Community-level influences on women’s experience of intimate partner violence and modern contraceptive use in Nigeria: a multilevel analysis of nationally representative survey

Abstract

Background: Modern contraceptives (MC) are important strategies for reducing unwanted pregnancies, unsafe abortion and maternal mortality, but MC remains low at 18% in Nigeria. Similarly, while there is increasing prevalence of intimate partner violence (IPV) in Nigeria, its effects on contraceptive use remain unclear. This study examined the influence of IPV on MC use, while adjusting for individual- and community-level confounders. Methods : The study utilized 2018 Nigeria Demographic and Health Survey data. We performed multilevel binary logistic regression analysis on 24,973 married women aged 15-49 49 (nested within 1,400 communities), who were sexually active and were not pregnant at the time of the survey. Results : Findings show that use of MC was higher among married women who reported experience of IPV than those without IPV exposure. After adjusting for individual-level and contextual factors, the odds of using MC was significantly higher among women who experienced any form of IPV (OR: 1.61, 95% CI: 1.17-2.21, p<0.005) compared to those who reported no IPV experience. Around one-quarter of the total variance in contraceptive use with respect to the different types of IPV could be explained at the community level. Conclusion : The study provides empirical evidence that there is significant community effect on IPV exposure and women’s contraceptive uptake. Attention must therefore be given to the context-specific social and gender norms that affect women’s sexual and reproductive health in Nigeria.

Influence of intimate partner violence and male involvement on maternal healthcare services utilisation in Nigeria

“…We found the proportions of women who experienced sexual (1.5%), emotional (4.0%) and physical violence (0.08%) in this study. This is contrary to previous studies conducted in Nigeria which reported a larger proportion of women who experienced IPV (7,16). For instance, Solanke (13) reported a higher prevalence of IPV, as well as a study by Adewoyin et al (15) which found 41% physical violence, 38% sexual violence and 29% emotional violence among women in Northern Nigeria.…”

“…The study further established that women who experienced IPV had lower odds of maternal health care uptake, with non-significant association after controlling for socio-demographic factors. Contrary to expectation, a study in Nigeria (16) found that women who were exposed to intimate partner violence had higher odds of using modern contraceptives. Another study found higher odds of nonuse of modern contraceptives among women not exposed to intimate partner violence (14).…”

“…This result echoes previous inconsistent patterns of relationships between IPV and maternal health care services utilisation. A study revealed that IPV has a significant relationship with modern contraceptive use (16). Prior studies have shown inconsistent relationship between IPV and maternal health care services uptake (15,22).…”