By December 2020 and January 2021, it is expected that there will be a baby boom in Niger State as a result of large numbers of women that were stuck at home with partners but also lost access to family planning due to COVID-19 restrictions. JUSTINA ASISHANA reports on the wave of COVID-19 pregnancies.
“I did not prepare for this pregnancy; it came unexpectedly. I think I got pregnant in April during the lockdown. It was not prepared for because I was planning on giving myself about three years before giving birth but this came”, Halima Yabagi, who was on an ante-natal visit to the Paiko Town Clinic in Paikoro Local Government Area of Niger State told our reporter.
According to her, she had missed her dose of Depo shot in March when the restriction of movement was announced and strictly enforced in the state.
The depo shot, also known as Depo-Provera, is a child-spacing shot (injectable) a woman gets once every three months.
Halima explained that when the lockdown was lifted, she rushed to the hospital to get another shot but was told she will have to undertake a pregnancy test before any shot can be given to her.
“So, they carried out the test and it was discovered that I was pregnant. What can one do? I just have to accept my fate. After all, I cannot refuse my husband when he needs me and being together day and night, indoors, I guess it was inevitable,” she said.
The three-month-stay-at-home order by the federal and state governments hindered access to health facilities that offered contraceptives and family planning services leaving the women vulnerable to pregnancy as a result of increased intimacy with their partners.
According to the Nigeria Demographic and Health Survey 2018, contraceptive prevalence rate (CPR) among married women from age 15 to 49 is 17 per cent out of which 12 per cent uses a modern method while five per cent use traditional method; 37 per cent of sexually-active unmarried women use a contraceptive method, with 28 per cent using a modern method and nine per cent using traditional method.
Missed visits to health centres
Six out of 10 women interviewed in the course of this investigation said they missed their visit days at least once and at most twice.
Three respondents said they usually visit the health centre once every three months, three respondents said they visit once every month while the other four respondents said they visit twice in three months.
The Niger State Family Planning Coordinator, Mrs Dorcas Abu, told our correspondent that if the women had been allowed access to the health facilities, there would have been no increase in conception because the health facilities were opened and services were available.
“But for the women who do not have access to these health facilities, it will lead to conception. Indeed, some women who were supposed to have a revisit and get another shot of their injectable was not able to do so,” she said.
The Director of Primary Health Centre in Chachanga Local Government Area of Niger State, Hajiya Fati Garba, echoed this as she said that there was a huge drop in the visitation for family planning services to the health facilities in the council.
“We are afraid we are going to have many deliveries of babies by December/January. This is because there was the restriction of movement during the lockdown and a lot of people were not able to access several health services, including family planning,” she said.
At the Maternal and Child Health Gwari Road Clinic in Chachanga Local Government Area, the hospital recorded 150 family planning visits in March, 120 visits in April and 185 visits in May but after the lockdown was lifted, the clinic recorded 195 family planning visits in June, 181 in July and 247 in August; showing an upward increase in visits after the lifting of the lockdown.
The officer in charge of the health facility; Adamu Adamu; said unlike the crowd that flocks into the clinic daily, the lockdown period did not allow a lot of people to access their services.
“Before the lockdown, the patronage is very high. As you can see today (early November), usually, we have crowds. But during the lockdown, because of lack of transportation and harassment from the security agents, a lot of people would not come to the hospital.
“Some of the patients that came told me they had to use their hand cards as a pass because even walking on the streets, people were not allowed,” Adamu said.
In Paiko Town Clinic, the Paikoro Health Educator, Ibrahim Tanko; said the feeling that members of staff in the health facility would also not work due to the lockdown made a lot of the clients to remain at home after the government announced the stay-at-home order,” he said.
However, in a different twist, the Head of Maikunkele Primary Health Centre in Bosso Local Government Area, Hadiza Hassan said although a lot of the clients missed their official visitation days, the local government council did not record many pregnancies like other councils due to ad-hoc arrangements it made.
According to the Head of Maikunkele Primary Health Centre in Bosso Local Government Area, majority of the women approached nurses and other caregivers who stay close to them to access these services.
At the PHC in Bosso Low Cost, 18 family planning clients were received in March, 19 clients in April, eight in May and 13 in June.
“Some of the clients had to follow some of us who provide the family planning services to our houses to get it. Although the official patronage in the health centre was low, we would not say that people could not access these family planning services,” she said.
796,000 condoms distributed during lockdown
The Niger State Family Planning Coordinator, Dorcas Talatu Abu revealed that from May to August, over 796,000 male condoms were distributed across the 25 local government areas of the state.
She also said that 11,000 jadelle, 14,760 microgyon, 15,000 norist, 3,200 microlut, 77,600 depo and 3,200 sayana press, which are all family planning commodities were also distributed during the period under review.
“The government had to purchase these commodities for distribution when it recognised that there is likely to be high demand for them, especially as couples stay at home during the lockdown.
Patronage of pharmacies and patent medicine shops for emergency contraceptives
Twenty-eight-year-old Mercy said she had to patronise the pharmacy close to her when it dawned on her that she could not go to the health facility to take her contraceptive during the lockdown.
Also, Florence Alba, who uses Sayana Press, said during that period she was supposed to have a shot but could not get to the hospital because of lack of transportation and this led her to get condoms for her husband who was not comfortable with it.
Strategic interventions by family planning agencies
The Marie Stopes International Organisation Nigeria (MSION) and the Planned Parenthood Federation of Nigeria (PPFN) are the visible organisations that provide increased access for high quality affordable sexual and reproductive health (SRH) services for people in Niger State.
A report entitled “Access to Family Planning Methods and Services in Niger State During and after Lockdown” which was made available to The Nation, revealed that Marie Stopes Nigeria continued to provide family planning and other sexual and reproductive health services across the country and in Niger State as part of the organisation’s responses in ensuring that women and girls were protected during the COVID-19 pandemic in Nigeria.
Clients’ visits grew from 10,600 in March, to 10,700 in April, 11,500 in May and 12,600 in June when the lockdown was relaxed.
They attributed the increase in service uptake to the strong collaboration with the government which granted them passes that allowed their teams to continue service provision in accordance with government and COID-19 guidelines.
However, while the number of women and girls accessing sexual and reproductive health services at MSION-supported facilities witnessed an increase, a downward trend was seen across the state in the overall number of women taking up the family planning from January through the lockdown until the last month of the lockdown when the number increased from 337,000 in May to 418,000 in June.
The organisation further observed that there was high male involvement during the lockdown which made their efforts to be successful, especially as house-to-house sensitisation was embarked upon by the community mobilisation officers and other health workers.
For the Planned Parenthood Federation of Nigeria (PPFN), the Niger State Volunteer Chairperson, Ruth Theresa Yisa said a lot of people visited the centre which operated throughout the period to access family planning services.
“PPFN got a lot of patronage during this period, unlike previous times. Although we offered skeletal services, we witnessed people coming in their numbers to the office.
“Before the COVID-19 lockdown, access to our services was about 60 per cent but during the lockdown, we recorded about 80 per cent access to our services,” she said.
Yisa also stated that most of the services accessed included Implanon, pills, injectable and male and female condoms.
She also stated that while observing the COVID-19 protocols, the organisation embarked on outreaches to take family planning services to the people who could not go to the health facilities.
§ This report was facilitated by the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under its COVID-19 Reality Check project.