Family planning is the means by which individuals or couples space the process of conception, pregnancy and childbirth at intervals mutually determined by both husband and wife in order to have the desired number of children that they can conveniently maintain. Family planning also assists couples who have difficulty in having children [1]. People everywhere have developed various means of family planning methods in fertility regulation for reasons such as ensuring better maternal / infant health, paternal care for children, reducing the burden of poverty, improving standard of living, education for wards, maternal adjustment between couples and welfare for the community and the nation at large [2].

According to [3], population growth before the industrial revolution worldwide was checked by fatal diseases, often epidemics, promoted by lack of proper sanitation, poor nutrition, natural disasters such as floods, earthquakes and others; death rates were high. Conversely, following the industrial revolution, modern preventive medicines such as immunizations and new drugs, (antibiotics) improved education, sanitation, better income and improvement in general living standard had a positive effect on population growth. In developing countries like Nigeria, birthrate remains high and declining more slowly than death rate [3]. Records show the current worldwide annual population growth rate is 1.7%, which, means an additional 90 million people each year, or an increase in the world’s population of 170 persons per minute [3]. The rates of population growth worldwide have caused political leaders to encourage national and regional fertility regulation projects as vital. Supports for regulation of individual fertility have been evident in all cultures and at all times even in those societies in which social and religious rules have favoured the abundant production of children [4]. The need for fertility regulation methods to be applied by national and regional authorities was discussed by the United Nations population Committee in 1947. In 1968, the United Nations General Assembly and other international bodies affirmed family planning as a basic human right [5].

The various methods of family planning can be categorized as; the traditional methods, which involves the use of native objects such as charms, amulets, rings, keys, fluid from dead bodies and other things for birth control purposes, while the modern methods involve the introduction and uses of contraceptives such as pills, injectable, intrauterine devices, implants and others for family planning purposes [2].  This is the commonest and mainly advertised form of family planning. However, some research results show that most Nigerian couples are non-contraceptive users [6]. Some of the reasons for the low rate of contraceptive practice according to [7], range from factors such as “the fear of side effects, husband’s objection, religious and cultural prohibitions”. The Nigerian population as at 2010, was estimated to be about 158 million by the population reference Bureau Washington USA, with fertility rate of 5.7 and 42 birth per 1000. Nigeria is ranked the 8th largest in population in the world behind China, India, United State, Indonesia, Brazil, Pakistan and Bangladesh followed by India and Japan. It is also on record that whenever a Nigerian woman gets pregnant, she has a 1 in 13 chance of dying, mainly due to the poor utilization of modern family planning methods [2].

However, there were problems associated with the introduction of the modern technological methods of family planning ranging from religious, moral and cultural prohibition. There is also the individual aspect to family planning as shown in the records of the world fertility survey in 1970. It was discovered that though people have strong desire for fertility regulation in nearly all societies, achieved family size is greater than desired family size. Presently, about half of the women in the world who currently have three or more children do not wish to have more but there still exist gaps between stated desire to control fertility and actual practice [8]. From experience, this may be because many women have neither sufficient motivation, nor adequate access to the services they would need to meet this goal. It may also be due to lack of knowledge in the application of other alternatives available, such as the natural family planning methods.

Family planning methods are considered a first line of defense against unwanted pregnancy, sexually transmitted infections (STIs) and human immune- deficiency virus (HIV). The consistent and correct use of modern family planning methods reduce greatly unwanted pregnancies, STIs and HIV among women of reproductive age in any nation thus enhancing their health. However, it appears that attitude and practice of modern family planning among women of reproductive age in Nigeria is low and it varies by demographic and socio-economic characteristics. This calls for a study to verify what obtains in Ekpoma using the primary health care centre in Ujoelen as reference point. The use of family planning methods among women of reproductive age will reduce unwanted pregnancy, mortality and morbidity associated with abortion. HIV and STIs incidence among women of reproductive age will also be minimized, thus, enhancing their health. Studies have been conducted on attitude to and practice of modern family planning methods among women of reproductive age in many parts of the World including Nigeria. However, none of such studies, to the best of my knowledge as the researcher, has been conducted in primary health care centers in Ekpoma. Following this, the need arose to study the knowledge and practice of family planning methods among women of reproductive age in the primary health care centre in Ekpoma using Ujoelen as reference point. The desired family size among the Nigerian women was estimated at 4 on the average from the national demographic health survey 2008 studies, which means there is every tendency for most of the women to have more than 4 children in their life time considering the problem that it is easier said than done. This is because achieved family size is greater than desired family size, a gap remains between stated desire to control fertility and actual practice. Particularly among poorly educated and low-income women, living in rural areas and urban slums [8].

Also, most maternal death has been associated with unwanted pregnancies resulting from unsafe abortions, high rate of infant and childhood mortality, miscarriages or foetal wastages are problems associated with short birth interval [6]. This study result can help alleviate these problems. Furthermore, certain studies showed that although most couples have knowledge about family planning but they lack adequate skill to practice it effectively in fertility regulation [9]. Also, the present economic situation in the country does not favour the production of large families. It can lead to unemployment, food shortage, inadequate housing, overused of health and educational facilities, increase in crime rates due to unemployment to mention a few. The introduction and use of modern methods of family planning though very useful in some cases at fertility regulation, its uses are not accepted by some couples for many reasons such as the report of side effects on users of some of the hormonal drugs. Some do not like using these hormonal drugs on religious and cultural prohibition. At times couples do not agree also on usage. In the search of method that can be culturally acceptable, tolerated by couples without complains of side effects, family planning and couples’ involvement in its knowledge and practice becomes necessary. The aim of the study is to determine the knowledge and practice of family planning among women in primary health center in Ujoelen, Ekpoma. This will be achieved by the following specific objectives: to find out the level of knowledge of family planning methods among women in primary health care center in Ujoelen, Ekpoma, to identify the types of family planning methods practised by women in primary health center in Ujoelen, Ekpoma and to determine the practice of family planning among women in the primary health care Center in Ujoelen, Ekpoma. The study will be used to determine the extent at which health education which includes family planning is effective at the grassroots. It is hoped that this study will have both theoretical and practical significance, since it is geared towards addressing an issue that is fundamental to the society at large, Nigeria in particular. Practically, the findings from the study will be used by future researchers to explore other ways of reducing maternal mortality/ morbidity, unwanted pregnancy/complications and sexually transmitted infections. The knowledge acquired from the study will be used to create the study awareness on the modern family planning methods. To individual, families and communities, a study of this nature will help the policy on the importance of child spacing to the public as it will help in the economic development of the nation. It will equally help in the management of populations control and human resources development.

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