Wealth index, empowerment and modern contraceptive use among married women in Nigeria: are they interrelated?

Abstract

Background Nigeria, a patriarchal society, is one of the more impoverished countries of the world and while its fertility and population growth rates are high, its modern contraceptive (MC) prevalence rate is low. The wealth status and decisionmaking power of a woman have implications on their use of MC. Studies that examined the relationship between women's empowerment, wealth index and MC use in Nigeria are scarce. Methods A national representative cross-sectional data on women of reproductive age (n = 5,098) was used. Data were analysed using Chi-square and interactive logistic regression models (α = 0.05). Results Mean age of the women was 32.9(σ = 8.0) and 23.8 % were currently using MC. Current use of MC was found to be higher among the following: Yoruba (48.5 %) than Igbo (27.3 %) and Hausa women (2.9 %); highly (36.9 %) than poorly empowered women (12.1 %); upper class (35.0 %) than lower class (5.9 %); and Christians (35.5 %) than Muslims (12.6 %; p < 0.001). Injectables and condoms were the most reported MC method currently used. In the interactive model, being in lower class and poorly empowered inhibits current use of MC. The predictors of current use of MC when wealth index and women empowerment were used either jointly or interactively in the controlled regression equation were wealth index, region, education, religion, ethnicity, family planning information access on media, receiving family planning information at health facility and living children sex composition. Conclusion Modern contraceptive prevalence rate among Nigerian women was low particularly among the lower class and poorly empowered. Strategies to improve the use of MC should target women in the lower class in Nigeria.

Modern contraceptive utilization and associated factors among reproductive-age women in Ethiopia: evidence from 2016 Ethiopia demographic and health survey

“…A woman who resides in the Afar and Somali region of Ethiopia was nearly 55 and 93% times less likely to utilize modern contraceptive methods as compared to a woman residing in Addis Ababa. The finding is consistent with the results of secondary data analysis of the 2013 Nigerian Demographic and Health Survey (NDHS) [19,25] analyzed by independent researchers.…”

“…Urban women are more educated, have better income, have better access to the health facility, and better media access than rural women which have a positive impact on modern contraceptive utilization. Rural women also need more children to help them with fieldwork which has a negative effect on their modern contraceptive method utilization [14,19,21,23,25,26]. But the result of secondary data analysis of the 2003-2014 Ghana Demographic and Health Surveys showed that rural resident women more likely utilized modern contraceptive methods than urban resident women which are in contrary to the results of the current study [17].…”

“…The results of the descriptive study also depicted that 24.65, 23.89, 29.01 and 24.44% of reproductive age women utilized modern contraceptive method from sales, agricultural employee, skilled manual working and others respectively, whereas, only 16.61% utilized modern contraceptive method from those who did not have any job. This could be due to the reason that women who are employed and have their private job do have better income, better access to media and health facilities which positively influence modern contraceptive method utilization [14,19,21,23,25,26]. Besides, they may need to have a gap between bearing children as they are on duty.…”

Geographical variation and factor associated with modern contraceptive utilization among Young married women aged between 15-24 years: Spatial and multilevel analysis of EDHS 2016.

“…High household wealth was positivly associated with modern contraceptive utilization those young women in poorest household were less likely to use modern contraceptive when compared to richest household. It is comparable to study conducted in Tanzania and Nigeria (47,48). The possible explanation could be related to the implicit costs needed to access health care services, mass media and education, as well wealthier background ought to have better decision making power on contraceptive use (44) .…”

Determinants of Modern Contraceptive Uptake among Nigerian Women: Evidence from the National Demographic and Health Survey

“…Several studies have recorded higher contraceptive use among women with the richest wealth quintile compared to the poorest 6,9,[11][12][13] . The use of modern contraceptives has been reported to be higher among the highly empowered and the upper class women compared to the poorly empowered and lower class women 14 . Strategies to improve contraceptive uptake should therefore focus more on the latter group of women.…”