percentage and frequency distribution methods and presented in tables and charts. Results: Findings revealed that 71.7% of respondents had accessed family planning services through a community health clinic. Community health clinics were rated as effective or very effective in providing family planning information (78.3%), making contraceptive methods available (72.5%), and addressing barriers to uptake (65.0%). The most commonly utilised contraceptive methods promoted through community health clinics were injectable contraceptives (38.3%), oral contraceptive pills (27.5%), and condoms (21.7%). Key barriers to family planning uptake included cultural and religious objections (60.0%), spousal disapproval (55.8%), fear of side effects (51.7%), and limited awareness of available methods (43.3%). Women who had received family planning counselling from a community health clinic were 2.3 times more likely to be currently using a modern contraceptive method. Conclusion: Community health clinics are effective platforms for promoting family planning in Asaba, Delta State, though significant cultural, social, and institutional barriers continue to limit uptake. Sustained investment in clinic-based family planning counselling, male partner engagement, community sensitisation, and quality improvement is recommended to increase contraceptive prevalence and improve reproductive health outcomes in Asaba.

 

Keywords: Family Planning, Community Health Clinics, Contraception, Reproductive Health, Asaba, Delta State, Nigeria.

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TABLE OF CONTENTS

 

Cover Page                                                                                                                                   i

Title Page                                                                                                                                    ii

Certification                                                                                                                               iii

Declaration                                                                                                                                iv

Abstract                                                                                                                                       v

Dedication                                                                                                                                  vi

Acknowledgements                                                                                                                  vii

Table of Contents                                                                                                                    viii

List of Tables                                                                                                                              x

List of Figures                                                                                                                            xi

 

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study                                                                                                1

1.2 Statement of the Problem                                                                                               5

1.3 Objectives of the Study                                                                                                  7

1.4 Research Questions                                                                                                        8

1.5 Significance of the Study                                                                                               8

1.6 Scope of the Study                                                                                                        10

1.7 Operational Definition of Terms                                                                                  10

 

CHAPTER TWO: LITERATURE REVIEW

2.1 Conceptual Review                                                                                                       12

2.1.1 Concept of Family Planning                                                                                      12

2.1.2 Community Health Clinics and Reproductive Health Services                                14

2.1.3 Contraceptive Methods and Their Effectiveness                                                       16

2.1.4 Factors Influencing Family Planning Uptake                                                            18

2.1.5 Role of Nursing in Family Planning Promotion                                                        20

2.2 Theoretical Review                                                                                                       22

2.2.1 Theory of Planned Behaviour                                                                                    22

2.2.2 Application of the Theory of Planned Behaviour to the Study                                 23

2.3 Empirical Review                                                                                                         24

2.4 Summary and Research Gap                                                                                        28

 

CHAPTER THREE: METHODOLOGY

3.1 Research Design                                                                                                           29

3.2 Research Setting                                                                                                           29

3.3 Population of the Study                                                                                                30

3.4 Sample Size Determination                                                                                          31

3.5 Sampling Technique                                                                                                     31

3.6 Instrument for Data Collection                                                                                     32

3.7 Validity of the Instrument                                                                                            33

3.8 Reliability of the Instrument                                                                                         33

3.9 Method of Data Collection                                                                                           34

3.10 Method of Data Analysis                                                                                            34

3.11 Ethical Consideration                                                                                                 35

 

CHAPTER FOUR: RESULTS

4.1 Presentation of Results                                                                                                 36

4.2 Answering Research Questions                                                                                    48

 

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATIONS

5.1 Discussion of Findings                                                                                                 52

5.2 Implications of the Study                                                                                              57

5.3 Limitation of the Study                                                                                                 59

5.4 Contributions to Knowledge                                                                                         60

5.5 Summary                                                                                                                       61

5.6 Conclusion                                                                                                                    62

5.7 Recommendations                                                                                                        63

5.8 Suggestions for Further Studies                                                                                    64

 

References                                                                                                                                65

Appendices                                                                                                                               69

 

 

LIST OF TABLES

 

Table 4.1: Age Distribution of Respondents                                                                           36

Table 4.2: Marital Status of Respondents                                                                                37

Table 4.3: Educational Level of Respondents                                                                         38

Table 4.4: Occupation of Respondents                                                                                    38

Table 4.5: Utilisation of Community Health Clinic Family Planning Services                      39

Table 4.6: Effectiveness of Community Health Clinics in Providing Family Planning Information           40

Table 4.7: Effectiveness of Community Health Clinics in Making Contraceptive Methods Available        41

Table 4.8: Contraceptive Methods Promoted Through Community Health Clinics               42

Table 4.9: Barriers to Family Planning Uptake Among Respondents                                    43

Table 4.10: Relationship Between Clinic Counselling and Contraceptive Use                      44

Table 4.11: Strategies for Improving Community Health Clinic Family Planning Services  46

 

 

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