Examining Contraceptive Ideational Disparities Among Adolescents and Young Women in Nigeria
Abstract:
Nigeria faces
a demographic challenge with a growing youth population and increasing fertility
rate. However, the use of modern contraceptives among adolescent girls and young
women has been declining. The young population emerges as a pivotal group in the
country’s efforts to achieving the pledge of 27% modern contraceptive rate by the
year 2030. This study aims to explore the disparities in contraceptive
ideation among adolescents and young women in Nigeria, focusing on the role of ideational
factors. The data for this study were collected through a cross-sectional household
survey in four Nigerian states, involving 2,857 sexually active women aged 15-24
years. Using an ideational framework of behavior that highlights psychosocial
influences, nine distinct ideational variables were examined. Multivariate logistic
regression analyses were used to assess associations between ideational factors
and contraceptive use among the total sample, adolescents, and youth. Statistical significance was defined as P<0.05.
The study’s results revealed significant associations between
the ideational variables and contraceptive use in all groups, ranging from p <
.05 to p < .001. Cognitive and emotional domains were found to be the strongest
predictors of contraceptive use compared to social domains in the general sample
and among both groups. This
study’s findings highlight the complex interplay of social, cognitive, and emotional
factors in contraceptive use. Understanding these dynamics is crucial in developing
effective strategies to overcome barriers and improve access to contraceptive services
among young women in Nigeria.
References:
[1] United
Nations. (2022). World Population Prospects 2022. Retrieved from UN: https://population.un.org/wpp/Graphs/DemographicProfiles/Pyramid/566.
[2] Olowolafe,
T. A., Adebowale, A. S., Fagbamigbe, A. F., Bolarinwa, O. A., & Akinyemi,
J. O. (2023). Shifts in age pattern, timing of childbearing and trend in
fertility level across six regions of Nigeria: Nigeria Demographic and Health
Surveys from 2003-2018. PloS one, 18(1), e0279365. https://doi.org/10.1371/journal.pone.0279365.
[3] National
Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and
Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
[4] Mandal,
M., Calhoun, L., McGuire, C., & Speizer, I. (2022). Using structural
equation modeling to examine the influence of family planning social norms on
modern contraceptive use in Nigeria. Front. Social, 7. https://doi.org/10.3389/fsoc.2022.866254.
[5] OlaOlorun,
F. M., Hindin, M. J., & Akinlo, A. D. (2014). Intention to use
contraceptives and subsequent contraceptive behavior in Nigeria: does
facility-level access matter?. Open Access Journal of Contraception, 5,
1-8.
[6] Babalola,
S., John, N., Ajao, B., & Speizer, I. (2015). Ideation and intention to use
contraceptives in Kenya and Nigeria. Demographic research, 33, 211-242.
doi: 10.4054/DemRes.2015.33.8.
[7] Babalola
S. (2017). Changes in Ideational Profiles of Women of Reproductive Age in Urban
Nigeria: The Role of Health Communication. Health education & behavior :
the official publication of the Society for Public Health Education, 44(6),
907–917. https://doi.org/10.1177/1090198117699510.
[8] Ezenwaka,
U., Ibekwe, P. C., & Anozie, C. (2020). A qualitative study of ecological
factors constraining adolescent’s access to contraception in southeast Nigeria.
BMC public health, 20(1), 1-14. doi: 10.1186/s12889-020-09533-5.
[9] Health
Communication Capacity Collaborative (HC3). (2014). Ideation: An HCS Research
Primer. Baltimore, MD: HC3, Johns Hopkins Center for Communication Programs. https://healthcommcapacity.org/hc3resources/ideation-hc3-research-primer/.
[10] Sobotka,
T., Zeman, K., & Kantorová, V. (2003). Demographic shifts in the Czech
Republic after 1989: A second demographic transition view. European Journal
of Population/Revue européenne de démographie, 19(3), 249–277. https://doi.org/10.1023/A:1024913321935.
[11] Leroy-Beaulieu.
(1896). Traité Théorique et Pratique d’ Économie Politique. Paris: Librairie
Guillaumin et Cie.
[12] Okigbo
CC, Speizer IS, Domino ME, Curtis SL, Halpern CT, Fotso JC. (2018) Gender norms
and modern contraceptive use in urban Nigeria: A multilevel longitudinal study.
BMC Womens Health. Oct 29;18(1).
[13] Adedini
SA, Babalola S, Ibeawuchi C, Omotoso O, Akiode A, Odeku M.(2018). Role of
religious leaders in promoting contraceptive use in Nigeria: Evidence from the
Nigerian Urban reproductive health initiative. Glob Heal Sci Pract. Oct
1;6(3):500–14.
[14] Moreira
L.R, Ewerling F, Barros A.J.D, Silveira M.F. (2019). Reasons for nonuse of
contraceptive methods by women with demand for contraception not satisfied: An
assessment of low and middle-income countries using demographic and health
surveys. Reprod Health [Internet]. Available from: https://reproductive-healthjournal.biomedcentral.com/articles/10.1186/s12978-019-0805-7.
[15] Fayehun
F. (2017). Contraceptive use in Nigeria is incredibly low. A lack of knowledge
may be why [Internet]. The conversation. Available from: https://theconversation.com/contraceptive-use-in-nigeria-is-incredibly-low-a-lack-of
knowledge-may-be-why-81453.
[16] Gueye A,
Speizer IS, Corroon M, Okigbo CC. (2015). Belief in family planning myths at
the individual and community levels and modern contraceptive use in Urban
Africa. Int Perspect Sex Reprod Health [Internet].
[17] Zavala,
A. R., Palma, S. M., & Kollath-Cattano, C. L. (2020). The role of
communication in contraceptive use among Hispanic young adults: A mixed-methods
study. BMC Public Health, 20(1), 1-12. https://doi.org/10.1186/s12889-020-09312-5.
[18] Khadduri,
R., Reece, M., Barakat, S., & Berenson, A. (2019). Examining the
relationship between sexual communication and contraceptive use in young women.
Journal of Women’s Health, 28(7), 940-947. https://doi.org/10.1089/jwh.2018.7139.
[19] Boyle,
C., & Conrad, M. (2020). Communication about contraception and sexual risk
behaviors among college students. Journal of American College Health, 68(7),
700-708. https://doi.org/10.1080/07448481.2019.1664399.
[20] Tschann,
J. M., & Adler, N. E. (1997). Sexual self-acceptance, communication with
partner, and contraceptive use among adolescent females: a longitudinal study.
Journal of research on adolescence: the official journal of the Society for
Research on Adolescence, 7(4), 413-430.
[21] Kincaid,
D. L. (2000). Mass Media, Ideation, and Behavior: A Longitudinal Analysis of
Contraceptive Change in the Philippines. Communication Research, 27(6),
723–763. https://doi.org/10.1177/009365000027006003.
[22] Arisukwu,
O., Igbolekwu, C.O., Efugha, I., Nwogu, J., Osueke, N., & Eyitayo, O.
(2021). Knowledge and Perception of Emergency Contraceptives Among Adolescent
Girls in Imo State, Nigeria. Sexuality & Culture 24, 273–290. https://doi.org/10.1007/s12119-019-09639-x.
[23] Calhoun,
L. M., Mirzoyants, A., Thuku, S., Benova, L., Delvaux, T., van den Akker, T.,
McGuire, C., Onyango, B., & Speizer, I. S. (2022). Perceptions of peer
contraceptive use and its influence on contraceptive method use and choice
among young women and men in Kenya: a quantitative cross-sectional study. Reproductive
health, 19(1), 16. https://doi.org/10.1186/s12978-022-01331-y.
[24] Ochako,
R., Mbondo, M., Aloo, S., Kaimenyi, S., Thompson, R., Temmerman, M., &
Kays, M. (2015). Barriers to modern contraceptive methods uptake among young
women in Kenya: a qualitative study. BMC public health, 15, 118. https://doi.org/10.1186/s12889-015-1483-1.
[25] Agyemang,
J., Newton, S., & Danso, K. A. (2019). Determinants of modern contraceptive
use among teenagers in Ghana: Analysis of the 2014 Ghana Demographic and Health
Survey. Journal of Public Health in Africa, 10(2), 949. doi:
10.4081/jphia.2019.949.
[26] Shahabuddin,
A. S., Nöstlinger, C., Delvaux, T., Sarker, M., Bardají, A., Brouwere, V. D.,
& Broerse, J. E. (2016). What Influences Adolescent Girls’ Decision-Making
Regarding Contraceptive Methods Use and Childbearing? A Qualitative Exploratory
Study in Rangpur District, Bangladesh. PloS one, 11(6), e0157664. https://doi.org/10.1371/journal.pone.0157664.
[27] Crawford,
E. E., Atchison, C. J., Ajayi, Y. P., & Doyle, A. M. (2021). Modern contraceptive
use among unmarried girls aged 15-19 years in South Western Nigeria: results
from a cross-sectional baseline survey for the Adolescent 360 (A360) impact
evaluation. Reproductive health, 18(1), 6. https://doi.org/10.1186/s12978-020-01056-w.
[28] Fehintola,
F., Okoro, N., Adedibu, D., Adeniyi, K.D., Adeniyi, C., & Folorunso, O.
(2022). Predictors of Willingness to Use Modern Contraceptives among female
undergraduate students in a tertiary institution in Nigeria: The Health Belief
Approach. Journal of Community Medicine and Primary Health Care, 34(3).
DOI: 10.4314/jcmphc.v34i3.12.
[29] Boamah-Kaali,
E. A., Ruiter, R. A. C., Owusu-Agyei, S., Asante, K. P., & Mevissen, F. E.
F. (2023). Social-psychological determinants of hormonal contraceptive use
intentions among adolescent girls in the Bono East Region of Ghana. Frontiers
in public health, 11, 1110112. https://doi.org/10.3389/fpubh.2023.1110112.
[30] Agha, S.,
Morgan, B., Archer, H., Paul, S., Babigumira, J. B., & Guthrie, B. L.
(2021). Understanding how social norms affect modern contraceptive use. BMC
public health, 21(1), 1061. https://doi.org/10.1186/s12889-021-11110-2.
[31] Sanchez,
E. K., Speizer, I. S., Tolley, E., Calhoun, L. M., Barrington, C., &
Olumide, A. O. (2020). Influences on seeking a contraceptive method among
adolescent women in three cities in Nigeria. Reproductive health, 17(1),
167. https://doi.org/10.1186/s12978-020-01019-1.
[32] Challa,
S., Shakya, H. B., Carter, N., Boyce, S. C., Brooks, M. I., Aliou, S., &
Silverman, J. G. (2020). Associations of spousal communication with
contraceptive method use among adolescent wives and their husbands in Niger. Plos
one, 15(8), e0237512. https://doi.org/10.1371/journal.pone.0237512.