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A cross sectional, community-based, descriptive study among women of reproductive age group (15-49 years) in Nigeria to explore the possible reasons for contraceptive non-use despite reported high awareness was carried out. Data were obtained using a standard questionnaire instrument and applied on 2001 respondents. Contraceptive prevalence among sexually active respondents was 14.8% for all methods, 10.1% for modern methods and only 0.8% for emergency contraceptives. The most frequently stated reasons for non-use of contraceptives, among those who had never used any contraceptives but who did not want more children were: "did not think about it", "against religious belief " and "fear of side effects." Prior counseling significantly improved the continuation rate of contraception. Multivariate analysis showed that older, married and more educated women tended to use contraceptives more. Health-care providers should be trained to offer counseling services to all clients in general, and young, unmarried and uneducated women in particular in order to improve their acceptance of contraceptives. RÉSUMÉUne étude à base communautaire sur le comportement du contraceptif au Nigéria. Nous avons mené une étude descriptive traversale à base communautaaire auprès des femmes dans le group en âge d'avoir des enfants (15-19 ans) au Nigéria afin d'explorer les raisons qui peuvent expliquer le non-usage des contraceptifs malgré le haut niveau de sensibilisation. Les données ont été recueillies à l'aide d'un instrument de questionnaires standards administrés aux 2001 répondantes. La fréquence contraceptive parmi les répondants qui sont sexuellement actives était de 14,8% pour toutes les méthodes, 10,1% pour les méthodes modernes et juste 0,8% pour les contraceptifs d'urgence. Les raisons les plus fréquemment données pour expliquer le non-usage des contraceptifs parmi ceux qui n'ont jamais utilisé les contraceptifs, mais qui ne voulaient pas encore d'enfants étaient: "je n'y ai pensé", "contre la croyance religieuse" et "la peur des effets secondaires". L'analyse multifactorielle a montré que les femmes les plus âgées, mariées et instruites avaient la tendance d'utiliser les contraceptifs. Il faut former des prestataires de services médicaux pour qu'ils puissent rendre les services d'orientation à tous les clients en général, mais sourtout aux jeunes, aux célibataires et aux femmes non-instruites afin d'améliorer leur acceptance des contraceptifs. (Rev Afr Santé Reprod 2006; 10[2]:90-104)

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Abortion is legally restricted in most African countries, and in Nigeria it is permitted only to save the life of a pregnant woman. Nevertheless, the practice is common: According to an estimate based on a 1996 national survey of physicians and hospitals in Nigeria, 610,000 abortions occurred in a one-year period, a rate of about 25 abortions per 1,000 women of childbearing age (15-44 years). 1 This study also found that 27% of physicians in private practice performed abortions despite the legal restrictions.A majority of the abortions in Nigeria take place under unsafe conditions and constitute a major source of maternal morbidity and mortality. A study based on the 1996 survey of physicians and hospitals estimated that 142,000 women were treated for complications of abortion each year, and experts believe that unsafe abortion accounts for at least 13% and possibly 30-40% of maternal deaths. 1-3 However, a substantial proportion of women having an abortion in Nigeria seek the procedure from a physician, often in a private clinic or hospital. Research in the mid-1990s, based on a nationally representative sample of facilities, estimated that 27% of women receiving abortion care were seeking an abortion, 47% needed treatment for complications of an abortion attempt and 26% were treated for complications of a spontaneous abortion. 1 The present study provides new and comprehensive information from personal interviews of women with all types of pregnancy loss, and also obtains medical information from their providers.Unsafe abortion is not only a significant cause of morbidity and mortality among women, but also an economic drain on the health care system. As in many other countries in the region, a high proportion of gynecological admissions to hospitals result from complications of unsafe induced abortion. Providing postabortion care to these women involves huge costs and thus diminishes the health care system's capacity to provide other needed services. 4 Reducing the burden of unsafe abortion on women, their families, health care providers and the fragile health care system presents an important policy challenge to Nigeria and similar developing countries.At the same time, some evidence suggests that abortions may be safer in Nigeria now than they were a decade ago, as more women appear to be obtaining the procedure from trained professionals. According to data from a survey of women in [2002][2003], an estimated 10% of women who had abortions were hospitalized due to complications. 5 In 1996, this proportion was estimated at 20% on the basis of health professionals' perceptions. 6 Although the methodologies that produced these estimates are different, the substantial reduction suggests that abortion may have become safer. Severity and Cost of Unsafe Abortion Complications Treated in Nigerian Hospitals

BackgroundUnderstanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives.Methods and FindingsA multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15–49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15–24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives.ConclusionStrategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.