Prevalence and associated factors of modern contraceptive discontinuation among sexually active married women in Nigeria

Abstract

Background Contraceptive discontinuation for reasons other than the desire for pregnancy is associated with a high rate of unintended pregnancies leading to unsafe abortions, maternal morbidity and mortality. In Nigeria, little is known about modern contraceptive discontinuation using the calendar data. Thus, this study examined the prevalence and associated factors of modern contraceptive methods discontinuation among sexually active married women in Nigeria. Methods Out of the total sample of 41,821 women (15–49 years) in the individual recode (IR) dataset of the 2018 Nigeria Demographic and Health Surveys (NDHS) with reproductive calendar history, this study analysed a weighted sample size of 3,433 currently sexually active married or in union women who have ever used a modern contraceptive 5 years before the survey and with complete reproductive histories and are not sterilised or declared infecund. The outcome variable was modern contraceptive discontinuation (Pill, IUD, Injections, diaphragm, male condom, female sterilization, male sterilization, implants, female condom, foam/jelly, and lactational amenorrhea) which was disaggregated based on whether discontinuation occurred even though they are still at risk of unwanted pregnancy or not. The explanatory variables examined are the socio-demographic characteristics of the respondents (age, wealth index, religion, education, marital duration, media exposure, and visitation to health facilities in the last 12 months). Data were analysed and displayed using frequency tables and charts, Pearson's chi-square test, and the binary logistic regression model. Results Among the sampled women, 35.8% discontinued using modern contraceptives with 45.8% of the women discontinuing using modern contraceptives while at risk of pregnancy. The most modern method discontinued was Injections (25.2%) while the commonest reason for modern method discontinuation was because they wanted to become pregnant (36.1%). Associated factors of modern contraceptive discontinuation among Nigerian women were: marital duration (AOR = 3.47; 95%CI: 2.0–6.0), visitation to a health facility in the last 12 months (AOR = 0.58; 95%CI: 0.4–0.8), education (AOR = 2.00; 95%CI: 1.2–3.4), wealth quintile (AOR = 0.81; 95%CI: 0.4–1.9) and region of residence (AOR = 2.73; 95%CI: 1.6–4.7). Conclusion This study concluded that modern contraceptive discontinuation was high. Region of residence, health facility visitation and marital duration were significantly related to modern contraceptive discontinuation. The study suggests that policymakers should recognise women's ability to visit a health facility, marital duration, and region of residence are significantly associated with modern contraceptives. Policymakers must recognise these factors to increase modern contraceptive use in the country.