CHAPTER ONE

INTRODUCTION

1.1 Back Ground of the study

World population is growing and became over the control of concerned organizations. The
main cause of population growth is to increase in the excess of birth over death .Now a days
high population growth is the main problem of most developing countries of the world,
especially in countries of sub Saharan African. The number of population combined with
worst economies in poor countries can be explained by fastest growing population, high
infant and child mortality, lack of basic health infrastructures including family planning and
low distribution and use of contraceptive among the main problems which could be at least
minimized in the future (Parking 2010).

The problem of population growth is not simply in numbers. It is also a problem of human
welfare and development. Family planning allows individuals and couples to their desired
number of children and the spacing and timing of their births. It is achieved through the use
of contraceptive method and the treatment of involuntary fertility. By reducing rates of un
intended pregnancy family planning also reduces the need for unsafe abortion. Promotion
of family planning and ensuring access to prefer contraception methods for women and
couples is essential to securing the well being and anatomy of women, while supporting and
development of communities, in any other countries in eastern and southern Africa
(FGAE,1999).

In Ethiopia people start to use family planning system, especially in The modern family
planning service in Ethiopia started as the family guidance association of Ethiopia, (FGAE)
established in 1966. In FGAE, family planning service was provided from a single room
clinic run by one nurse. At the former there is a hospital in A.A and FGAE program activities
and services are now broadly spread all town. Peoples who are literate or educated are
using family planning system effectively (FGAE, 1999). We can get various advantages by
using family planning system for example; we can limit number of our children. Based on
our income the age gap between the children should be decided. Ethiopia has made
incredible progress over the last eleven years in increasing access to family planning. This
has come in tandem with strong progress on millennium development goals, with maternal
mortality falling from 990 deaths for 100000 live births in 2000 to 440 in 2013. In 2000,
Ethiopia had a modern contraceptive prevalence rate (modern CPR) for all women of less
than 5 percent but just 11 years. In the early 2000, the Ethiopia government and particular
the ministry of health recognized the vital rate that family planning can play in preventing
maternal death, delivering millennium development goal commitments and ultimately

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improving the availability of voluntary family planning service but it is recognized that they
could not

achieve this alone and that such a rapid increase in access to family planning would need to
delivered in partnership ( FGAE, 2000).

1.2 Statement of the problem

Family planning is the practice of controlling the number in a family and intervals between their
berths, particularly by means of artificial contraception or voluntary sterilization. It will helps to
protect the womens and children health and present the well being of the whole family (WHO,
2000). A women ability to choice and when to be pregnant has direct impact on her and well
being. Family panning prevents young women from increasing risk of heath problem and death
from early child bearing and can prevent pregnancy among older women who also face increasing
risk. Report suggests that a womans who have more than four children at increased risk of
maternal mortality (WHO, 2010). Contraceptive use various widely around the world wide, both
in terms of total use and type of method used. Worldwide, 63 percent of married women aged 15-
49 use a method, and while most women in more developed countries use contraception, where as
in developing countries one out of five married used modern method (WHO, 2012).

Fertility and future projected population growth are much higher in sub Saharan Africa than in
any other region of the world, and the decline in birth rates which was already modest, has solved
even further over past decade. In sub Saharan Africa, 23 percent of married women are using
family planning, out of this 18 percent use method and 5 percent with a tradition method
(Gribble, 2013). Ethiopias average family size is slowly declining from 6.4 children per women
in 1990 to 5.9 in 2000 and 5.4 in 2005; yet this fertility rate is still much higher than the average
of four children per women that people actually want to have, many Ethiopian family planning
service they need to do so. Studies find that 68 percent of sexually active women in Ethiopia have
unmet need for contraception (MOH, 2010). Position of development is critical. In 2000, in
Ethiopia contraceptive rate for modern methods was only 6.3 percent, which at that time lower
than any other. With regarded to the study area, 01 kebele the status of family planning depends
on the attitude and degree of awareness of couples towards it. According to the Albuko woreda
health office (2005), the utilization of contraceptive use is low due to lack of knowledge about
modern contraceptive, religion, less accessibility of family planning method and negative attitude
of the society towards family planning are hindered the use of modern contraceptive (WHO,

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2012). The problem may be connected with the people who are uneducated because the kebele
when researcher sees most women, they have an early born child and other child less than three
years. Therefore consecutive annual rate is a great problem in this kebele.

1.3. Objectives of the study

1.3.1. General objective

The general objective of this study is to investigate the factors that affect effective use of family
planning in Albuko woreda in case of 01 kebele.

1.3.2. Specific objective:-

The specific objectives of the study are;

To Assess the attitude of societies towards use of family planning

To Identify the factors that hinder the use of family planning
To Describe the problem that women faced while not using family planning

1.4. Research questions

A. What looks like the attitude of societies towards the use of family planning?

B. what factors hinder the use of family planning?

C. what are the problems that women faced due to absence of using family planning ?

1.5. Significance of the study

This study will motivate government, non government organization and the community at large to
take measure to help the factors that affect family planning, to reduce population by increasing
contraception distribution rate and to establish sustainable family planning system for the future
and it could be helpful somewhat to initiate policy makers so as to

design policy to solve the problem.

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1.6. Delimitation of the study

High population growth due to lack of family planning is crucial issue in Ethiopia. Due to the
financial and time constraints, the study focuses on 01 kebele in Albuko woreda. Because the
researcher is more familiar with the area so the researcher has more informations and sources
about the problem.

1.7. Limitation of the study

This study might have faces the following limitations.

Lack of well documented reports concerning factors that affect the use of family planning
in the study area.
There might be shortage of time due to the researcher having regular class attending
while doing the study.
Community around the study area might not be voluntary to give the real information
concerning the issue of the study.

1.8. Organization of the paper

The research paper will have five chapters. The first chapter consists of background of the study,
statement of the problem, objective, research question, and significance of the study, delimitation
of the study, limitation of the study and organization of the paper. The second chapters deal with
review of related literature, chapter three is about description of the study area and research
methodology, chapter four is data analysis and interpretation and the final chapter deal the
conclusion and recommendations.

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 CHAPTER TWO

2. REVIEW OF RELATED LITRATURE

2.1. Definition and the concept of family planning

Family planning refers to the action couples take to have the desired number of children. Family
planning helps to protect the womens and children health and preserves the well being of the
whole family. People should actively promote assess to family service for individual desiring
them. Family planning is the decision making process by individual, on the number they would
like to have in their life times and age interval between children. Family planning is one of the
leading strategies to improve family life, and welfare control unwanted population growth and aid
the development of the nation (WHO, 2000).

2.2. Factor affecting use of family planning

In developing countries, millions of women in the reproductive age who use contraceptive prefer
to postpone or limit their birth. This indicates their failure to take necessary decision to prevent
and avoid unwanted pregnancy. Unmet need for planning is defined as percentage of all found in
union and presumed to be sexually active are not using methods of contraception either do not
wanted to have more children or want to postpone their next birth for at least two or more years.
One of the sequences of unmet need is unwanted pregnancy with it (WHO, 2013).

2.3. Family planning methods (contraception)

There are different types of family planning methods used to prevent pregnancy. Family planning
methods vary widely and can be divided in several categories.

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2.3.1. Terminal method

In this category, female sterilization (tubectomy) and male sterilization (vasectomy) are included.
Sterilization is most effective and safe form of long term family planning method. It is also
permanent. (WHO, 2011).

2.3.2. Barrier method

The barrier methods are those methods that can prevent the sperm from entering to womens
vagina. These include condom, which is a soft tube made of laxer rubber and closed at one end. It
is put on the mans erect pennies before sexual intercourse. When the man ejaculates the sperm is
collected in the tip of the condom. Therefore, the condom not only prevent pregnancy is offers
protection against sexually transmitted disease including AIDS (Gribble, haffey, 2013).

2.3.3. Hormonal method

These methods includes pills, which contains artificial forms of hormones (chemicals) by the
body, a women swallows one tablet at the same time every day, whether or not she and her
partner have sexual intercourse. If a woman misses taking the pills for even few days, it is
possible for her to get pregnant (WHO, 2011).

2.3.4. Natural method of family planning

Natural method of family planning includes all methods that do not involve taking any drugs or
using a device to prevent pregnancy. Most of methods involve finding out women during the
menstrual cycle (seyoum, 2005).

2.4. Factors that influence the use of family planning prevalence of contraceptive and access
to family planning

Result of a study showed that in 1990 about 63 percent of Ethiopian women reported to have
knowledge of family planning. However, 4 percent have ever used a method; studies have shown
that the use of family planning method is higher among urban women when compared to rural
women. The study carried in 1990 showed that the prevalence of contraceptive use among urban
women was 20 percent when compared to only 2 percent among rural women factors such as
education age of women affects use of family planning (seyoum, 2005).

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2.4.1. Education

There is negative relationship between education and fertility, meaning education exposes women
to new idea, the new idea helps them to have access to information. The information they acquire
enlightens them to limit family size, rise marriage age use contraceptives and promote the role of
women in decision making, in most developing countries, education of female children needs
serious attention, not only because of the linkage between education and fertility, but also for
reasons of improving health and nutrition, enhancing female production and more generally
promoting the development of womens human resource potential (UNFPA, 2000).

2.4.2. Age of women

In most countries, contraceptive prevalence is lowest among young women, reaches a peak
among older women, then growing interest in spacing and limiting. Prevalence declines among
older women because in pregnancy the use of contraception by type of method also varies
according to age since some women changes from using temporary method for spacing birth to
permanent method for liming after attaining desired number of children (Gribble haffey, 2013).

2.4.3. Religion

Religion is also one of the social factors that have an impact on practice of contraception.
Researchers conducted in developing countries revealed that social, cultural, and religious
unacceptability of contraception repeatedly emerged as an important obstacle to use a method of
family planning (seyoum, 2005).

2.4.4. Desired for more children

The desired for additional children is to be an important demographic variable, which determine
womens motivation to practice contraception either for limiting of spacing the child bearing. A
woman who has attained the number of children that she desires to have is more likely to use
contraception than a women who has not yet achieved the number of children (Gribble haffey,
2013).

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2.4.5. Sex preference

Sex of children contributes to difference in fertility behaviour, for example, couples prefer male
children, but they may still have female children. This situation forces the couples to produce
more and more children until they get the preferred sex (seyoum, 2005).

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 CHAPTER THREE

MATERIAL AND METHODS

3.1 DESCRIPTION OF STUDY AREA

3.1.1 Location

Albuko is found in south wollo zone of Amhara region. Its areal coverage is 49182 hectar . it
situated south of dessie zuria worda, east of worealu worda, west of dawa chefi worda(oromia
special zone)and north of semen shewa(geshe rabeal)worda. the woreda is divided into
18kebeles,13 rural and 5 urban kebelels.

Map of the study area

3.1.2 Population of the study area

According to Albuko woreda government communication affairs office , the woreda has a total
population of 85747( according to 1999 census) from those 45886 are male and 39361 are
female .

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3.1.3 Topography

The topography of the woreda is rugged and mountainous .From the total land area of the woreda
27 % is mountanius, 35% is plato , 27% is flat land(plain)and 11% is valley.

3.1.4 Climate

The woreda has 11% low land (kola),76% mid land (woina dega) and 11.24% highland (dega)
agro climatic zones and 1.76% wurchi.

3.1.5 Health service in the study area

In Albuko woreda, there are numbers of governmental, and private health institution. In the
worda there are four public clinic and two private clinic and 15 health extention.In the study area
there are two private clinic and one public clinic.

3.2 Research design

I will conduct in this senior essay in qualitative and quantitative design. The major reason is that
qualitative design was use to show data,and information which can not be describe in number,
and also quantitative design is used to show the factor affecting use of family planning in
percentage by using a table from.

3.3 Data source

The information and data required for this study is collected from both primary and secondary
sources to get valid information about factors affecting the utilization of family planning. In terms
of primary source the researcher used asked 40 respondents in a form of questionnaires for the
household and structure interview with three health extension workers from Keble. Secondary
source collected from books, internet and other related to the issue.

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3.4 Sampling size and sampling techniques

I will select one kebele from 18 kebeles in Albuko woreda for further sampling and the area
population will known easily. The problem of the study will identify from the selected household
respondents as a sample by using lottery method simple random sampling.

3.5 data collection tools

I will collect the data by using interview and questionnaire to get full and reliable information.
During the study, I will have combined different data collection tools. These tools will be both
close ended and open-ended questions and interview.

3.6 Method of data analysis and interpretation

Data will be gather through questionnaires and analyze quantitatively in percentage and
frequency and also,it will be present in the form of table. The data from interview will be analyze
qualitatively in the form of words and statements.

o WORK PLAN AND COST BUDGET

Work plan schedule

NO ACTIVITY TO BE DONE DEC JAN FEB MARCH APRIL MAY JUNE

1 Personal development

2 Title selection

3 Proposal 1st draft

4 Proposal final draft

submitted
5 Data collection and analyses

6 Final research paper

submitted
7 Research presentation

Table 1. Work plan schedule

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 o Cost budget schedule
NO ITEMS AMOUNT UNIT COST TOTAL
NEEDED (BIRR)
1 Pen 10 5 50
2 Paper 200 0.70 140
3 Writing and 45 pages 5 225
printing
4 Copying 60 pages 0.5 30
5 Telephone and 120minute 0.80 96
internet
6 Transportation ____________ ____________ 400
7 Others ____________ ____________ 300
Total Total cost 1241 birr
Table 2. Cost budget schedule

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 REFERENCE

Ethiopia journal of development research, vol_14 no, 2 (2000).

Central statistics authority, (2000). Demographic and health survey, Addis Ababa

Ethiopia.

Family guidance association of Ethiopia, (2000). Thirty four years of dedicated

Service addis ababa Ethiopia.

F.G.A.E, (2000). Curriculum guide lines for family life education A.A Ethiopia

F.G.A.E, (2000). Twenty five years of family planning services in Ethiopia (1966-

1991) addis ababa Ethiopia.

James gribble and Joan haffey, (2013). Reproductive health in sub Saharan Africas.

Michael park, (2000). Microeconomics, 4th edition.

Michael Todaro and Steffen smith, (2011) .Economic development, 8th edition.

Ministry of health, (2010, 2011 and 2013) .Annual report on family planning.

Seyoum Joseph, (2005). Six years of review of maternal mortality in a teaching

Hospital addis ababa Ethiopia.

World health organization, (2010, 2011 and 2012). Report on family plan.

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