Implementing the Ottawa Charter for Health Promotion in Nigeria

The Ottawa Charter for Health Promotion, adopted by WHO in 1986, provides a strategic framework aimed at enhancing public health globally. While its principles have been influential worldwide, their application in the context of developing countries like Nigeria presents unique challenges. This paper examines how these guidelines can be adapted and implemented within the Nigerian healthcare system, addressing specific cultural, socioeconomic, and infrastructural constraints. It analyzes current practices, identifies gaps, and proposes strategies for more effective health promotion that aligns with national priorities. The discussion includes stakeholder roles, potential policy adjustments, and community engagement techniques to foster sustainable health outcomes.

Running head: INEQUALITY IN ACCESS TO MODERN CONTRACEPTION IN NIGERIA
Inequality in access to modern contraception in Nigeria
Name of the Student
Name of the University
Author’s Note

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Executive Summary
This report discusses about the challenges faced by women in Nigeria. Inequality in the use of
the modern contraceptive in Nigeria has been depicted in the report. A specific action area of
Ottawa Charter has been provided in the report. The proper implementation of the Ottawa
Charter has been discussed in the chapter. The implementation has been critically analyzed at the
end of the report.

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Table of Contents
Introduction......................................................................................................................................3
Part 1................................................................................................................................................3
Ottawa Charter.................................................................................................................................3
Planning...........................................................................................................................................5
Challenges........................................................................................................................................6
Part 2................................................................................................................................................8
Conclusion.......................................................................................................................................9
References......................................................................................................................................11

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Introduction
Health Care Issues are prevailing every nations of the world. This study emphasizes on
“Inequality in access to modern contraception in Nigeria”. The use of the modern conceptive
medicines has been unequally divided in Nigeria. This has created several problems for women
in the country. The uptake of the contraceptive pills have caused disastrous effect on fertility of
women.
This report discusses about the challenges faced in Nigeria related to inequality in
modern contraceptive. The Ottawa Charter has been discussed in the report with its
implementation of the action area in this case. Data has been collected from the World Health
Organization reports.
This report outlines about critical analysis of the implementation of action area of Ottawa
Charter in this case. The barriers in addressing this area of concern has been discussed in the
report. Tis report focuses on strategies to mitigate these barriers and involvement of stakeholders
into this matter.
Part 1
Ottawa Charter
The Ottawa Charter is an international agreement made by World Health Organization
(WHO) for health promotion. Health Promotion is process that enables people for increasing
control over and improving the health care services in various health care organization (World
Health Organization, 2017). Health promotion focuses on achieving equity on health care. It
depicts equality in achieving heath care services for individuals. Health Promotion strategy
requires identification of obstacles for securing adoption of health care policies in non-health

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sectors. In this case, health promotion in Nigeria has been focused by implementing one of the
action area of Ottawa Charter. According to the case study, creating supportive environment is
the action area that can be used in this case. A supportive environment is required in maintaining
the statistical data regarding this case. The condition in the Nigeria has been worse by inequality
in use of modern contraceptive.
According to the survey done by WHO in Nigeria, there has been reduction in fertility by
one child per woman. This has caused 13% reduction in GDP of the country in 20 years. Studies
revealed that 30% to 40% of maternal deaths and 90% of induced abortion has occurred due to
inequality in use of contraceptive (Fry & Zask, 2016). Contraceptive use have minimizes the
fertility rate and increase in threat of abortion among women in Nigeria. Fertility decline in an
area is demographic depended, consequent reduce in poverty, enhancing economic growth and
contributing to families and societies. Therefore, by supportive environment, the mentality of the
human beings can be changed. Equality in the use of contraceptive for women might enhance.
This policy have helped in maintaining the fertility rate in Nigeria.
The supportive environment for use of modern contraceptive by women helps in
controlling the rate of abortion and increase the rate of fertility in Nigeria. The family planning
has been key option for the couples in the country. Before 1980s, family-planning programs was
not a priority in Nigeria (Mendes, Plaza & Wallerstein, 2016). Later on, this program has gained
attention with the implementation of various policies by the Nigerian government. The policies
include Nigeria’s National Population policy 1988. This policy was revised in 2004. The policy
focuses on enhancing the use of modern contraceptives for health goals. The target for policy
was to increase the use of contraceptive up to 80% among women (Lee, 2015). The revised
policy concludes for a reduction to 75% by 2015. The fertility rate has reduce by 0.6 children per

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woman every five years and there is a 2% annual increase in proportion of women using
contraceptives. Nigeria developed a blueprint for accelerating uptake of family planning with a
target of increasing the national contraceptive prevalence rate to 36% by 2018 (Davies et al.
2014).
According to 2013 NHDS, awareness about contraceptives is more and uptake is low.
Only 15% of married women are using contraceptive and 10% are using modern family planning
techniques. The statistic variables might be relieved by natural and behavioral components, for
example, fertility, sexual movement and want for kids. African social orders are genius natalist,
trust that kids are blessing from God, and are social and financial ventures; this has negative
suggestions on utilization of contraceptives (Stock, Milczarski & Saboga-Nunes, 2016). Couples
and women who want more kids are less inclined to utilize contraceptives. Studies have
discovered that a reverse relationship exists between quantity of living youngsters and utilization
of present day contraceptives (Chen et al. 2016).
A solid relationship has been found between women’s training, particularly finished
essential training and passage into auxiliary level, and ripeness decrease. A few examinations
have detailed that women’s instruction has a solid positive effect on prophylactic utilize (Gagné,
T., Lapalme, J., & Leroux, 2017). In Nigeria, training has been found to increment prophylactic
utilize. Free of socioeconomic factors, information of contraceptives is determinant of
prophylactic utilize. Introduction towards mass communications affects family planning
arranging through ideation, which has been found to add to watched fertility decline. Proof from
various researches uncovers that introduction to broad communications messages advancing
family arranging may influence preventative conduct. In Nigeria, utilization of present day

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contraceptives, the expectation to utilize them, want for less youngsters were observed to be
related with introduction to media message about family arranging.
Planning
Several steps are required during planning a project. In this, case the use of modern
contraceptive among women has been described. The steps that are involved in the planning has
been mentioned below:
• Understanding the timeline, resources, budget and contracts needed to implement the
interventions
• Identification of stakeholders and ensuring appropriate participation and partnership
• Priorities interventions
• Phase in program’s implementation.
For completing a project plan:
• Prioritize interventions by ability for providing possible gain given the cost and available
resources
• Preparing a budget
• Constructing a project implementation plan
• Arranging contracts for delivery of services and agreements on collaborative action
• Establishing a monitoring system.
Challenges

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There are various challenges in implementation of equality in the use of modern
contraceptive. These challenges are described below:
Lack in Awareness
There is a lack in the Nigerian people regarding the use of the contraceptive for women.
The education system of the country is bad that have caused low literacy rate in the country.
Therefore, there is an inequality in using the modern contraceptive among women. Due to
inequality, the fertility rate of the country has been continuously decreasing by years
(Eckermann, 2017). The consequences of the abnormal use of contraceptive in the society has
been worse among the women. The health of women has been continuously degrading.
Therefore, there is requirement of awareness among the people of Nigeria.
Lack in policy
The policy against these misconduct activities in the country has not been yet
implemented properly. This have caused imbalance in the reproduction rate of the country. The
improper use of contraceptive have caused different problems (Sarmiento & Sarmiento, 2017).
The government of Nigeria has not concerned about this problem. There is no strict policy made
by the government against the inequality in the use of the modern contraceptive.
Demographic
In Nigeria, most of the married women plan their pregnancies without the use of the
modern contraceptive. They stop child bearing without using the modern contraceptive. This has
affected the reproduction rate in the country. Many women are having their child before 18 years
of age, which is detrimental for both girl and child (Kickbusch & Nutbeam, 2017). This causes

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high risk in the life of the girl. The use of the modern contraceptive can help them in this
situation. However, they are not using the modern contraceptive.
Part 2
The Ottawa Charter has been an important part of the history in the field of health
promotion among people. The ideas associated with the application of the Ottawa Charter has
been properly magnified in the first part. The post colonialism gives a framework that depicts
destabilized dominant Western discourse. The feature of post-colonial theory is to examine of the
effect and legacy of the European colonization. It helps in recognizing the colonial assumption
and consequences having inequality in the health promotion. It draws attention towards the
Western culture and colonial activities in the society (Furber et al., 2017). The Ottawa Charter
have helped in implementing equality among the colonial. The Postcolonial standpoint has been
critical for considering different way by which particular colonial vision of the global health has
been mobilized. In the case of Nigeria, the inequality in the use of modern contraceptive has
been depicted in the paper. The implementation of the Ottawa Charter have helped in mitigating
these problems in the country. As argued by (Dyment et al., 2017), in the wider context of
Ottawa Charter has its own production that puts in practice with the help of generalized
principle.
The critical examination of the context of the Nigerian people regarding the use of the
conceptive has been performed for implementing the Ottawa Charter. The action areas of the
Ottawa Charter has been decided including creating supportive environment (McFarlane et al.,

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2017). A supportive environment helps in maintaining proper use of the modern contraceptive
among women in Nigeria. Proper knowledge and awareness regarding the use of the
contraceptive is required among the people pf Nigeria. This might help in understanding them
about the use of the modern contraceptive. However, it is difficult not to see colonial imagination
at work in a charter that is concerned with the Nigerian context. Various range of strategies are
discovered for the implementation of the Ottawa Charter for maintaining balance in the use of
the modern contraceptive in Nigeria. The health promotion have become a channelized process
in the industry that is required by every organization. The use of the modern contraceptive have
helped in maintaining the birth rate of child (Alami et al., 2017). The implementation of the
Ottawa Charter in the Nigerian area have helped in maintaining the reproduction rate of the
child. The mortality rate of the country has been balanced. The health promotion campaign under
the Ottawa Charter have helped in providing awareness about the modern contraceptives among
people in society. Emotions and social identity affects the colonial activities in the country.
People are socially and emotionally attached to their loved one and require proper health care.
The health promotion have been properly managed in the country for helping women from
miscarriage.
As commented by Eckermann, (2017), the use of the modern contraceptive have helped
in providing proper solution for the problems faced by women in Nigeria. The use of the modern
contraceptive have provided various approaches for the women in their marriage life in Nigeria.
The women in the society are benefited from the action area implemented by the Ottawa Charter.
The positive normalization of the health promotion in the western countries have able to position
this action area for intervention of everyday behavior of people. The Ottawa Charter masked
power imbalances and Western-centric worldviews, while also silencing non-Western voices.

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Conclusion
It can be concluded that the Ottawa Charter have helped in maintaining the equality of
use of modern contraceptive among women. The research has focused on inequality in use of
modern contraceptive in the Nigeria. The Ottawa charter has been briefly described in the report.
The factors implementing in the Ottawa Charter has been properly discussed in the chapter. A
critical analysis has been provided at the end of the report that help in proper understanding
about the implementation of the Ottawa Charter for health promotion in Nigeria.

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References
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Chen, T. H., Huang, J. J., Chang, F. C., Chang, Y. T., & Chuang, H. Y. (2016). Effect of
workplace counseling interventions launched by workplace health promotion and tobacco
control centers in Taiwan: An evaluation based on the Ottawa charter. PloS one, 11(3),
e0150710.
Davies, S. C., Winpenny, E., Ball, S., Fowler, T., Rubin, J., & Nolte, E. (2014). For debate: a
new wave in public health improvement. The Lancet, 384(9957), 1889-1895.
Dyment, J., Emery, S., Doherty, T., & Eckhardt, M. (2017). Move Well Eat Well: Case study of
a successful settings-based approach to health promotion. Health and Wellbeing in
Childhood, 283.
Eckermann, E. (2017). Global health promotion in the era of ‘galloping populism’. Health
Promotion International, 32(3), 415-418.
Fry, D., & Zask, A. (2016). Applying the Ottawa Charter to inform health promotion programme
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Furber, C., Pusey, H., Busby, A., & Stringer, E. (2017). Integrating public health practice into
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Midwifery, 25(5).
Gagné, T., & Lapalme, J. (2017). 1986: Ottawa and onwards. The Lancet Public Health, 2(2),
e71.