Assessing the relationship between knowledge and the actual use of contraceptives among childbearing women in South-South Nigeria: evidence from the 2018 Nigeria demographic and health survey

Abstract

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.

Association between knowledge and use of contraceptive among women of reproductive age in sub‐Saharan Africa

“…That is, the higher the knowledge level of a woman, the more likely she is to use any method of contraception. This is similar to what has been reported in Ukoji et al 15 and Yaya et al's 32 study where high contraceptive knowledge was significantly associated with higher odds of actual use of any method of contraception. One possible explanation for the observed association could be an increase in the perceived self-efficacy to use From a cultural perspective, most countries within the sub-Saharan African region frown on pregnancy out of wedlock and pregnancy when one is an adolescent.…”

“…Higher educational attainment of the woman and her partner was associated with a higher likelihood of using any method of contraception. Similar findings have been reported in Nigeria 15 and Kenya. 37 Higher educational attainment enables both the woman and her partner to have greater access to health information including information on contraceptives.…”

“…Overall, only 24.32% of sexually‐active women aged 15–49 used any method of contraception in SSA. The proportion observed in this study mirrors that of a study conducted in South Nigeria 15 that found only 18.3% use any method of contraception. However, the observation is lower when compared to high‐income countries like the United States where there is a 61.4% use of any method of contraception 31 .…”

“…Knowledge and use of contraceptives among women is a concern for health organizations when it comes to assessing family planning as women bear almost all the responsibility for regulating fertility 7 . In Nigeria, 82% of childbearing women knew at least one method of contraception, yet 82% had never used any contraceptive method 15 . The probability of using any contraceptive method was high among those with knowledge of contraceptives 15 .…”

Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression

“…For instance, compared to women who resided in urban settings, rural women had a higher prevalence of shorter birth spacing, which is consistent with the findings of the previous studies [ 15 – 17 , 24 , 26 ]. A higher risk of shorter birth intervals among rural women might be linked to lower contraceptive knowledge and limited access to contraceptive services and health information in rural settings [ 31 , 32 ]. In addition, the finding might also be explained by urban–rural differences in the socio-cultural contexts and geographic access to health facilities that deter maternal utilization of modern fertility control methods, particularly in rural areas [ 33 ].…”