Social consequences of COVID-19 on fertility preference consistency and contraceptive use among Nigerian women: insights from population-based data

Abstract

Background Emerging evidence from high income countries showed that the COVID-19 pandemic has had negative effects on population and reproductive health behaviour. This study provides a sub-Saharan Africa perspective by documenting the social consequences of COVID-19 and its relationship to fertility preference stability and modern contraceptive use in Nigeria. Method We analysed panel data collected by Performance Monitoring for Action in Nigeria. Baseline and Follow-up surveys were conducted before the COVID-19 outbreak (November 2019-February 2020) and during the lockdown respectively (May-July 2020). Analysis was restricted to married non-pregnant women during follow-up (n = 774). Descriptive statistics and generalized linear models were employed to explore the relationship between selected social consequences of COVID-19 and fertility preferences stability (between baseline and follow-up) as well as modern contraceptives use. Results Reported social consequences of the pandemic lockdown include total loss of household income (31.3%), food insecurity (16.5%), and greater economic reliance on partner (43.0%). Sixty-eight women (8.8%) changed their minds about pregnancy and this was associated with age groups, higher wealth quintile (AOR = 0.38, CI: 0.15-0.97) and household food insecurity (AOR = 2.72, CI: 1.23-5.99). Fertility preference was inconsistent among 26.1%. Women aged 30-34 years (AOR = 4.46, CI:1.29-15.39) were more likely of inconsistent fertility preference compared to 15-24 years. The likelihood was also higher among women with three children compared to those with only one child (AOR = 3.88, CI: 1.36-11.08). During follow-up survey, 59.4% reported they would feel unhappy if pregnant. This was more common among women with tertiary education (AOR = 2.99, CI: 1.41-6.33). The odds increased with parity. The prevalence of modern contraceptive use was 32.8%. Women aged 45-49 years (AOR = 0.24, CI: 0.10-0.56) were less likely to use modern contraceptives than those aged 15-24 years. In contrast, the odds of contraceptive use were significantly higher among those with three (AOR = 1.82, CI: 1.03-3.20), four (AOR = 2.45, CI: 1.36-4.39) and at least five (AOR = 2.89, CI: 1.25-6.74) children. Unhappy disposition towards pregnancy (AOR = 2.48, CI: 1.724-3.58) was also a significant predictor of modern contraceptive use. Conclusion Some social consequences of COVID-19 affected pregnancy intention and stability of fertility preference but showed no independent association with modern contraceptive use.

Fertility decision of Iranian women during the COVID-19 pandemic and home quarantine: A cross-sectional study in Iran

“…In line with our results, Akinyemi et al (2022) in a study on 774 married and non-pregnant women found that COVID-19 pandemic caused women to postpone their pregnancy, and this decision was related to age, higher education, and household food insecurity.…”

Comparing reproductive intentions before and during the COVID-19 pandemic: a cross-sectional study

“…Similar to the findings reported here, in Nigeria, 8.8% of participants changed their minds about getting pregnant due to concerns about the COVID-19 pandemic [ 24 ]. In Italy, concerns about future economic problems were also similarly among the main reason for abandoning the intention to reproduce during the pandemic [ 16 ].…”

“…Furthermore, in Burkina Faso, a decrease in the desire to have children was reported in comparison to the pre-pandemic period [ 22 ]. In Nigeria, 8.8% also reported a lesser desire to reproduce due to concerns about the COVID-19 pandemic [ 24 ]. In Tehran, approximately three quarters of participants within a separate study similarly reported no intention to reproduce [ 21 ].…”

Factors Associated with Fertility Intention among Women during the COVID-19 Pandemic in Government Hospitals of Kaski District, Nepal

“…The study demonstrates that the socio-demographic factors have been responsible in determining the fertility intentions among women seeking fertility at the time of crisis or uncertainty. The study conducted by (Akinyemi et al, 2022) among Nigerian women have similar results and stated that the fertility intentions have been influenced by "some social consequences of COVID-19" (p. 2). The findings of the study have been consistent with previous studies as fertility intention changes among women can be considered to be caused by the uncertain future due to pandemics or similar situations such as economic recession (Aassve et al, 2021), health and financial situation of a person (Hašková et al, 2019).…”

“…Since the outbreak of the COVID-19 pandemic, the people's livelihood has been affected, especially, in terms of reproductive health such as fertility preference and family planning (Akinyemi et al, 2022;Kahn et al, 2021;Naya et al, 2021;Roy et al, 2021). After the outbreak of the COVID-19 pandemic, people from all over the world, regardless of their ages and other background, were affected in various ways.…”