Missed Opportunity for Family Planning among Obstetric Fistula Clients in North-Western Nigeria

Background: For Nigeria to attain a Contraceptive Prevalence Rate (CPR) of 36% in 2018 as committed by the Federal Government at the London 2012 summit, Family Planning (FP) services must be provided to all eligible couples at every contact with the health system, including the Obstetric fistula (OF) units. In Nigeria, about 20,000 women develop OF annually for which access to FP services will prevent recurrence of OF and increase the FP utilization. This study therefore assessed the prevalence of missed opportunities for FP, its trend amongst repaired OF clients, the possible causes and suggested recommendations. Methods: This cross-sectional descriptive study was conducted in two OF and FP units of hospitals in Zaria and Sokoto. Records of FP for the 1,015 OF clients admitted from 2011-2015 were extracted and analyzed on SPSS version 20. Also questionnaire survey were applied and analyzed on excel for all the 8 health workers and 18 repaired OF clients available in the units during the study period. Results: Seventy percent of the 1,015 OF repaired by the two units did not take a FP method post repair.. The main reasons given by OF service providers for these missed opportunities were the desire for more children by OF client having lost the index one, inadequate FP training for OF staff and client ignorance. Suggestions by the OF service providers for improvement include improved client counselling, quality FP services and information, client sensitization, training of staff on FP services and balanced counselling. Conclusion: The implementation of the above suggestions by stakeholders, reinforced with appropriate IEC strategy will reverse these missed opportunities