A High Level of Knowledge and Positive Attitude Among Men in Both Urban and Rural Populations Studies

The World Health Organization defined family planning as the act which allows individualities and couples to anticipate and attain their asked number of children and the distance and timing of their births. It's achieved through use of contraceptive styles and the treatment of involuntary gravidity  A woman's capability to space and limit her gravidity has a direct impact on her health and well- being as well as on the outgrowth of each gestation. Family planning is regarded as a vital and integral element of Primary Health Care which aims at promoting responsible parenting, controlling population and perfecting quality of life of the people. One of the most serious problems developing countries still have to break is their rapid-fire and unbridled increase in population. numerous developing societies are characterized by rapid-fire population growth due to high fertility and declining mortality inSub-Saharan African. The rate of population growth is one of the loftiest in the world, with an average growth rate of 2.53.

The World Health Organization defined family planning as the act which allows individualities and couples to anticipate and attain their asked number of children and the distance and timing of their births. It's achieved through use of contraceptive styles and the treatment of involuntary gravidity (1). A woman's capability to space and limit her gravidity has a direct impact on her health and well- being as well as on the outgrowth of each gestation (1).

Family planning is regarded as a vital and integral element of Primary Health Care which aims at promoting responsible parenting, controlling population and perfecting quality of life of the people (2). One of the most serious problems developing countries still have to break is their rapid-fire and unbridled increase in population (3). numerous developing societies are characterized by rapid-fire population growth
The world's population has been rising steadily, reaching above 7billion with further than 71 living in developing countries (5) and current United Nations' protrusions showed a uninterrupted increase in population in the near future, with the global population anticipated to reach between8.3 and10.9 billion by 2050(,7). Nearly all (97) of the2.3 billion projected increase will be in the less advanced regions, with nearly half in Africa (8). Average world population change is estimated at around 80million per time with a growth rate of around1.14 per time (9) and2.53 inSub-Saharan Africa (4). Nigeria's population growth rate of2.553 per annum results from a fat of births over deaths giving a population of over 167million which is said to be too large for comfort( 10) and is anticipated to surpass the United States population in 2045 to come the third most vibrant country in the world, starting to compete China by the end of the century with nearly 1billion people in 2100( 9). With a large unmet need for family planning and a low contraceptive frequence rate, Nigerians are still having further children than planned and at a shorter than asked birth intervals( 11).

It's well proved that men's general knowledge and stations concerning the ideal family size, gender preference of children, ideal distance between parturition, and contraceptive system use greatly impact women's preferences and opinions( 12). Fertility and family planning exploration and programs have ignored men's places in the once fastening on women's geste, (12) and services are traditionally presented within the environment of motherly and child health (13). African men play important places in the opinions about family life including fertility and family planning (14).

Since the 1994 International Conference on Population and Development (ICPD) and the 1995 United Nations World Conference on women, interest in men's involvement in reproductive health has increased (14). exploration on the determinants of fertility inSub-Saharan African and in programs designed to increase contraceptive use among African Population shows adding attention is being paid to the contraceptive knowledge, stations and practices of African men (15). The shift in focus on men's reproductive health was told by the 1994 Cairo (ICPD) Action Plan to promote gender equivalency and equity, empower women and ameliorate family health in society (16).

Women depend on men to take opinions on contraception, and more so in the pastoral areas where traditional settings still live. There appears to be a difference between the knowledge and station of contraception between civic and pastoral manly residers.

This study aims at comparing the position of knowledge and station of family planning among men in two (civic and pastoral) LGAs of Anambra state of Nigeria. Specifically, the objects of this study is to compare the knowledge and station of Family Planning among men in two LGAs, Onitsha North (civic) and Ayamelum LGA (pastoral), both in Anambra state, Nigeria.

This is a descriptive, relativecross-sectional study conducted from January 8th to February 7th 2014 in Onitsha North LGA (civic LGA) and Ayamelum LGA (pastoral LGA) both in Anambra state, Southeast of Nigeria. The population of Onitsha North LGA is,726, while that of Ayamelum LGA is,835(,18). The state population is4.2 million and substantially inhabited by Igbo speaking people who are substantially Christians and most members of the population are growers, crafters and civil retainers. The study population was 388 males (194 in each LGA) aged 19- 61 times of age who were sexually active and in current sexual relationship with women aged 15- 49 times anyhow of their connubial status but were resident in the areas of study.

Multistage slice fashion was used to elect 388 men from 388 homes.

Stage 1 one civic and one pastoral LGAs were named through simple arbitrary slice.

Stage 2 two wards were named from the list of wards in each named LGA through arbitrary slice.

Stage 3 two thorough fares (from a frame of 8 thoroughfares) and 2 townlets (from a frame of 6 townlets) were named aimlessly from civic and pastoral wards independently.

Stage 4 194 homes (from a frame of 473 homes) and another 194 homes (from a frame of 451 homes) were named through methodical slice from civic and pastoral wards independently i.e., an aggregate of 388 homes from 924 homes with PHC house marking (used for vaccination). The first eligible manly encountered in each ménage was signed for the study.

 Data was collected with the aid of two exploration sidekicks using tone- administered questionnaire for the educated males and canvasser - administered for thenon-educated repliers. The questionnaire waspre-tested for felicitousness and clarity on men analogous in characteristics to the population studied but in different LGAs of the state. It has sections that explore the socio- demographic characteristics of the repliers, knowledge and station of family planning and also on factors impacting their decision on the practice of family planning. The section on knowledge and station contains five questions each with statements taking choice of answers in three orders, i.e., agree, differ, and doesn't know.

Data was entered and analysed using Statistical Package for Social lores (SPSS) interpretation 16. frequentness and probabilities were presented as tables. Statistically significant differences (P<0>

Ethical Blessing for the study was attained from the Ethics Committee of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Informed concurrence was attained from all repliers.

A aggregate of 388 males, 194 from each of the study areas were canvassed. Enrollees were aged 19- 61 times with a mean age of 36 ±10.2 times and39.9 ±10.6 times for the civic and pastoral areas independently and utmost were married. The modal age for both pastoral and civic repliers was 30 to 39 age group. The proportion of youngish age groups (20- 29 and 30- 39 times) among the civic actors (24.2 and34.3, independently) compared to the pastoral actors (15.6 and31.3, independently). also, the proportion of aged actors (40- 49 and 50- 59 times groups) are lesser among the pastoral than civic people (29.8 and20.2 compared to27.8 and0.1, independently. These difference in their age distribution is statistically significant X2 = 11.24, Df = 4, P- value = 0.02 (p<0>

The maturity of the pastoral actors were growers (41.8) followed by sloggers (19.6) compared to their civic counter parts (0.0 and7.8, independently), while Dealers constitutes the maturity in the civic actors (40.2). These differences is statistically significant X2 = 176.067, Df = 6, P- value = 0 (p<0>

The maturity of the repliers in both civic and pastoral actors were Christians( 95 and86.1, independently), of which51.0 and48.5, independently were Catholics. The difference was statistically significant X2 = 38.41, Df = 4, P- value = 0.0( p<0>

A lesser proportion of the actors in the pastoral area(72.2) was married compared to figure in civic area(61.3). There were further single actors in the civic area(35.1) than in the pastoral area(23.7). The difference was statistically significant X2 = 9.64, Df = 3, P- value = 0.02( p<0>

Fifty percent of actors in the civic group attended tertiary education compared to only14.9 in the pastoral groups. Also, a advanced chance(19.6) of pastoral actors had no formal education compared to the civic group(0.5). The difference was statistically significant X2 = 81.37, Df = 3, P- value = 0.00( p<0 xss=removed xss=removed xss=removed>0.05). Also, 120(61.9) of civic and 96(49.5) of pastoral repliers dissented with the fact that all artificial styles of family planning cause endless sterility( statistically significant X2 = 6.016, Df = 1, P- value = 0.01; p<0 xss=removed xss=removed xss=removed>0.05).

A lesser chance of civic actors 146 or75.3 differ with the statement that birth control is a sin compared with 115 or59.3 in the pastoralgroup.The difference is statistically significant( X2 = 12.24, Df = 2, P<0 xss=removed xss=removed xss=removed>0.05). also, the negative response to the statement that birth control is a woman's business weren't statistically significantly different between the two groups( X2 = 0.336, Df = 2, P- value = 0.84 p>0.05). still, the difference in negative response to the statement that family size doesn't have effect on the well- being of the family 166 or85.6 for civic and 135 or69.6 for pastoral groups was statistically significantly( X2 = 14.51, Df = 2, P = 0 p<0>

The difference is statistically significant( OR = ,95 C1 = 1.3 to17.5, P- value = 0.01 p<0 xss=removed xss=removed xss=removed>0.05). A advanced chance of civic actors 120 or61.9 perceived that all artificial styles of family planning cause endless gravidity compared to 98 or49.5 of pastoral group. The difference is statistically significant (OR = 1.655, 95 CI = 1.105-2.48; P- value = 0.014). also, a advanced chance of civic actors (178 or91.8) agree that family planning is necessary for good health of the family compared to 158 or81.4 or the pastoral group. The difference is statistically significant (OR = 2.535, 95CI = 1.354-4.744, P- value = 0.002; p<0>

The difference is statistically significant (OR = 8.303, 95 CI = 3.64-18.92, P- value = 0.00; p<0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>0.05). also, there was no statistically significant difference between the negative response of the civic (90.7) and the pastoral groups (90.2) on birth control being a woman's business (OR = 1.062, 95 CI = 0.56-2.09, P- value = 0.1 p>0.05). An advanced chance of the civic group (166 or85.6) differ that the family size doesn't affect the wellbeing of the family compared to 135 or69.6 of the pastoral group. The difference is statistically significant (OR = 2.59, 95 CI = 1.56-4.3, P- value = 0.00; p<0>

There was a statistically significant difference between the socio- demographic distribution of civic and pastoral actors. The modal age of the actors was the same for both, while there were generally youngish age groupsin the civic group (mean and progress group distribution) than in the pastoral group. This is to be anticipated because the youngish people tend to resettle to the civic areas in hunt of better profitable well- being. Also, the finding of ascendance of husbandry followed by homemade occupation in the pastoral area in discrepancy with trading conditioning in civic area is presumably due to vacuity of land and other ranch coffers and smaller employment openings in the pastoral areas of Nigeria. The study revealed a high position of knowledge about family planning among both groups which is harmonious with findings by other experimenters (19- 23). still, the civic group has lesser chance of people with the correct knowledge about family planning. This is to be anticipated because of the advanced educational attainment in the civic group in discrepancy with those of the pastoral group. The difference in knowledge of the two main types of family planning among the two groups is comparatively not significant, while there's a significant difference between civic and pastoral repliers in terms of misconceptions about all artificial family planning styles causing gravidity. also, there's also a lesser misconception about family planning being a sin, and only about precluding pregnancyin the pastoral population compared to civic area. The reason for this difference in misconception is presumably due to the difference in educational attainment between the civic and pastoral populations studied.

Also, utmost repliers display more positive station in discrepancy with some other reports that mens' station to family planning is poor. The positive station is shown by advanced negative response to similar questions as family planning being meant for wayward women, Family planning being a sin and women's business. Although, the findings show high negative response in both groups, there's comparatively a advanced proportion in the civic group. The recrimination is that there's need for further health education and crusade in the pastoral areas. lately, the crusade for family planning had been boosted especially with the collaboration of the Nigeria Governments through health institutions, primary health centres, transnational agencies andnon-governmental agencies, with the result that mindfulness about the benefits of family planning has grown veritably much. Also, the traditional and artistic practices of having numerous children who would work in the ranch is on the decline. People are presumably seeing the need for a reduction in the size of the family in the face of rising profitable difficulty. still, the belief by the repliers that artificial styles of family planning cause endless sterility, cancer raises concern on the correctness of the knowledge of the repliers particularly among the pastoral repliers where further than half (50.5) uphold similar belief. Although this was reported by another experimenter, it's a cause for concern since this will affect station and eventual use of similar system if not checked.

The misconception that family planning is just about precluding gestation probablyresulted from the emphasis being placed on the control of the number of children to the near rejection of other benefits of family planning. The use of family planning styles for other purposes similar as forestallment of sexually transmitted conditions isn't emphasized much because some Christian appellations, especially Catholics believe that use of condom would encourage promiscuity. similar beliefs could affect in men not approving of the use of family planning for themselves or for their consorts before reaching their asked number of children. The recrimination is that motherly and child mortality and morbidity would remain high or indeed rise advanced.

Quite a reasonable number of the actors dissented with the fact that only wayward women use contraception, although, further of the pastoral residers suppose else when compared with their civic counterpart. This misconceptions could be the reason for the difference in the knowledge and station of pastoral men to family planning when compared to their civic counterparts. There's thus a need to have further ferocious enlightenment crusade to be targeted at the pastoral residers.

Although, there's a high position of knowledge and positive station among men in both civic and pastoral populations studied, theurban men have a significantly advanced position of knowledge and positive station than their pastoral counterpart.

Misconceptions about family planning is significantly high among the men, still, this is indeed advanced in the pastoral population in discrepancy with the civic residers.

There's a need for agencies working in the area of family planning to increase mindfulness about birth control practices targeting men generally and especially those in the pastoral areas. Also good public enlightenment program (forums, shops and colloquies) should be used to correct the misconception that sterility or cancer affect from artificial styles of family planning. There's need for farther studies on men's practice of family planning.

Competing interests

The authors declare that they have no competing interests.

1. World Health Organization. Health topics: family planning. WHO. 2013.
2. Obionu CN. Primary Health Care for developing countries. Enugu. Delta publications. 2007; 249-250.
3. Mistik S, Nacar M, Mazicioglu M and Cetinkaya F. Married men's opinions and involvement regarding family planning in rural areas. Contraception. 2003; 67:133-7.
4. Trading Economics. Population growth (annual %) in sub-Saharan Africa. World Bank indicators. 2012.
5. United State Census Bureau. USCB world POP clock projection 2012. 2013.
6. World population prospects. The 2012 Revision-‘low variant’ and ‘high variant’ values. UN. 2012.
7. UN News Center. World population projected to reach 9.6 billion by 2050. UN report. 2013.
8. World Population to surpass 7 billion in 2011. Explosive population growth means challenges for developing nations, Harvard school of Public Health. 2011.
9. World Population Clock. 7 Billion people (2013)-worldometers. 2013.
10. Advanced family planning 2011. AfriComNet. 2013.
11. Kofoworola AO and Bose EI. Promoting male participation in family planning in rural Nigeria: A community-based intervention. International conference on family planning. Dakar,Senegal. 2011.
12. Oyediran KA, Ishola GP and Feyisetan BJ. Factors affecting ever-married men's contraceptive knowledge and use in Nigeria. J Biosoc Sci. 2002; 34:497-510.
13. Mason K and Lynnam P. Not for women only: child-spacing clubs for Malawian men. In: Male involvement in family planning decision-making in Ile-Ife.Osun state, Nigeria. Afr J Reprod Health. 2010; 14:45-46.
14. Osede OI, Uwaifoh A, Anthony ON, Charity UO, Harrison OO and Okhiai O. Contraceptive choice among married men in Ekpoma. African Journal of Biomedical Research. 2011; 14:13-14.
15. Gbolahan AO and James M. Family planning knowledge, attitudes and practices of males in Ilorin, Nigeria. International family planning perspectives. 1991; 17:21-22.
16. Bustamante-Forest R and Giarratano G. Changing men's involvement in reproductive health and family planning. Nurs Clin North Am. 2004; 39:301-18
17. NPC/ICF. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF macro. 2009.
18. Lawoyin TO, Osinowo H, Babatunde M, Bajomo TG, Betiku AO, Biakolo, Busari KT and Fehintola A. Family planning in rural Nigeria: a study among men. Afr J Med Med Sci. 2002; 31:159-62.
19. Orji EO and Onwudiegwu U. Prevalence and determinants of contraceptive practice in a defined Nigerian population. J Obstet Gynaecol. 2002; 22:540-3.
20. Duze MC and Mohammed IZ. Male knowledge, attitudes, and family planning practices in northern Nigeria. Afr J Reprod Health. 2006; 10:53-65.
21. Uwaifo A, Anthony ON, Harrison OO, Charity UO, Williams AA and Okhial O et al. Comparative study on the awareness of contraceptive methods amongst married males population of Ekpoma, Nigeria. African Journal of Biomedical research. 2011; 14:3-4.
22. Ozumba CO. Family planning among married men: a pilot study in Abakpa Nike Enugu state Nigeria. Sixth African Population Conference. 2011.