A cross sectional, community-based, descriptive study among women of reproductive age group (15-49 years) in Nigeria to explore the possible reasons for contraceptive non-use despite reported high awareness was carried out. Data were obtained using a standard questionnaire instrument and applied on 2001 respondents. Contraceptive prevalence among sexually active respondents was 14.8% for all methods, 10.1% for modern methods and only 0.8% for emergency contraceptives. The most frequently stated reasons for non-use of contraceptives, among those who had never used any contraceptives but who did not want more children were: "did not think about it", "against religious belief " and "fear of side effects." Prior counseling significantly improved the continuation rate of contraception. Multivariate analysis showed that older, married and more educated women tended to use contraceptives more. Health-care providers should be trained to offer counseling services to all clients in general, and young, unmarried and uneducated women in particular in order to improve their acceptance of contraceptives. RÉSUMÉUne étude à base communautaire sur le comportement du contraceptif au Nigéria. Nous avons mené une étude descriptive traversale à base communautaaire auprès des femmes dans le group en âge d'avoir des enfants (15-19 ans) au Nigéria afin d'explorer les raisons qui peuvent expliquer le non-usage des contraceptifs malgré le haut niveau de sensibilisation. Les données ont été recueillies à l'aide d'un instrument de questionnaires standards administrés aux 2001 répondantes. La fréquence contraceptive parmi les répondants qui sont sexuellement actives était de 14,8% pour toutes les méthodes, 10,1% pour les méthodes modernes et juste 0,8% pour les contraceptifs d'urgence. Les raisons les plus fréquemment données pour expliquer le non-usage des contraceptifs parmi ceux qui n'ont jamais utilisé les contraceptifs, mais qui ne voulaient pas encore d'enfants étaient: "je n'y ai pensé", "contre la croyance religieuse" et "la peur des effets secondaires". L'analyse multifactorielle a montré que les femmes les plus âgées, mariées et instruites avaient la tendance d'utiliser les contraceptifs. Il faut former des prestataires de services médicaux pour qu'ils puissent rendre les services d'orientation à tous les clients en général, mais sourtout aux jeunes, aux célibataires et aux femmes non-instruites afin d'améliorer leur acceptance des contraceptifs. (Rev Afr Santé Reprod 2006; 10[2]:90-104)

BackgroundUnderstanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives.Methods and FindingsA multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15–49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15–24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives.ConclusionStrategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.

RÉSUMÉEnquête à base communautaire sur la grossesse non-désirée au sud-ouest du Nigéria.Unwanted pregnancy, and consequently unsafe abortion, remains major reproductive health problems in Nigeria that needs to be tackled. Unfortunately, there is a dearth of information on this problem at the community level. This study therefore examined the prevalence of unwanted pregnancy in the community as well as associated factors including the views, perceptions and attitudes of community members towards unwanted pregnancy and the pattern of help-seeking behaviour on unwanted pregnancy. Information was obtained from 3,743 women in urban and rural communities in two Nigerian states of Lagos and Edo. At some point in life, 26.6% of the respondents had had unwanted Pregnancy while abortion prevalence was 21.7%. Short birth intervals (21.1%), high cost of raising children (20.1%), interruption of education (20.1%) and being unmarried (17.3%) were the most common reasons for not wanting pregnancies. Most of the respondents (91.3%) were aware of some form of contraception but ever-use rate was only 36.6% while current use rate was 23.4%. Both abortion and contraceptive use were significantly associated with increasing levels of education. Unwanted pregnancy constitutes a problem even at the community level and more research is needed to understand the persistent disparity between contraceptive knowledge and usage, as increased usage will reduce unwanted pregnancy and induced abortion. La grossesse non-désirée et par conséquence l'avortement à risque, demeure un des problèmes majeurs de la santé de reproduction qu'on devrait aborder. Malheureusement, il y a une pauvreté de renseignement à l'égard de ce problème au niveau de la communauté. Cette étude a donc examiné la prévalence de la grossesse non-désirée dans la communauté ainsi que les facteurs qui y sont associés, y compris des points de vue, des perceptions et attitudes des membres de la communauté envers la grossesse non-désirée et les traits comportementaux du nécessitaux sur la grossesse non-désirée. Nous avons recueilli des renseignements auprès des 3,743 femmes dans des communautés rurales et urbaines dans deux Etats nigérians que sont Lagos et Edo. A un certain moment de leur vie, 26% des répondants avaient eu des grossesse non-désirées alors que la prévalence de l'avortement était de 21,7%. De courts intervales de maissance (21,1%), de coût considérable de l'éducation des enfants (20,1%) l'interruption de la scolarité (20,1%) et le fait d'être célibataire (17,3%) étaient les raisons les plus communes données pour ne pas vouloir des grossesses. La plupart des répondantes (91,3%) étaient conscientes d'une forme ou d'une autre du contraceptif, mais le taux d'usage n'était que de 36,6% alors que le taux d'usage courant était de 23,4%. Et l'avortement et l'usage du contraceptif ont été liés de manière significative aux niveau croissants de scolarisation. La grossesse non-désirée constitue un problème même au niveau de la communauté et il faut davantage de recherc...

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RÉSUMÉ Caractéristiques des chercheuses des soins de l'avortement au sud-ouest du NigériaThis prospective hospital-based study was carried out to understand the characteristics of abortion care seekers in south-western Nigeria. Information was obtained from a total of 1876 women seeking abortion at hospitals using a questionnaire. The results show that majority (60%) were between the ages of 15 and 24 years, of which adolescents between the ages of 15 and 19 years constituted 23.7%. Most (63.2%) of the respondents were unmarried, but married women also constituted a significant proportion (30.2%) of the abortion care seekers. Students were the single highest group, while the predominant economic activity was trading (26.7%). Respondents terminated their pregnancies mainly because they were students or because they did not desire to have children. Most (35.5%) of the women were introduced to providers by friends. Average contraceptive prevalence among the abortion care seekers was 27.4%. It is obvious from the results that young persons, especially in-school adolescents, should be targeted for comprehensive sexuality education especially in view of the current HIV/AIDS pandemic. . Cette étude prospective centrée sur l'hôpital a été menée pour comprendre les caractéristiques des chercheuses des soins post avortement au sud-ouest du Nigéria. Les renseignements ont été recueillis à l'aide d'un questionnaire de la part de 1876 femmes, à la recherche de l'avortement auprès des hôpitaux, les résultats montrent que la majorité (60%) avaient entre 15 et 24 ans dont les adolescentes ayant entre 1519 constituaient 32,7%. La majorité (63,2%) constituaient une proportion importante (30,2%) des chercheuses de l'avortement. Les étudiantes constituaient le seul groupe le plus nombreux, alors que l'activité économique la plus fréquemment avancées pour l'interruption de grossesse étaient le statut estudiantin et ne voulant pas avoir des enfants alors qu'elles n'étaient pas encore mariées. La plupart (35,5%) des femmes ont fait la connaissance des dispensateurs de soins grâce à leurs amis. La prévalence contraceptive moyenne chez les chercheuses des soins de l'avortement était de 27,4%. Il est évident, d'après ces résultats que les jeunes gens, surtout les adolescentes en scolarisation, devraient être les cibles de l'éducation sexuelle compréhensive surtout étant donné la pandémie actuelle qu'est le VIH/SIDA.