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.
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
