Locating and Critically Evaluating Family Planning in the Sexual and Reproductive Health Agenda

Nigeria is a country of great diversity. On a national level, it has one of the highest maternal mortality rates (630) and fertility rates (5.7) in the world. The International Conference on Population and Development adopted a rights-based approach toward the achievement of comprehensive sexual and reproductive health, while Millennium Development Goal 5b aims for universal access to voluntary family planning. Modern contraceptive methods are promoted and supported by the Nigerian national government and the United States Agency for International Development to decrease fertility rates and address unmet need in Nigeria. However, total demand for child limiting and modern methods of contraception remains low nationally, although great regional variation exists. This thesis critically examined the gap between the needs for family planning/reproductive health programmes as identified by Nigerian individuals and couples, and the programmatic responses of USAID. Through a literature review, socio-cultural factors preventing the use of modern contraception were identified and reframed as needs using an intersectionality lens. The concept of unmet need was critically analysed. A review of USAID's policies and programmes [available online] revealed that their programmes respond adequately to certain social issues (regional diversity) and insufficiently to others (resistance to long-acting permanent methods of contraception). Disjointedness exists between locally-defined needs and national health priorities. Intersectionality is a useful framework to conceptualize context-sensitive family planning programmes that reach marginalized groups in Nigeria.msc_srhunpub1451_ethesesunpu