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“The implant does not become active until after a week, but they go ahead to have sex, if they take note she won’t conceive insha Allah, but if they failed to adhere to this, and she had sex, nothing stops her from conceiving, that’s the why a woman get pregnant after using an implant, violation of the guidelines is the actual reason.”

That was Zarah Usman a child spacing, CS, servi ce provider at the Pantami community primary healthcare Center, PHC, Gombe. She is a trained CS provider. She says she has been offering CS services for four years now. According to her, they hear many things from women on the use of implants for child spacing that are not correct.

“If an implant is inserted, it doesn’t start working until after 7 days, we use to explain to the clients that it is not allowed to have sex until at least one week of the procedure, if a client’s husband can’t restraint from sex, we offer condoms, I don’t know whether some of them are shy to receive the condoms, they go ahead and have sex within this seven day, but this will not stop the woman from conceiving”
Usmn insists that when used properly implants are very effective in checking pregnancies. Her advise to women of child bearing age is to not listen to wrong information on child spacing like the one on implants above. “Dispel all rumours and visit a health facility for the right information” she said.
Health experts say misconceptions and bad practice on child spacing is common in many parts of the country including Gombe. One bad practice common in Gombe is women who are already pregnant still coming to request for the implant as a child spacing method.
Nurse Zainab Garba Wali, is the facility manager at the Bolari community PHC. She says they have recorded several situations of that happening at the centre.

“Some come for the insertion Without knowing that, they are pregnant already” she said adding that there is no truth in the claim by some women that the implant change from its inserted position which they claim is responsible for its failure in stopping them from getting pregnant.”It was not possible” she added.

According to the World Health Organisation, WHO, implants and other child spacing methods are very effective. “Methods of contraception include oral contraceptive pills, implants, injectables, patches, vaginal rings, Intra uterine devices, condoms, male and female sterilization, lactational amenorrhea methods, withdrawal and fertility awareness based methods.  

“These methods have different mechanisms of action and effectiveness in preventing unintended pregnancy” the world body said in a 2018 report.

For Nurse Usman implants are less effective from her experience over the years because users do not adhere to post insertion advise when they get home.
“There are some guidelines that are … issued after the insertion of implant in the arm, you are not allowed to lift a heavy weight, for four days, because if you lift a heavy item, you are putting so much pressure on the arm, the implant will be forced out or the flash will developed a wound” she said

It can also become less effective due to inexperience by the health worker at the point of insertion, “that’s why people say the implant had disappeared, but it’s not like that, it must have been inserted deeper than expected.”

Even at that she says the efficiency of the method is not diluted.
Nurse Zainab Garba Wali, the facility manager at the Bolari community PHC agrees with her colleague Nurse Usman.  

“Some (women) come for the insertion without knowing that, they are pregnant already” and on the issue of the implant changing position she said “it was not possible, rather at the process of inserting the implant, sometimes it enter deeper”.

At the Pantami PHC this mother narrates a not too good story on her daughter’s experience with using the implant. “l brought my daughter to the clinic for FP and the clinic suggested implant for her which she go for it. Along the line there was some complications which lead to release of blood and some fluid. At a long run she has to remove it, to her she don’t know the reason for that.”

When things like this happens Nurse Usman and Garba Wali advise a quick return to the health centre for professional review and action. They say self – action like the one taken by the user spoken about above is wrong and can even be dangerous.