How Informed counselling dispels myths on FAMILY PLANNING

By Joan Idu

Family Planning (FP) is the use of education, methods, and medical services to help individuals and couples decide if, when, and how many children to have.

The journey to achieving Nigeria’s FP 2030 commitment of 27% modern contraceptive prevalence by the year 2030 is a concerted one. However, for many women of reproductive age, there remain some barriers to accepting these modern methods.

For many women, fear of side effects has been a reason for their inability to take active steps toward acting on their intentions or need for family planning services. Like many other medications and medical procedures, there are some side effects associated with family planning, but these side effects are neither associated with all the methods, nor with everyone who receives a method.

Medically, side effects refer to the various ways in which an individual’s body reacts to medications or new introductions to the body system. For family planning, experts explain that various women may react to various methods. Hence, the advice is to always seek services through a trained provider for proper examination and identification of the most suitable method for each individual.

Side effects associated with family planning are simply the various ways that people’s bodies react to specific methods, and the need to identify individual body types with proper counselling, so as to know what method suits best for them, to either avert any side effect, or minimise it, if there is to be any, likemany other medications, or even food and medical procedures.

Some people fear the possibility of side effects associated with family planning, but even though there are some side effects associated with family planning, these are not common with everyone who uses the services or common with all the available methods.

This underscores the importance of the need to also take up services from trained providers and at designated service delivery points, with the use of quality counselling techniques, which are a key component of competence assessment of trained providers.

The key to addressing fears and myths around side effects of family planning is for trained professionals to ensure that everything from quality information, education and communication about family planning and the peculiarity of each method is explained to users and basic tests are conducted before providing a method. This ensures that only a method that best suits a woman’s body as well as the option that meets her choice or circumstances in life, is provided for her.

But unfortunately, due to many reasons associated with literacy, inadequate quality information and myths, most women rely on negative information from friends and relatives to shape their perspectives on side effects, and this undermines the efforts in expanding access.

As these efforts are put in place, the myths still surrounding family planning seem to outweigh the side effects, thereby preventing a wide acceptance of the various sexual and reproductive health choices available to users, and in turn, hindering the pace of the gains of family planning which include primarily ensuring women and families having children by choice not by chance, that is, preventing unintended pregnancies, bringing maternal mortality rate to its barest minimum by improving the health and survival rates of mothers and babies, preventing teenage pregnancies, reducing the chances of pregnancy related health risks, giving individuals more control over their education, careers, and future, among many others.

To curb the impact of fears spread by rumours of these myths, quality counselling on family planning methods and associated possible side effects before and during service uptake has helped bridge this gap among many women. Informing users about these side effects ahead of time, helps them make an informed decision about what works best for their body, as well as their responsibilities in ensuring the effectiveness of the methods they are using and the best ways to minimise any possible side effects or even the required psychological preparations to understand the harmlessness of most side effects, if they occur.

Data from the Nigeria Demographic and Health Survey (NDHS) 2023/24 shows that the acceptance of family planning and modern contraceptive prevalence rate (mCPR) among married women in Nigeria remains relatively low at approximately 15% to 20% while sexually active unmarried women report a higher acceptance and usage rate of 30% to 50%. Implants make up 6% of those statistics, while Injectables are 4%. These are the most common methods among married women, while male condoms (26%) dominate among unmarried women. 

Daily insider spoke to some. women of child bearing age including nursing mothers, to gain insight into their fears about family planning and the misinformation that might have been fuelling it.

While speaking to Mrs. Kadijah Rabiu; a family planning subscriber and mother of two who started using family planning after her first child, conceived her second child after 4 years, and is about to get back into family planning.

Daily insider learned that although she is literate and open to the various contraceptive choices available, she is also skeptical that the one she had wanted to switch to (implant) seems to have led to a higher complication to her close friend, therefore this fear has prevented her from switching methods, as she would rather stick to hers (injectable). 

Experts explained that some common side effects of various modern methods may include weight gain in some women, heavier bleeding, cessation of monthly flow, mild headaches, and cramps. Although those symptoms are explained to occur within a short period and are not supposed to be severe, proper counselling from trained providers equip women to understand which method is associated with each symptom and how compatible it is with each woman before deciding on its use. 

However, for Mrs Kadijah, although her monthly period ceased for six months until she got off the method to try for her second child, In terms of her experiences with side effects, she also explained that while she added weight, and her friend using another method lost weight, another friend of theirs neither added excessive weight, nor lost significant weight while using family planning. This suggests that possible side effects may result from individual body types, medical history, specific methods, and many other factors. 

As these fears, driven by rumours and myths continue to prevail, efforts to encourage greater adoption of modern contraceptive methods for family planning may not be successful unless a novel counselling approach is implemented.

Putting this into consideration, organisations such as MSI Nigeria Reproductive Choices, a member of the MSI Reproductive Choice Global Network, have taken the bull by the horns through their interventions, evident in their training of health care workers, family planning implementers and primary health care providers in quality counselling, sensitisation and family planning service delivery protocols.

Similarly, MSI Nigeria directly offers a range of short-term, long-term and permanent methods, with a view to giving women the opportunity to choose what is right for them and their future through proper counselling. According to available MSI data, MSI Nigeria, through one of its service delivery approaches called the Outreach Channel, visits about 9,699 sites across the country annually.

Designed to reach the underserved, poor, vulnerable and mostly rural populations. The Outreach Channel operates in 32 states across the country and, in 2025, delivered 2.6 million Couple Years of Protection (CYPs), through Family Planning.

A component of the intervention to ensure quality counselling and the confidential provision of information on contraception and family planning, is the MSI Nigeria Contact Centre. It provides awareness, counselling support, and a continuum of care, and offers information and support before, during, and after care. It also refers clients to a network of safe, youth-friendly providers and follows up with clients to ensure quality of service. 

During a recent clinical service provider training session, over a thousand family planning service providers were trained in the first quarter of 2026 across the country.

The Country Director, Emmanuel Ajah, explained, “recognising that stronger health systems begin with stronger providers, we have made health workforce capacity strengthening a core pillarof our strategy by equipping health care providers with the knowledge,practical skills and support they need, while strengthening the public health system through expanding access to quality family planning services for women and girls across Nigeria.”

The organisation conductedmore than 60 competency-based training sessions across 12 states in the country; a total of 1,283 health care providers completed these sessions which covered LARC Insertion and removal, Infection prevention and control, family planning, counseling, and incident management. 

Quality counselling is a central part of these trainings, and participants included nurses, midwives, community health extension workers, and community health officers, all of whom play critical roles in expanding access to quality sexual and reproductive health care at primary health care levels.

These training sessions by organisations like MSI Nigeria have undoubtedly borne fruit, as seen during a journalists’ field visit to St. Philomena School of Nursing Sciences in Benin City, Edo State, where Dr. Christiana Ijeghede, a retired Director of Nursing and Matron of the State School of Midwifery, who is also a knowledgeable family planning provider, emphasised the importance of visiting a trained service provider for proper counselling in family planning. 

This allows the provider to gain background knowledge of the user's personality type, medical history, and health status, helping to ensure little or no side effects. She noted that a user with a tendency towards increased blood pressure is counselled against a particular hormonal method due to its specific nature. She also mentioned that during such counselling, users are made aware of the roles they are to play in ensuring that the methods they are using are as safe as possible, stating that a woman on an intrauterine method is to take her hygiene very seriously to avoid complications like ascending infection, and that if or when complications arise, they are to visit the centre immediately, get examined, have a solution proffered, and, where necessary, have the method changed to a more suitable one. 

This touches on the need for more friendly family planning providers and for more male involvement. If health services are of poor quality or providers discourage certain methods due to bias, this may not yield as much result, thereby the need for training and monitoring. 

While these training sessions have proven productive, there is a need for their replication by Government Institutions, Medical and Nursing Training establishments, Health Agencies and other Non-governmental organisations to achieve wider reach, ensuring the training and retraining of more family planning providers, especially in public health facilities, to reduce women’s fears arising from rumours and myths associated with the side effects of modern family planning methods and to minimise the side effects where they occur.

If more health centres do not adopt this in-depth quality counselling method, and if family planning providers are not as friendly as they ought to be, these myths and fears may still persist, with their significant impact on the progress of expanding access to modern family planning towards Nigeria’s 2030 mCPR target. 

Therefore, these new approaches to counselling are recommended for widespread implementation to achieve greater results.