Maternal grand multiparity and intention to use modern contraceptives in Nigeria

Abstract

BackgroundGrand multiparity and low contraceptive prevalence are dominant among Nigerian women. These elevate the risk of unintended pregnancies, high-risk fertility and adverse maternal and child health outcomes among women in the country, particularly grand multiparous women. Studies have examined predictors of intention to use modern contraceptives among women of reproductive age. However, these studies did not ascertain the extent to which grand multiparity is associated with intention to use modern contraceptives. This study examined association between grand multiparity and intention to use modern contraceptives in Nigeria.MethodsThe study pooled data from 2003 to 2013 Nigeria Demographic and Health Surveys. The weighted sample size analysed was 34,302 women. The outcome variable was intention to use contraceptive. The main explanatory variable was parity with specific attention to grand multiparity. Unadjusted multinomial logistic regression coefficients were used to examine association between specific explanatory or control variables and intention to use contraceptives while the adjusted multinomial logistic regression was applied to further examine associated factors of intention to use contraceptives relative to being uncertain about future contraceptive use. Four multinomial logistic regression models were fitted using Stata 14.ResultsMore than half of respondents do not intend to use contraceptives, while less than one-fifth of respondents intend to use contraceptives in the future. Across the four fitted models, the relative risks of intention to use compared with being uncertain about future contraceptive use were significantly lower among grand multiparous women. Results further revealed pregnancy termination, fertility planning status, exposure to mass media family planning messages, knowledge of modern contraceptives, ideal family size, remarriage, household power relations, and maternal education as other key factors influencing expected risk of intention to use contraceptives relative to being uncertain about future contraceptive use.ConclusionMaternal grand multiparity is significantly associated with intention to use contraceptives among women in Nigeria. The development of a specific population and health programme to target grand multiparous women is imperative in the country. Such programme could be integrated into existing national family planning programme through specific contraceptive education, counselling and information for high parous women.

Examining the Determinants of Contraceptive Use in Northern Nigeria

“…We found an inversely proportional association between contraceptive use and desire for more children [11]. Previous research has found that maternal grand multiparity is negatively associated with intention to use contraceptives in Nigeria, which indicates that there is unlikely to be a rise in future contraceptive use and a decline in the fertility rates in the near future [12]. Given the importance of religiosity and the how children are viewed within regional social norms, a culturally and religiously sensitive framing of contraception may be necessary.…”

Determinants of modern contraceptive use among sexually active men in Ethiopia; using EDHS 2016 national survey

“…In addition, research examining determinants of couples' modern contraceptive use has ignored men's crucial role [11,12], which has eventually resulted in underlining the idea of contraceptive use as women's concern, leaving little or no role for men [13][14][15]. It was observed [16] that men, particularly in low socio economic settings, prefer large numbers of children both as a source of labor and profitable gain, and as a source of respect. Men's role as central decision makers, are believed to determine men's and couples' use of contraceptives [17,18].…”

“…A men's agreement of the use of contraception is a key for effective family planning programs [19,20]. A study illustrated that men had complete decision making supremacy and the ability to result in compliance or submission from their partners [16].…”

Comparison of postpartum family planning uptake between primiparous and multiparous women in Webuye County Hospital, Kenya

“…The reason given for the higher PPFP uptake among multiparous women is that when a woman has had a higher number of children, her desire to either space or limit childbearing is usually stronger. 15,19 For the same reason, it has been demonstrated in other studies that couples usually delay contraceptive use until after attaining their desired family size. 15 In this study, this is hinted at by the…”