Factors Affecting the Uptake of Modern Contraception Services among Women of Reproductive Age in Nigeria

Abstract

Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert high risk pregnancies and consequently reduce maternal deaths. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. Therefore, this study was conducted to assess the factors affecting the uptake of modern contraception services among women of reproductive age in Oyo state, Nigeria. A cross sectional descriptive study using a two stage systematic sampling technique was used to select 530 women of reproductive age in five wards using sample size based on proportion to size in 20,000 households. Respondents were interviewed using a semi structured questionnaire which included questions on socio-demographic characteristics, awareness, knowledge, factors affecting the usage of modern contraceptives and perception of contraceptive use. Knowledge was assessed on a 5 point scale in which score of ≤ 2 were rated poor while perception was scored on a 36 point-scale in which scores ≤ 18 rated low. Data were analysed using descriptive statistics, Chi-square test and logistic regression at p=0.05. Age of respondents was 30.3 ±7.8 years and 73.0% were married. Sixty percent were muslims and 34.5% had secondary education. Seventy two percent of the respondents were self-employed. About 90% had good knowledge of contraception while 60.8% had ever used contraceptives. The commonest source of information about contraception was mass media (72.8%). Twenty six percent obtained husbands' approval before using contraceptives while 20.0% had used modern contraceptives before first birth. Fifty percent of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraceptive services included poor service providers' attitude (33.3%) and congestion at the service centers (4.5%). Respondents with non-use of contraceptive before first birth were less likely to subsequently use contraceptives (OR= 0.324, 95%CI= 0.1-0.5). Husband's approval of contraceptives use was the major determinant of women's contraceptive use (OR = 3.4, 95%CI = 1.3-8.7). About 42.0% of the respondents had family planning centers not more than 5 kilometers walking distance to their residence. Twenty-one percent of those who had to take transportation to the service venues did not use contraception services. Majority of the women in Ibadan North West were knowledgeable and aware of contraception services but husband's approval on the use of modern contraceptives remains poor. Programmes that enhance husbands' approval of modern contraception are thus recommended.