Introduction:

“Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility. A woman’s ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy.” (WHO)

Following are the barriers to family planning:

Socio-cultural barrier
Educational/Information barrier
Political barrier-irregular supplies
Economic barrier
Fear of side effect
Misconception about family planning
Geographical accessibility
Administrative barriers

Socio-cultural barrier

Culture is one of the main reasons for high fertility. In certain tradition and culture, people take having more number of children as their pride or gift of God and people do not use family planning devices.
Similarly, in male dominant societies, men after marriage treat their wife as their property and do not involve their wife in family planning and take decision about it entirely.
In some cultures, people see family planning device such as condom as a means to protect themselves from STDs only.
Eg.: Muslim community encourage large number of children and forbids the use of family planning devices but do use traditional methods for birth spacing.

Educational/Information barrier

Lack of counseling services to couple may also reduce its use. (Proper counseling helps to make couple familiar to different family planning devices and its benefits along with side effects. It also helps couple in voluntary adoption of any methods/devices that would be favorable to them. When people are completely known or aware about the methods, people are more likely to use it.) When there is not proper counseling people are likely to have doubts about its use.
Mostly women are less literate than man and cannot take decide for using family planning devices. In Africa, woman with more than 7 years of education have fewer number of children as compared to illiterate ones (Hobcraft, 1993)
Also, when couples do not have information regarding benefits of family planning devices for mother, child and to whole family.

Political barriers

Lack of trained and qualified health personnel to provide quality service- due to lack of family planning trainings.
Weak plans and policies related to family planning
Supply of family planning devices is insufficient and irregular.

Economic barrier

Every members of population are not economically established. Especially in developing and under developed countries large, portion of population lies below poverty line. People do not have income to afford meal for twice a day and also cannot afford to buy family planning devices and services such as Condom, Pills, IUCD, and Norplant or to carry out sterilization.
As health facility may be far away from the place where they live and may also encounter transportation cost in the process of taking services and do not wish to take the service because of economic inconvenience.

Fear of side effect

One of the well known barriers to family planning is the fear of side effect from the use of devices.
Lack of proper information on family planning devices give rise to fear of side effect on fertility and menstruation etc.
Fear of side effect arises among individuals either by documenting/observing people using the devices or through misconception.
For e.g. when old user say it causes persistent weight loss or gaining weight due to its use to new user then, new user are less likely to use the method

Myth/Misconception about family planning

Wrong information related to use of family planning devices is also a barrier for its use.
Certain people say that family planning device can move to heart and other vital organs of the body from where it is placed and cause damage to them. Similarly, people also belief that injection such as Depo will cause infertility in them, Pills can cause cancers. These myths about family planning devices are preventing the use of it.

Geographical accessibility

Geographical accessibility is also a major barrier to family planning as mostly in developing countries where every part of the country is not connected by roads.
Mostly, people in rural areas are disadvantaged as they have to walk for hours, days or weeks to reach the place that provides services i.e. clinics. As a result, people do not wish to use family planning devices due to difficult geography.

Administrative barriers

Clinics may not be providing quality of service to its patients. (Lack of unqualified health worker, lack of services etc)
Bad behavior of service providers towards users.
Previous bad experience of individual in medical facility such as long waiting time, no privacy, lack of availability of devices in health facility etc
When people do not get satisfactory services from health facility, they are unlikely to visit for taking family planning services and when they share their experience to other members of community, they also refuse to go to health facility fo taking family planning services.

Effect of family planning barriers on maternal and child health

According to article titled, “Impact of family planning on maternal-child health. The future of humanity depends on our children”, following are the effect of family planning barriers on maternal and child health:

Lack of spacing between two children results in high infant and child mortality. It is estimated that one out of five children could be saved if there was proper interval between the two consecutive births.
Mental health problems can be seen among mothers due to lack of recovery period due to inadequate spacing between two children.
When there are many children, mother may not be able to give quality care to her children due to lack of time or may be due to limited resource.
Women are at four time higher risk of abortion in her third pregnancy as compared to her 1^st and 2^nd
There is high chance that next babies may have low birth weight after 4^th child increasing the chance of various health issues.
Proper nutrition may not be provided to babies when family size is large and may suffer from nutritional deficiencies and disorder.
According to World Fertility Survey, it is estimated that access to family planning services can save around 200,000 maternal deaths.

References and for more information:

http://www.emro.who.int/emhj-vol-19-2013/5/barriers-affecting-utilization-of-family-planning-services-among-rural-egyptian-women.html

http://www.who.int/pmnch/media/news/2010/20100322_d_shaw_oped/en/

http://www.emro.who.int/emhj-vol-19-2013/5/barriers-affecting-utilization-of-family-planning-services-among-rural-egyptian-women.html

http://overpopulation.org/pdf/BarriersSolutionsToFP_resistance.pdf ——

https://www.girlsglobe.org/2013/11/14/cultural-barriers-to-family-planning/

http://digitalcollections.sit.edu/cgi/viewcontent.cgi?article=2744&context=isp_collection

https://www.theguardian.com/journalismcompetition/2011-theme-family-planning

http://www.iosrjournals.org/iosr-jrme/papers/Vol-6%20Issue-2/Version-1/C006211221.pdf

https://www.slideshare.net/jakeodunga/contraceptive-use-in-sub-saharan-africa-the-sociocultural-context

https://www.slideshare.net/nuhubankwhot/socio-cultural-presentation-finals

https://www.google.com.np/url?sa=t&rct=j&q=&esrc=s&source=web&cd=11&cad=rja&uact=8&ved=0ahUKEwii77j8p5fXAhXBoJQKHWHPA4E4ChAWCCUwAA&url=http%3A%2F%2Fwww.curationis.org.za%2Findex.php%2Fcurationis%2Farticle%2Fdownload%2F875%2F812&usg=AOvVaw04lYP93zhaBPpKwtTe-yiL