Barriers To Family Planning Uptake In Nigeria’s Rural Communities
Many times in Africa, discussions about reproductive health issues are hushed and women and girls bear the brunt of the injustice owing to no faults of their own. In this special report, our co- editor, Princess-Ekwi Ajide, takes a look at the barriers to family planning Uptake In Nigeria’s Rural Communities. The report shall be in 4 parts
Part 1: “The Whisper Network”
In the heart of Enugu State, tucked between lush green hills and quiet red-soil paths, sits the village of Ndeabor. It’s a place where the day begins with rooster calls, and ends with the hum of generators fighting back the African night.
On the surface, it appears like any peaceful rural community. But for the women of Ndeabor, decisions about their bodies and future are often anything but peaceful.
Thirty-four-year-old Ngozi, a mother of six, sits under a mango tree weaving mats with quiet precision. Her hands move deftly, but her eyes carry the weight of choices she never made.
“I didn’t want more children after the third,” she says in Igbo, her voice barely above a whisper. “But my husband said it was not his business to discuss family planning. He wanted sons. I kept having babies, hoping one would be a boy.”
Ngozi’s story is not unique. In rural parts of Nigeria, conversations about contraception and reproductive choice rarely happen in the open. They are tucked into hushed exchanges between women at village streams, behind church walls, or whispered during clinic visits.
There’s a palpable fear of stigma, of being labelled promiscuous, or worse, disrespectful to one’s husband and culture.
The Culture of Silence
In many Nigerian villages, family planning remains enmeshed in myth and suspicion. While national health policy supports reproductive rights and access to modern contraceptives, the reality on the ground is far more complex.
“The culture is patriarchal, and many women are afraid,” explains Nurse Gloria Ibe, the only health worker at the local primary health centre in Ndeabor. “Some come here in secret to take injectables or pills, but if their husbands find out, there can be serious consequences verbal abuse, even physical violence.”
She pauses, before adding: “One woman’s husband poured palm oil on the pills and forced her to swallow all of them at once. He thought she was trying to make herself barren.”
Such reactions are fuelled by long-standing cultural beliefs that view childbearing as a woman’s primary purpose, and contraception as a foreign, dangerous interference.
Some men fear that once a woman is on family planning, she’ll become sexually unfaithful. Others see it as a challenge to their authority.
The results? Many women are trapped in cycles of pregnancy, poverty, and powerlessness.
Distance and Dilemma
Even when a woman overcomes social resistance, another hurdle looms large—access.
Ngozi’s village, like many others, is miles away from the nearest clinic that offers a full range of contraceptive options. The local centre where Nurse Gloria works only receives family planning commodities sporadically. Sometimes, the shelves are empty for months.
Transportation is another issue. For a woman in a rural household with no income of her own, affording a ₦1,500 motorcycle ride to a better-equipped facility may be out of reach. And if she’s caught making the trip by a suspicious relative or neighbour, questions will follow.
“There was a woman who trekked for two hours to get an implant,” says Gloria. “The clinic had run out. She wept.”
Add to that a lack of privacy, with cramped health posts that barely separate waiting areas from consultation spaces, and you have the perfect storm one that discourages women from seeking care at all.
Enter the Myths
At the heart of the resistance are the myths deep-rooted, often absurd, but powerful.
“One woman told me she heard that if you use a coil, it can travel to your brain,” says Gloria, chuckling with fatigue rather than humour. “Another said contraceptives cause infertility, cancer, or madness.”
A 2022 survey conducted by the Nigerian Urban Reproductive Health Initiative (NURHI) found that over 40% of rural respondents associated modern contraception with serious health risks, despite evidence to the contrary.
These fears are fanned by traditional birth attendants (TBAs), religious leaders, and even older women who view contraception as a betrayal of ancestral values.
At a church service in Nsukka, a pastor warned women to “flee from the devil’s medicine,” claiming that God alone determines the number of children a woman should have.
This religious framing complicates efforts by public health officials and NGOs, who find themselves in a tug-of-war between science and superstition.
But the Tide is Shifting…
Despite these barriers, change is bubbling quietly beneath the surface.
In neighbouring Amagunze village, 26-year-old Ogechi is part of a youth-led radio programme that discusses family planning in local dialects. “We use folktales, riddles, even drama skits,” she says. “People are listening. Especially the younger generation.”
Gloria confirms that uptake has improved slightly over the past year, thanks to targeted outreach and sensitisation. But she insists it’s not enough.
“Until husbands are involved and myths are addressed by people they respect, like priests, imams, village heads, progress will remain slow,” she says.
And yet, the courage of women like Ngozi gives her hope. “She came back last week,” Gloria says with a smile. “She asked for the implant again. This time, she said, ‘I don’t care what they say. I want to live.’”
Up next: Part 2 – “The Invisible Cost of Control”
We’ll explore how gender-based violence and economic dependency tie into reproductive oppression, with voices from survivors and community workers.
