TY - JOUR
T1 - From non-use to covert and overt use of contraception
T2 - Identifying community and individual factors informing Nigerian women’s degree of contraceptive empowerment
AU - OlaOlorun, Funmilola M.
AU - Anglewicz, Philip
AU - Moreau, Caroline
N1 - Funding Information:
PMA2020 was supported by a grant (OPP1079004) from the Bill and Melinda Gates Foundation (https://www.gatesfoundation.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2020 OlaOlorun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/11
Y1 - 2020/11
N2 - Objective In Nigeria, unmet need for contraception is high despite improved access to modern contraception. To identify factors that support Nigerian women’s contraceptive decisions to achieve their reproductive goals, in the presence or absence of their partner’s support, we seek to identify individual/couple and community level determinants of a spectrum of contraceptive practices, from non-use to covert and overt use of contraception. Methods Data were drawn from a national probability survey conducted by Performance Monitoring and Accountability 2020 in Nigeria in 2017–2018. A sample of 12,948 women 15–49 years was included, 6433 of whom were in need of contraception at the time of the survey. We conducted bivariate and multivariate analysis to identify individual/couple and community level factors associated with covert use relative to non-use and to overt use of contraception. Results Altogether, 58.0% of women in need of contraception were non-users, 4.5% were covert users and 37.5% used contraception overtly. Covert users were more educated and wealthier than non-users, but less educated and less wealthy than overt users. Covert users were less likely to cohabitate with their partner compared to non-users [AOR = 4.60 (95%CI: 3.06–6.93)] and overt users [AOR = 5.01 (95%CI: 3.24–7.76)] and more likely to reside in urban areas. At the community level, covert users were more likely to live in communities with higher contraceptive prevalence and higher levels of female education relative to nonusers. They were also more likely to live in communities with higher female employment [AOR = 1.62, (95%CI: 0.96–2.73)] compared to overt users. Conclusion By identifying individual and community level factors associated with the spectrum from non-use to covert use and overt use of contraception, this study highlights the importance of integrating individual and community interventions to support women’s realization of their reproductive goals.
AB - Objective In Nigeria, unmet need for contraception is high despite improved access to modern contraception. To identify factors that support Nigerian women’s contraceptive decisions to achieve their reproductive goals, in the presence or absence of their partner’s support, we seek to identify individual/couple and community level determinants of a spectrum of contraceptive practices, from non-use to covert and overt use of contraception. Methods Data were drawn from a national probability survey conducted by Performance Monitoring and Accountability 2020 in Nigeria in 2017–2018. A sample of 12,948 women 15–49 years was included, 6433 of whom were in need of contraception at the time of the survey. We conducted bivariate and multivariate analysis to identify individual/couple and community level factors associated with covert use relative to non-use and to overt use of contraception. Results Altogether, 58.0% of women in need of contraception were non-users, 4.5% were covert users and 37.5% used contraception overtly. Covert users were more educated and wealthier than non-users, but less educated and less wealthy than overt users. Covert users were less likely to cohabitate with their partner compared to non-users [AOR = 4.60 (95%CI: 3.06–6.93)] and overt users [AOR = 5.01 (95%CI: 3.24–7.76)] and more likely to reside in urban areas. At the community level, covert users were more likely to live in communities with higher contraceptive prevalence and higher levels of female education relative to nonusers. They were also more likely to live in communities with higher female employment [AOR = 1.62, (95%CI: 0.96–2.73)] compared to overt users. Conclusion By identifying individual and community level factors associated with the spectrum from non-use to covert use and overt use of contraception, this study highlights the importance of integrating individual and community interventions to support women’s realization of their reproductive goals.
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U2 - 10.1371/journal.pone.0242345
DO - 10.1371/journal.pone.0242345
M3 - Article
C2 - 33206705
AN - SCOPUS:85096407877
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 11 November
M1 - e0242345
ER -