Socioeconomic inequalities in high-risk fertility behaviour among Nigerian women: A non-experimental population-based study

Abstract

Background High-risk fertility behaviour (HRFB) has adverse health, social and economic effects on women. An understanding of socioeconomic inequalities is needed to design effective interventions targeted to lower maternal morbidity and mortality due to HRFB. Objectives The objective was to quantify socioeconomic inequalities in HRFB among Nigerian women. Design This was a cross-section study that used population-based data. Methods A sample of 21,792 Nigerian women aged 15–49 years from the 2018 Nigeria Demographic Health Survey was analyzed. Percentage was employed in univariate analysis. In addition, concentration index was used to assess the extent of inequalities in HRFB. This was further decomposed to ascertain the explanatory components’ relative contributions to the socioeconomic inequalities in HRFB. Results The weighted prevalence of HRFB (63.5%; 95% CI: 62.6–64.4%), included <18 years at childbirth (4.9%; 95% CI:4.5–5.3%), >34 years at childbirth (18.3%; 95% CI: 17.6–19.0%), >3 children birth order (49.6%; 95% CI: 48.7–50.5%) and <24 months at preceding birth interval (17.0% 95% CI: 16.3–17.6%) were estimated. Education (Contri: 50.3997%, Ec: 0.2771), wealth (Contri: 27.2811%, Ec: 0.2665), socioeconomic disadvantaged (Contri: 14.9163%, Ec: -0.0996), religion (Contri: 13.8636%, Ec: -0.0496), region (Contri: 11.1724%, Ec: 0.0711), partner education (Contri: 7.1351%, Ec: 0.2138), media use (Contri: 4.5064%, Ec: 0.1449) and family motility (Contri: 3.7890%, Ec: -0.0281) were positive contributors to HRFBs among Nigerian women. However, age (Contri: -14.6237, Ec: 0.0089) and history of contraceptive use (Contri: -8.7723, Ec: -0.2094) were negative contributors to HRFBs among women of reproductive age in Nigeria. Conclusion Women who have low socioeconomic level reported higher prevalence of HRFB. Targeted interventions are required to lower HRFB among Nigerian women from poor households and with no formal education. Women should get counselling and assistance from healthcare and educational institutions to help them adopt healthy sexual and reproductive practices.