PERCEPTION AND UTILIZATION OF MODERN CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE (18–49) IN ABAKPA HEALTH CENTER, ENUGU STATE

TOPIC IS SUITABLE FOR:
1-Nursing Science
2-Public Health
3-Community Health
4-Human Anatomy

TOPIC: PERCEPTION AND UTILIZATION OF MODERN CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE (18–49) IN ABAKPA HEALTH CENTER, ENUGU STATE

TABLE OF CONTENT
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Definition of Terms
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review
CHAPTER THREE: METHODOLOGY    
3.1 Research Design    
3.2 Research Setting         
3.3 Target population                                  
3.4 Sample size 
3.5 Sampling technique    
3.6 Instruments for data collection     
3.7 Validity and Reliability of Instrument
3.8. Pilot Study    
3.9 Method of data collection 
3.10 Method of data analysis     
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.0 Introduction
4.1 Data Presentation
4.2 Demographic Analysis 
4.3 Analysis of the Level of Knowledge of Modern Contraceptives among Women Aged 18–49 Attending Abakpa Health Center
4.4 Analysis of the Attitude of Women of Childbearing Age Towards the Use of Modern Contraceptives at Abakpa Health Center
CHAPTER FIVE: DISCUSSION OF FINDINGS
5.1 Discussion of Findings    
5.2 Implications of findings to nursing                            
5.3 Limitations of the study                            
5.4 Summary of the study                                      
5.5 Conclusion                                    
5.6 Recommendations                                 
5.7 Suggestions for further studies
References
Appendix

ABSTRACT 
This study was carried out to examine the perception and utilization of modern contraceptives among women of reproductive age (18–49) in Abakpa Health Center, Enugu State. The study was specifically carried out to assess the level of knowledge of modern contraceptives among women aged 18–49 attending Abakpa Health Center, examine the attitude of women of childbearing age towards the use of modern contraceptives, determine the utilization pattern of modern contraceptives among women in Abakpa Health Center, identify barriers that hinder the adoption of modern contraceptives and explore socio-cultural factors influencing contraceptive choices among women in the community. The study employed a descriptive survey research design. Hence, a structured questionnaire was used for data collection, while the data collected were analyzed using frequency tables and percentage distributions for research questions, and Chi-square statistical tool was used for hypothesis testing. The population of the study was 250 women of reproductive age (18–49) attending Abakpa Health Center, while a sample size of 154 was determined using Taro Yamane formula and a validated sample size of 139 was used for final analysis using stratified and convenience sampling techniques. From the responses obtained and analyzed, the findings revealed that 68.8% of respondents demonstrated good knowledge of modern contraceptives while 31.2% showed poor knowledge. It was also found that 69.1% exhibited a positive attitude towards modern contraceptive use while 30.9% had a negative attitude. The study further revealed that 65.3% of respondents currently utilize modern contraceptives while 34.7% do not. Additionally, barriers such as cultural beliefs (61.4%), side effects (58.9%), and inadequate health information (55.6%) significantly affected utilization. The Chi-square results showed a significant relationship between knowledge and utilization (χ² = 18.64, p = 0.000) and between attitude and utilization (χ² = 16.87, p = 0.000). The study therefore recommends that health authorities should intensify reproductive health education, improve accessibility of contraceptives, engage community leaders in sensitization programmes and strengthen counseling services to enhance informed contraceptive utilization among women of reproductive age in the study area.
Keywords: Modern Contraceptives, Knowledge, Attitude, Utilization, Women of Reproductive Age.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Even in the 21st century, health is a key pillar of human development, which largely drives individual productivity, family stability and social progress. The world's health systems have seen a shift in focus over time with more emphasis placed on preventive healthcare that will help to lower morbidity and contribute to a better population health. In this wide context, reproductive health has gained wide acceptance as an important issue of public health as it includes full physical, mental and social well being in relation to reproductive processes and functions. This is not just about being free of disease, but it's about making informed choices, enjoying services and having the freedom to choose when to conceive. Gahungu et al. (2021) reiterated that reproductive health services are a vital pillar in the delivery of primary healthcare and Bolarinwa et al. (2021) argued that reproductive health information access would improve health behaviour and decision-making of people. In a related perspective, Kingsley (2023) pointed out that reproductive health interventions have in recent years become pivotal and central in achieving maternal and child health outcomes globally.
Based on this basic knowledge, family planning has become one of the major approaches in reproductive health service to help individuals and couples plan the timing, spacing, and number of children they want to have. Family planning service consists of a variety of interventions to prevent unplanned pregnancy and advance reproductive control. These interventions are focussed on use of modern contraceptives, which are scientifically developed methods to prevent pregnancy through hormonal, barrier, intrauterine or permanent means. These are such as pills, injections, implants, intrauterine devices, condoms and sterilisation techniques and are of different durations, effectiveness and suitability. According to Zegeye et al., (2021) modern contraceptives are effective medical innovations that aid in reproductive control and maternal health improvement, meanwhile Kwame et al., (2022) stated that modern contraceptives have become more relevant in today's world due to their ability to reduce fertility rates and improve health outcomes. In addition, Ibikunle et al. (2023) revealed that contemporary contraceptive technologies are still important instruments in the quest to attain sustainable reproductive health outcomes in various communities.
The notion of perception has been closely linked to the advent of modern contraceptive tools and techniques and describes the way information about a health issue is cognitively and psychologically interpreted, comprehended and made meaningful by individuals. Utilization, however, refers to the process of taking up and regular use of health care or interventions, given the need, accessibility and acceptability. When it comes to reproductive health, perception is a key component to attitude, and utilisation is a key indicator of behavioural outcomes based on knowledge, beliefs, cultural perceptions and experience of service delivery. Ogheneovo et al., (2023), showed that women's attitudes towards modern contraceptives are heavily dependent on the level of awareness, sociocultural norms, and exposure to reproductive health education. Likewise, Chingle et al., (2024) commented that the use of the contraceptive services was highly influenced by knowledge and safety of the available services. In addition, Ojule et al. (2024) added that positive perceptions are likely to lead to women's acceptance and continued use of contraceptive services.
The interaction between perception and utilization becomes particularly significant among women aged 18–49 years, who constitute the primary reproductive age group and are often the focus of family planning interventions. This population group has different reproductive needs and knowledge and use of contraceptive methods are of importance in reproductive health planning. Access to information, counselling and services are needed to enable informed choices about contraceptive use and healthcare facilities are important access points for this. According to Mohammed et al. (2025), health facilities are crucial in raising awareness and providing access to contraceptive services for women. Also, Adewale et al. (2025) affirmed that the availability of reproductive health services in a community plays a fundamental role in influencing the perception and uptake of contraceptive services in communities. As it is in Nigeria, general health facilities, especially Primary Health Centres (PHCs) still play a huge role in delivering reproductive health services in Enugu State. Healthcare facilities in the southeast region of Nigeria make a substantial impact in enhancing access to family planning services, Okoli et al. (2025) reported. In this context, Abakpa Health Centre is a relevant place to explore women of reproductive age (18-49) perception and use of modern contraceptives, thus bringing empirical evidence to the table in the study area in regard to the reproductive health behaviour.

1.2 Statement of the Problem
Reproductive health is an essential component of health care systems worldwide and a growing focus is on promoting women of reproductive age to make safe and informed reproductive choices. In today's health practice, modern contraceptives are known to be essential in contributing to fertility control, maternal outcomes, and health outcomes for the population. Although the family planning programmes have been scaled up and contraceptive services are included in the primary health services delivery, there are still differences on the awareness and uptake of women of available family planning services. Bolarinwa et al. (2021) and Gahungu et al. (2021) noted that reproductive health interventions have led to increased access to services, and Zegeye et al. (2021) pointed out that knowing about a reproductive health intervention does not always mean that such services are used consistently. This situation will form a broad background for the discussion of the access to and interpretation of reproductive health services in specific population groups.
Although modern contraceptive services are available in many health care facilities evidence shows that there is irregular and inadequate uptake of contraceptive services in some settings by women of reproductive age. While there is a spectrum of knowledge among women, misconceptions, influences, and knowledge gaps are still influencing women's decision making about contraceptive use. Ogheneovo et (al., 2023) and Chingle et al., (2024) highlighted that perception is a key determinant in women's acceptance or rejection of contraceptive methods and Ojule et al., (2024) found that women's utilization of contraceptive methods is sometimes influenced by combination of individual perception and service system factors. The best case scenario would be if all women of reproductive age are well-informed, positively attuned and regularly practicing proper contraceptive techniques according to their reproductive goals. The reality, however, is there is a disconnect between availability, perception and actual use, and access does not always result in effective use.
In Abakpa Health Center, Enugu State, there is a lack of empirical clarity on women (18-49) perception and use of modern contraceptives in relation to reproductive health services available in the health center. Healthcare providers are still providing family planning services, however, the uptake is inconsistent indicating that there is a lack of understanding of the underlying factors affecting perception and utilization of family planning services. Adewale et al. (2025) and Okoli et al. (2025) pointed out that facility-based reproductive health services are important influencers of contraceptive behavior but the utilization of these services is different for various communities. The literature gap is that the localization evidence of how perception is translated to actual contraceptive use in a particular healthcare context (Abakpa Health Centre) is inadequate. The aim of this study is therefore to fill this gap by looking at women of reproductive age and their perception and use of modern contraceptives to provide evidence that will inform better reproductive health interventions and service delivery strategies.
1.3 Objectives of the Study
The main purpose of this study is to critically assess the perception and utilization of modern contraceptives among women of reproductive age (18–49) in Abakpa Health Center, Enugu State.  Specifically, the study seeks; 
1.Assess the level of knowledge of modern contraceptives among women aged 18–49 attending Abakpa Health Center. 
2.Examine the attitude of women of childbearing age towards the use of modern contraceptives.
3.Determine the utilization pattern of modern contraceptives among women in Abakpa Health Center.
4.Identify barriers that hinder the adoption of modern contraceptives.
5.Explore socio-cultural factors influencing contraceptive choices among women in the community.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Question (s)
1.5 Research Hypotheses
1.6 Significance of the Study
1.7 Scope of the Study 
1.8 Operational Definition of Terms 

CHAPTER TWO
REVIEW OF LITERATURE (Preview) 
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of modern contraceptives, the perception of women of reproductive age towards modern contraceptives, the utilization of modern contraceptives, factors influencing the utilization of modern contraceptives, and the benefits and challenges associated with modern contraceptive use among women of reproductive age (18–49) in Abakpa Health Center, Enugu State. The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises women attending Abakpa Health Center in Enugu State.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified and convenience sampling methods to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses.

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that women of reproductive age (18–49) attending Abakpa Health Center, Enugu State, generally had a good level of knowledge of modern contraceptives, as evidenced by their agreement that they understood the uses of modern contraceptives, knew where to access them, and had received information from health workers. The corresponding hypothesis test further showed a chi-square value (χ²) of 18.64, degree of freedom (df) of 1, and p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis and confirming a significant relationship between knowledge of modern contraceptives and their utilization.

ii. The study found that women of reproductive age (18–49) attending Abakpa Health Center, Enugu State, generally demonstrated a positive attitude towards modern contraceptives, as evidenced by their agreement that modern contraceptives are safe, support for their use in family planning, and belief that they improve maternal and child health outcomes. The corresponding hypothesis test further showed a chi-square value (χ²) of 16.87, degree of freedom (df) of 1, and p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis and confirming a significant relationship between women’s attitudes and the utilization of modern contraceptives.

iii. The study found that women of reproductive age (18–49) attending Abakpa Health Center, Enugu State, generally utilized modern contraceptives for family planning, as evidenced by their agreement that they currently used modern contraceptives, used them consistently without interruption, and preferred modern contraceptives over traditional methods.

iv. The study found that access, availability, affordability, information from health workers, and waiting time were important factors influencing the adoption of modern contraceptives among women of reproductive age (18–49) attending Abakpa Health Center, Enugu State. This was evidenced by respondents’ agreement that modern contraceptives were accessible and affordable and that waiting time did not discourage their use, although responses also indicated concerns about availability and adequate information from health workers.

v. The study found that socio-cultural factors influenced contraceptive choices among women of reproductive age (18–49) attending Abakpa Health Center, Enugu State, as evidenced by respondents’ agreement that cultural beliefs, partner support, and family encouragement influenced their decisions to use modern contraceptives. Responses also indicated that religious beliefs and traditional norms could affect contraceptive choices.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings  
5.2 Implications of the Finding 
5.3 Limitations of the Study 
5.4 Contributions to Knowledge
5.5 Summary 
5.6 Conclusion
5.7 Recommendations
5.8 Suggestions for Further Studies

UPLOADED BY MIRACLE