Background Nigeria has one of the world's highest fertility rates, which is detrimental to its public health and socioeconomic growth. Despite several efforts by the country and other development partners to reduce high fertility by increasing contraceptive use, the contraceptive prevalence rate among childbearing women remains low, particularly in the South-South compared to other Southern regions. This study, therefore, assessed the relationship between knowledge of and actual use of contraception among women in South-South Nigeria. Methods The study employed a cross-sectional analysis of a nationally representative weighted sub-sample of 4,553 South-South childbearing women extracted from the 2018 National Demographic and Health Survey dataset. The dataset was weighted and examined for missing values that were excluded during the analyses at univariate, bivariate, and multivariate levels. The analyses involved a baseline descriptive analysis, a chi-square test, and logistic regression models using Stata software. The results of the explanatory variables were presented as odds ratios (OR) and 95% confidence intervals (CI). Results Eighty-two per cent of the respondents knew at least one form of contraception, while approximately 82% never used any contraceptive method. The likelihood of using any contraceptive method increased among those who knew about contraceptives (aOR: 1.40; CI: 0.93–2.11). Also, contraceptive use was significantly higher among women and their partners who had post-primary education (aOR: 1.34; CI: 1.25–2.43 and aOR: 1.74; CI: 1.25–2.43, respectively). Furthermore, the prevalence of contraceptive use among women significantly increased with an increase in the household wealth index. Similar results were recorded among women who had five or more living children, who were residents of Rivers State, were married or lived with their partners, were aged 35 years or older, and were currently working. Conclusions Contraceptive knowledge was high but did not translate into actual practice among childbearing women in South-South Nigeria. The use of any contraception was highly influenced by contraceptive knowledge, education, age, marital status, place of residence, and household wealth index, among others. Therefore, some policy issues relating to contraceptive knowledge and actual adoption must be addressed to improve the low rate of contraceptive use in Nigeria.
Background Nigeria has one of the highest fertility rates in the world, which is problematic for public health and a major obstacle to socioeconomic growth. Nigeria’s high fertility rate is caused in part because of low contraceptive use among sexually active childbearing women. However, the Nigerian government and other development partners are working to reduce fertility by increasing the use of contraceptives. Consequently, this research looked at sexually active childbearing women’s knowledge of and actual use of contraception in South-south Nigeria. Methods The study utilised cross-sectional data from the 2018 Nigeria Demographic and Health Survey. Being the sixth in the series conducted in the country, the 2018 National Demographic and Health Survey is a nationally representative survey of women of childbearing ages 15–49 years and men aged 15–59 years. One of Nigeria’s six geopolitical zones, the South-south, provided data on 4553 sexually active childbearing women, which were retrieved and analysed using descriptive and Chi-square statistics at P ≤ 0.05. Results Eighty-two percent of respondents knew about at least one form of contraception, and 63% and 32% agreed that using contraception prevents undesired pregnancies and spacing children, respectively. Regardless of the widespread awareness of contraceptives, approximately 82% of respondents reported they never use any form of contraception. In comparison to 4.2% who reported utilising traditional methods, 14.06% reported using modern methods. Compared to Bayelsa State (3.8%), Rivers State had the highest prevalence for ever using contraceptives (39.5%). The standard-days technique was shown to be the least frequent method of contraception, with the male condom being the most common at 36.4%. Significant influences on the usage of contraceptives included age (P = 0.00), education (P = 0.00), work status (P = 0.00), wealth index (P = 0.00), religion (P = 0.00), knowledge of contraceptive options (P = 0.00), and the desire to have more children (P = 0.00). Conclusions Among sexually active childbearing women in Nigeria’s South-south geopolitical zone, the high awareness of contraception has not translated into actual practice. To improve on Nigeria’s low contraceptive prevalence rate and achieve the Sustainable Development Goals for maternal health, some issues that lie between contraceptive awareness and actual adoption must be unravelled and addressed head-on.
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