Husbands grant wives access to family planning as economic crisis rises
Many Nigerian couples are feeling the brunt of the current economic hardship that has deepened poverty in the country as they have vowed to ignore culture and embrace family planning to have fewer children, JANET OGUNDEPO writes
In the bustling Oshodi area of Lagos, where the hum of commerce fills the air, Mr Idowu Lookman juggles two lives with quiet determination.
As hunger persists, Lookman has to turn to a side hustle to supplement his income.
By day, he is a bus conductor, navigating the hectic roads of Lagos. By evening, he trades the chaos of the streets for the rhythmic hum of sewing machines in his wife’s tailoring shop.
On Tuesday evening, Lookman sat on a small stool in the shop, watching his three-year-old son scribble in a notebook.
The boy’s soft giggles blended with the clatter of scissors, the whirr of fabric being stitched and the noise on the busy street.
When greeted by our correspondent, Lookman straightened slightly, a mix of curiosity and caution in his eyes.
The conversation began with the state of the economy, a topic he addressed with zeal and tact.
From rising fuel prices to political banter, his insights revealed a man deeply attuned to the challenges shaping his family’s future.
And when the question of having another child arose, Lookman’s reflective pause spoke volumes, hinting at the balancing act between dreams and the reality of the recent economic situation.
With a vehement shake of his head and a negative response, he said, “This is not the time for that. Things are hard and I am barely meeting up to my responsibilities.”
To ensure that he did not “mistakenly” impregnate his wife, the Osun State indigene said he has agreed to his wife’s decision to go to the clinic for family planning.
Although Lookman couldn’t mention the particular FP method his wife adopted, he expressed assurance that the economy had compelled him to put a stop to childbearing.
Like Lookman, a trader in foodstuff, Mrs Bukola Olatinwo, is a mother of three.
Olantinwo, in a conversation with our correspondent, expressed her desire to have five children based on the initial agreement she and her husband had.
But the economic situation, she said, has put a stop to those plans.
“I am no longer giving birth to children!” Olatinwo exclaimed.
She told PUNCH Healthwise that since her decision to stop childbearing, she had to convince her husband who was initially reluctant to agree to the FP services.
“With the agreement of my husband, I have gone to the Primary Health care Centre close to us and have received the contraceptive implant because I heard that one lasts for a long time,” the trader said.
Why family planning
The Demographic and Health Surveys program states that family planning is the use of modern contraceptives or natural techniques to limit or space pregnancies.
Modern contraceptive methods include the use of pills, injectables, implants, male and female condoms, female and male sterilisation and emergency contraception. Traditional methods include abstinence, withdrawal and folk methods.
Modern contraceptives
The World Health Organisation says the use of contraception advances the human right of people to determine the number and spacing of their children.
However, several barriers such as lack of spousal consent, limited access to accurate information, fear of side effects and delayed fertility, societal norms and religious beliefs have hampered the adoption of modern FP methods.
High fertility rate
Another grocery trader in Ibadan, Mrs Ada Ogini, told PUNCH Healthwise that she had shelved her plans of having six children, citing the economic hardship.
Ogini, who currently has three children, says the economic situation has crippled her desire for more children.
“I’d love to have half of a football team but the current economic situation is still making me reconsider such plans,” she said hastily as she went away to attend to a waiting customer.
Nigeria, which is known for its high fertility rate of 5.3 children per woman, according to the Nigeria Demographic and Health Survey, 2018, has a low adoption rate of modern family planning methods.
However, the 2023-24 NDHS shows that the fertility rate has declined with an average of 4.8 children per woman.
A research and data company, Macrotrends, reports that Nigeria’s fertility rate was 5.01 births per woman in 2024.
Although the country plans to achieve a 27 per cent modern contraceptive prevalence rate by 2030, as of August 2021, Nigeria’s mCPR is 12 per cent.
PUNCH Healthwise reports that family planning experts stated that if action was not taken, Nigeria’s population may rise to 450 million by 2050.
Dr Ejike Oji
The Chairman of the Management Committee of the Association for the Advancement of Family Planning, Dr Ejike Oji, recently said, “If we continue with the same fertility rate that we have now, our population is going to be driven to 450 million by 2050.
“If we do not bring down our fertility rates, by the year 2050, we will be 450 million, based on the percentage increase every year. Every year, we add about four million people to our population. So if you look at that, you know that it’s going to be a lot of problems for us.”
At the 8th Nigeria Family Planning Conference 2024 in Abuja, a former Minister of Health, Isaac Adewole, mentioned that effective family planning services were necessary for national development by curbing population growth and alleviating resource pressure.
He emphasised that FP could reduce maternal and infant mortality, improving quality of life and economic empowerment.
The Coordinating Minister of State for Health and Social Welfare, Prof Muhammad Pate, also identified family planning as a critical tool for managing population growth.
He further reiterated the country’s commitment to achieving the FP2030 target.
The FP2030 is a global partnership supporting women and girls’ reproductive rights and ensuring they make informed choices about contraceptive use.
‘Behind husbands’ back’
Many couples who spoke with PUNCH Healthwise all revealed that the economic hardship had forced them to embrace the several modern family planning methods initially rejected due to cultural reasons and lack of awareness.
One of them, a petty trader whose husband is a commercial driver, identified only as Mrs Akinola, stated that she was currently comfortable with her two children.
“I have no plans to give birth to more children. With the situation in Nigeria, now way!” she retorted.
When asked if her husband persuaded her to have more children, the trader said, “I won’t accept that. I have already gone behind his back to begin a family planning method because he doesn’t like me using FP or him using condoms.”
Akinola maintained her resolve to continue the modern FP, stating that she would appeal and make her husband understand her decision if he insisted on having another child.
Biting economy
The three words, “subsidy is gone” mentioned by President Bola Tinubu at his inauguration on May 29, 2023, began the downward trend of the Nigerian economy.
This decision, which led to the rise in prices of petrol, popularly called fuel, has had a ripple effect on the prices of food and transportation costs.
The price of fuel rose from N175 in May 2023 to N1,030 in October 2024 with the prices of food increasing to over 152.9 per cent.
Also, the decision by the Central Bank of Nigeria in June 2023, to allow a free float of the naira against other currencies led to the naira depreciation.
The respondents further mentioned that the increase in the cost of food, school fees, clothing, house rent and transportation, the high inflation and economic instability, which has led to the shrinking in household income has strengthened their resolve to stop childbearing.
Their fears were confirmed as the World Bank reports that 47 per cent and over 14 million Nigerians have been pushed into poverty and now living below the poverty line.
The World Bank also predicted that 52 per cent of Nigerians were estimated to live in poverty in 2026.
The Federal Government approved the new N70,000 minimum wage in July 2024, and many states have announced their plans to pay N70,000 or above.
However, not many states have begun the implementation as over five states announced their decision to pay the amount a few weeks ago to avert the planned strike by members of the National Labour Congress.
Silencing desire for more
A chemist, Mrs Adewa Iyin, says she loves children and would love to have as many as possible.
The mother of two, however, said that her desire had been placed on hold.
“Inflation has affected the prices of things. The school fees are high, things we ought to get at a cheaper rate are now high, so I have no choice but to reduce the number of children I want to have,” Iyin said.
Although the chemist says she used the barrier method to delay pregnancy, she was not consistent in its use.
Thankfully, she mentioned that her husband had agreed with her choice of FP.
Like Iyin, a commercial bus driver and father of three, Mr Ayoade, has no desire for more children.
His current earnings, which he said were currently insufficient to take care of his family of five due to the inflation, had waned his desire.
Ayoade said, “I have told my wife to go for FP because we cannot afford to have more children.”
Hardship increasing FP uptake
“Garri is now expensive; to cook soup is no longer feasible,” Mr Niyi Adebisi, a father of two, told PUNCH Healthwise.
Continuing he said, “We have decided to stop having children. The two that we have are okay. We have gone to the General Hospital for FP. We are using the injectables and we make sure to keep up with the appointment dates. We can’t afford to mistakenly get pregnant.”
WHO notes that there has been an increase in the number of women desiring to use family planning, stating that the figure rose to 1.1 billion in 2021 as against 900 million in 2000.
The United Nations sexual and reproductive health agency, UNFPA stated that the Federal Government of Nigeria committed to providing free access to family planning commodities towards achieving the goal of a contraceptive prevalence of 36 per cent by 2018.
The country also committed to financing family planning by allocating one per cent annually of the National and State Health budgets.
More couples embracing FP
Contraceptives
Data from the 2023-24 NDHS also shows that the contraceptive prevalence rate among married women has increased to 20 per cent from the previous 16.6 per cent.
It, however, noted that over 51 per cent of the country’s family planning demands remained unmet.
Maternal and Family Planning experts, who spoke to PUNCH Healthwise in exclusive interviews, also confirmed that while there is an increase in the uptake of FP, there was unavailability of FP products.
Nurses from two teaching hospitals in Lagos State also confirmed to PUNCH Healthwise that there was an increase in FP uptake.
Socioeconomic factors fuelling FP – Experts
A seasoned Professor of Obstetrics and Gynaecology, Oluwarotimi Akinola, stated that socioeconomic factors were fuelling the rise in the uptake of FP.
Professor Oluwarotimi Akinola
Professor Oluwarotimi Akinola
Akinola, who is the Head of the OncoGynaecology Unit at the Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, further noted that some women, due to the socioeconomic factors, were visiting the FP clinics without their husband’s knowledge.
Continuing, he said, “Availability and affordability matters. Sometimes, there is a problem with the availability of commodities and we cannot run away from that. The evidence from the NDHS shows that in urban areas, modern contraceptives are used more compared to rural areas.
“Look at it from the perspective of total fertility rates. The total fertility rate in the urban areas is usually much lower. So, while in 2018, we were talking about 5.3, every woman will have 5.3 kids, averagely in Nigeria, rural areas was about 5.7 or thereabouts. And now, it has come down to 4.8. This is because the total fertility rate in urban areas is going down because people are being more careful because of the economy. I cannot say it’s because of improvement in educational status within this short period. So, the only thing that can teach you is economy.”
The don stated that the current population, compared to our Gross Domestic Product, would put a strain on the country’s economy.
He further stated that due to the country’s high fertility rates and to foster economic progress, the contraceptive prevalence rate should go up.
Akinola called for further awareness and education about available contraceptives.
“If you improve education, you will find out, for example, that uptake will be more because people will be more aware and will seek it. So, it’s a measure of health-seeking behaviour. Also, women’s empowerment matters so that they can make that decision on their own. What do you empower women with? Education is also a major issue, so that if they are well-educated and all that sort of thing, they can take decisions on their own, take responsibility, have more finance to be able to power their way through so many things,” the maternal health expert said.
The don urged health workers to further educate and create awareness about FP.
He further called on the government to ensure that FP consumables were available in the centres.
‘Economic hardship a motivator’
Prof Panti
Professor Panti
Also, a Professor of Obstetrics and Gynaecology at the Usmanu Danfodiyo University, Sokoto, Sokoto State, Abubakar Panti, affirmed that there had been a small increase in FP uptake.
He noted that despite the FP consumables not being free, the economic hardship was fuelling the rising uptake.
Panti said, “I went to the family planning unit to look at their statistics and I noticed that although they are now paying for service, there is a slight increase in their uptake compared to when it was free.
“So if the government will just make it free, people will now have at least a soft landing. But some people cannot afford that small N1,000, or N2,000 that they will have to go and pay for consumables, especially if they are choosing the long-acting contraceptive piece, the one they have to insert implants or IUCDs, they have to use consumables. So sometimes those consumables used to make the price go up.”
The maternal expert further stated that the rise would contribute to the reduction in the prevention of unplanned pregnancies and preventing maternal mortality rising from unwanted pregnancy or unsafe abortion,
Panti called for affordability and accessibility to FP services, especially to unmarried couples and young girls.
“But suffice to say that there are a lot of packages that can help in preventing unwanted pregnancy. One of them is, of course, education and awareness, you know, sexual education, comprehensive education on reproductive health, reproductive methods, and of course, consequences of unprotected sex. This will help individuals to make informed choices in family planning.
“And of course, empowerment promotes understanding. So if people are empowered, that will, of course, improve our uptake. There should be access to contraceptives, including emergency contraception, counselling, support and personalised guidance,” the don said.
The fertility expert further called for support for teenagers and adults, stating that they needed advice that addresses their unique needs for contraceptive services.
Panti added, “We also need to have intervention for at-risk groups, especially young adult teens. Also, you support individuals who face unplanned pregnancies with counselling and information on options, including adoption, and legal abortion, where applicable.
“So definitely, family planning contributes to better health outcomes, economic stability, and empowerment for individuals and families. It helps reduce maternal and infant mortality, improve childhood, and allow women to pursue educational career opportunities.”
