Project – ACCESSIBILITY AND USAGE OF COMBINED ORAL CONTRACEPTIVE AMONG WOMEN OF CHILD BEARING AGE IN AGEGE, LAGOS

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Reproductive health is a significant public health concern, particularly in low- and middle-income countries where unintended pregnancies and unsafe abortions remain prevalent. Contraceptive methods are central to addressing these issues, with combined oral contraceptives (COCs) being one of the most widely used modern contraceptive methods globally. COCs contain both estrogen and progestin hormones, and when taken correctly, are over 99% effective in preventing pregnancy (World Health Organization [WHO], 2022).

In Nigeria, the use of modern contraceptives has gradually increased over the years, yet the prevalence remains relatively low compared to global standards. According to the Nigeria Demographic and Health Survey (NDHS, 2018), only 17% of married women of reproductive age use modern contraceptive methods, with a much smaller proportion relying on combined oral contraceptives.

Urban areas like Agege, Lagos, offer relatively better access to healthcare facilities and pharmacies, yet socio-cultural, religious, economic, and educational factors often influence contraceptive usage. Misconceptions about side effects, poor counseling, irregular supply, and partner disapproval are among the challenges faced by women in using COCs effectively (Adelekan et al., 2019).

This study seeks to explore both the accessibility and usage of COCs among women of childbearing age in Agege, Lagos, examining the extent of their knowledge, the sources of information, and the barriers they face.

1.2 Statement of the Problem

Despite increased global awareness and the availability of family planning services, many Nigerian women still experience barriers to contraceptive access and usage. In particular, combined oral contraceptives, though widely recognized and available in urban areas, are often underutilized due to socio-cultural myths, lack of awareness, fear of side effects, and inconsistent supply (Ijadunola et al., 2020).

Agege, a densely populated area in Lagos, is representative of urban communities with mixed socio-economic and cultural backgrounds. While healthcare infrastructure exists, the rate of contraceptive use, especially of COCs, remains uncertain. Understanding the specific challenges in this community is crucial for designing effective public health interventions.

This study addresses the gap by investigating the real-world accessibility and actual usage patterns of COCs among women of reproductive age in Agege, Lagos.

1.3 Objectives of the Study

The general objective of the study is to examine the accessibility and usage of combined oral contraceptives among women of childbearing age in Agege, Lagos.

The specific objectives are to:

1. Assess the level of awareness and knowledge of combined oral contraceptives among women of reproductive age.

2. Determine the level of accessibility of combined oral contraceptives in Agege.

3. Investigate the extent and patterns of usage of COCs among the target population.

4. Identify socio-cultural, economic, and healthcare-related barriers to the usage of COCs.

1.4 Research Questions

1. What is the level of awareness and knowledge about combined oral contraceptives among women in Agege?

2. How accessible are combined oral contraceptives to women of reproductive age in the community?

3. To what extent are COCs being used among women in Agege?

4. What are the major barriers affecting the usage of COCs in Agege?

1.5 Research Hypotheses

• H₀ (Null Hypothesis): There is no significant relationship between accessibility and the usage of combined oral contraceptives among women of childbearing age in Agege, Lagos.

• H₁ (Alternative Hypothesis): There is a significant relationship between accessibility and the usage of combined oral contraceptives among women of childbearing age in Agege, Lagos.

1.6 Significance of the Study

This study will be of immense value to public health policymakers, non-governmental organizations, healthcare providers, and community leaders. By identifying the key factors affecting the accessibility and usage of COCs in an urban Nigerian setting, interventions can be better tailored to address the needs of women. Additionally, the findings may guide the design of health education campaigns, improve service delivery, and contribute to reducing the rates of unintended pregnancies and unsafe abortions.

1.7 Scope of the Study

The study is limited to Agege Local Government Area in Lagos State and focuses on women of childbearing age (15–49 years). It investigates the availability, accessibility, usage, and factors influencing the use of combined oral contraceptives. Other forms of contraception, such as implants, injectables, and natural methods, are not covered in this study.

1.8 Operational Definition of Terms

• Combined Oral Contraceptives (COCs): A type of birth control pill that contains synthetic forms of two hormones—estrogen and progestin.

• Accessibility: The ease with which women can obtain COCs in terms of physical availability, affordability, and information.

• Usage: The actual practice of taking COCs for the purpose of preventing pregnancy.

• Women of Childbearing Age: Females between the ages of 15 and 49 who are biologically capable of becoming pregnant.

Project – ACCESSIBILITY AND USAGE OF COMBINED ORAL CONTRACEPTIVE AMONG WOMEN OF CHILD BEARING AGE IN AGEGE, LAGOS