The influence of socioeconomic status on women's preferences for modern contraceptive providers in Nigeria: a multilevel choice modeling

Abstract

BackgroundContraceptives are one of the most cost effective public health interventions. An understanding of the factors influencing users’ preferences for contraceptives sources, in addition to their preferred methods of contraception, is an important factor in increasing contraceptive uptake. This study investigates the effect of women’s contextual and individual socioeconomic positions on their preference for contraceptive sources among current users in Nigeria.MethodsA multilevel modeling analysis was conducted using the most recent 2008 Nigerian Demographic and Health Surveys data of women aged between 15 and 49 years old. The analysis included 1,834 ever married women from 888 communities across the 36 states of the federation, including the Federal Capital Territory of Abuja. Three outcome variables, private, public, and informal provisions of contraceptive sources, were considered in the modeling.ResultsThere was variability in women’s preferences for providers across communities. The result shows that change in variance accounted for about 31% and 19% in the odds of women’s preferences for both private and public providers across communities. Younger age and being from the richest households are strongly associated with preference for both private and public providers. Living in rural areas and economically deprived neighborhoods were the community level determinants of women’s preferences.ConclusionThis study documents the independent association of contextual socioeconomic characteristics and individual level socioeconomic factors with women’s preferences for contraceptive commodity providers in Nigeria. Initiatives that seek to improve modern contraceptive uptake should jointly consider users’ preferences for sources of these commodities in addition to their preference for contraceptive type.

A Multilevel Logit Estimation of Factors Associated With Modern Contraception in Urban Nigeria

“…The findings of this study answered three research questions providing information on the individual-level and community-level determinants of modern contraceptive use among urban women in Nigeria – an African country with high fertility rate and low contraceptive prevalence rate. The finding that only two intrapersonal factors – parity and family planning self-efficacy – were significantly associated with modern contraceptive use is consistent with previous findings in the literature (Campbell et al 2006; Ezeh et al 2010; OlaOlorun and Hindin 2014; Lamidi, 2015; Dias and Oliveira, 2015; Aremu, 2013). However, these studies found significant positive associations between modern contraceptive use and other individual-level factors such as age, education, and household wealth, which this study did not find.…”

“…A majority of the studies focused on assessing the effect of community socioeconomic status (wealth, education, and employment status) on modern contraceptive use (Lamidi, 2015; Dias and Oliveira, 2015; Aremu, 2013). These studies show a positive association between community socioeconomic status and modern contraceptive use; however, there is a need for evidence on other relevant community factors such as access to health services and fertility norms.…”

“…Despite the recent increase in the number of studies utilizing a multilevel approach in assessing modern contraception, gaps still exist on the associations between community factors and modern contraceptive use. A majority of the studies focused on assessing the effect of community socioeconomic status (wealth, education, and employment status) on modern contraceptive use (Aremu, 2013;Dias & de Oliveira, 2015;Lamidi, 2015). These studies show a positive association between community socioeconomic status and modern contraceptive use; however, there is a need for evidence on other relevant community factors such as access to health services and fertility norms.…”

Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

“…Multinomial logistic regression in the current study is consistent with other studies, showing the richest wealth quintile had significantly lower odds of unmet need for spacing in comparison to poorest wealth quintile [31]. Since stockouts of family planning methods are common in public health facilities in Nepal [32], poor women might not be able to afford to purchase them from private facilities and hence may experience unmet need.…”

Factors affecting contraceptive use among married women of reproductive age in Bangladesh

“…However, we found that the actual CPR is 81.3%. In BDHS report, women who were currently not in any marital relationship (1,033), had hysterectomy (932), postpartum amenorrheic (379), infertile or subfecund (78) and sexually inactive (3,711) were not excluded to calculate CPR. After excluding, we found that CPR is 81.3%.…”