Contextual factors influencing modern contraceptive use in Nigeria

Abstract

Background: Despite the acknowledged health and socioeconomic benefits of use of modern contraceptives their use in Nigeria remains persistently low with wide variations in pattern of use. Given Nigeria’s commitment to doubling her contraceptive prevalence within four years it is imperative to investigate the mediating role of contextual factors in influencing contraceptive behavior for more responsive programming. This study therefore aims to assess the role of contextual factors in determining use of modern contraceptives in Nigeria. Methods: A multilevel modelling was carried out using data from the 2013 Nigeria Demographic and Health Survey (NDHS) among women age 15-49. The weighted sample used in the analysis comprised 13835 women of reproductive age who were married fecund and did not desire a child within two years of the study drawn from 904 clusters (enumeration areas) across the country. The clusters were taken as representative of communities. The outcome variable used in the modelling was current use of modern contraceptives. Results: Overall individual and community level variables accounted for 82% of the variations in contraceptive use in Nigeria. Positive community-level predictors of contraceptive use level were the level of female autonomy female education and access to health facilities within the community. Conversely communities with higher proportions of Muslim and higher proportions of polygynous marriages negatively predicted use of modern contraceptives. Also compared with the South West Zone all the other zones of the country except the South Zone had significant lower odds of contraceptive use. Poverty and rural residence had no significant effect on use of modern contraceptives. Conclusion: Individual and community characteristics were significant predictors of use of modern contraceptives in Nigeria and thus these factors should be taken into account in programming for family planning in the country.