Across many communities in Nigeria, misconceptions, cultural resistance and religious misunderstandings continue to limit access to family planning.
Persistent myths suggest that contraceptives cause barrenness among women of reproductive age.
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As a result, young and married women face unintended pregnancies, rising maternal deaths, pressure on household resources and reduced access to education and economic opportunities.
Albeit growing awareness nationally, access to and uptake of modern family planning methods remain uneven.
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According to the 2024 Nigeria Demographic and Health Survey (NDHS), the percentage of currently married women using modern contraceptives varies widely across states; from a high of about 43 per cent in Ekiti State to as low as three per cent in Kebbi State.
Against this backdrop, Enugu State is making relative progress.
The NDHS shows that 50.5 per cent of women in Enugu have never used family planning methods, with 35.6 per cent currently using them, figures that are comparatively higher than many states but still below optimal levels of demand satisfaction.
However, cultural barriers continue to make uptake difficult in some settings, especially where women cannot freely make reproductive health decisions.
Nationally, only three out of 10 married women report being able to make informed decisions on sexual relations, contraceptive use and personal healthcare, a key benchmark of reproductive autonomy.
Advocacy from traditional leaders
In Enugu, traditional and religious leaders are increasingly expanding family planning awareness and acceptance by providing the cultural legitimacy and moral framing that health workers often struggle to achieve on their own.
Through community dialogues, village meetings and faith-based gatherings, these leaders correct misinformation, reassure families that family planning aligns with cultural and religious values, and encourage couples to make informed reproductive choices.
The Traditional Ruler of Amorji Nike and former Chairman of the Enugu East Local Government Area Council of Traditional Rulers, Titus Okolo, stated that he is utilising his office to amplify campaigns and community demand for modern family planning.
According to Mr Okolo, in spite of Igbo culture’s encouragement of large families, he has sensitised couples to embrace modern family planning to reduce maternal and newborn deaths.
“Life is a stage. As we grow older and die, the community needs new ones who will help to keep the community going.
“So in Igboland, there is nothing that forbids a woman from giving birth to as many children as she desires if the family has the resources to train them.
“But the present condition of the country does not support giving birth to many children that the family cannot train. So we encourage them to adopt family planning to control the number of children,” Mr Okolo said.
He added that his advocacy has influenced other traditional rulers to speak openly about safer pregnancies and healthier, economically stable families.
“MSI Nigeria Reproductive Choices and Nigeria Health Watch have been inviting me to their programmes through which they teach us about family planning and contraceptives.
“Based on that, I have made child spacing part of my leadership advocacy as I call on men and other traditional rulers to help disseminate these messages. Culture and religion are no longer a barrier,” he stated.
And religious leaders, too
Religious leaders are also contributing to the shift in attitudes.
Ifeanyi Ofili, a pastor with the Redeemed Christian Church of God, Enugu, said the church is using the pulpit to educate members on responsible reproductive choices.
“As Christians, we believe that sexual intercourse involves both partners who plan together and encourages child spacing,” Mr Ofili said.
He emphasised that family planning decisions should be made jointly by couples.
“We encourage spacing because a woman’s body undergoes a lot with continuous childbirth.
“We do not encourage giving birth to children you cannot cater for, because they (eventually) become a burden to the family and society.
“With my effort, our church now organises health talks two or three times a year. We invite experts.
“They even come for cervical cancer screening. We are not health professionals, so we allow them to do their work,” he explained.
Resident shares her experience
For Enugu residents like Jonnex Onu, the advocacy influenced her decision to adopt modern family planning for child spacing and to improve her health outcomes.
“I have been into modern family planning methods for over a year now.
“I went into modern family planning methods because of the economic hardship.
“I have two children now, and the main thing that motivated me to go into modern family planning is increased awareness.
“My first child is four years plus, and the second child is two years now. And when I talk of we, I mean my husband and I, because it is not only me that is in it.
“So he gave his consent for me to take the modern family planning method,” he said.
Mrs Onu also addressed early concerns about side effects.
“At the initial time I took the implant method, I was having spotting and irregular menstrual cycles, but later on it stopped”.
At the service delivery level, health facilities are also reporting an increase in demand.
A family planning provider at Hilltop Health Centre in Enugu Ngwo, Chidimma Nnamani, stated that the facility now attends to dozens of women each month.
The facility provides family planning services to 50 to 60 women per month.
“We also educate couples about family planning, especially those in rural areas, to prevent them from dying from unwanted pregnancies,” she said.
In spite this progress, national and state data suggest that unmet need for family planning remains high, and no Nigerian state has yet met the National Policy on Population target of reducing unmet need to 10 per cent by 2025.
State variations are also stark. While some southern states have doubled contraceptive prevalence in recent years, many northern states still report single-digit modern contraceptive use.
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Policy experts argue that sustaining and accelerating progress will require more decisive government action.
This includes increased funding, improved supply chains, expanded community education and male engagement, alongside continued support from traditional and religious institutions.
Ultimately, while challenges remain, the consistent voices of trusted leaders in Enugu have helped soften resistance, reshape attitudes, improve maternal health outcomes, and empower families to plan their futures with dignity.
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