Impediments to effective fertility reduction

“ Doctors are in the best position to know …”: The perceived medicalization of contraceptive method choice in Ibadan and Kaduna, Nigeria

“…Studies conducted in Nigeria among college students, married women, and urban women show the most common reason for contraceptive nonuse is fear of side effects [5] , [8] , [20] , [28] . Although fear of side effects is an important barrier to family planning use, only 47 percent of women in Nigeria using a modern method of contraception obtained from the private medical sector were informed about side effects or method-related problems, compared to 76 percent of women who used a public facility [1] .…”

“…Evidence also exists of health facility barriers in method choice, including staff levels, expired stock, provider bias, and lack of training in Nigeria and other developing countries [3] , [17] , [18] , [19] . The general medicalization of family planning and the clinic-based nature of distribution has been criticized as a barrier to increasing levels of contraceptive use [20] , [21] , [22] . These medical barriers include eligibility criteria, over applied contraindications, and numerous process hurdles that clients face when trying to obtain contraception [22] .…”

Contrasting views on human population growth

“…Learned societies and research funding agencies are reminded that taboos are detrimental to learning. We hope that the BMJ will receive many communications on such issues as: the tensions between sustainable development, economic growth, and employment; human rights in the face of demographic pressures; humankind's reasonable share of the world's natural resources and habitats; more user-friendly, safe, long term, and “forgettable” contraceptive technologies, freely or cheaply available and uninhibitedly advertised6; and state of the art (often peer provided) age specific sexual health education for the young. We need vigorous initiatives in both North and South, with vastly increased funding to ensure that everybody in the world who wants contraception can actually get it.…”