article · Primary Health Care Practice Journal
A cross-sectional investigation in Bade Local Government Area in Yobe State, Nigeria, assessed contraceptive practices among 542 nomadic Fulani women. Findings show an exceptionally high demand for contraception at 79.1 per cent, alongside an unmet need of 76.5 per cent. Despite this considerable interest, actual contraceptive use remained low at just 11.8 per cent. Attending antenatal care emerged as the only significant predictor of ever using contraception, increasing the likelihood more than fivefold. Qualitative evidence highlighted several substantial obstacles preventing uptake, including entrenched cultural beliefs, gaps in knowledge, financial costs, and difficulties with transportation. Proposed interventions to bridge the gap between high demand and low uptake include targeted community education, structured training programmes for healthcare staff, loan initiatives to alleviate financial pressure, and mobile healthcare delivery services adapted to nomadic lifestyles.
Maternal mortality remains a critical challenge in low- and middle-income regions, frequently exacerbated by limited family planning access. Understanding the factors driving high unmet contraceptive need among nomadic and hard-to-reach communities helps public health planners design tailored interventions. Highlighting antenatal care as an essential touchpoint offers a practical focus for reducing maternal health disparities and improving service reach.
While focused primarily on public health policy, the findings indicate practical delivery opportunities for mobile health service providers and digital health education platforms serving remote populations. Such applications remain at an early, exploratory stage, pointing to potential roles for private or non-profit healthcare operators developing low-cost transport logistics, microcredit schemes, and mobile clinic models tailored to nomadic communities.
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Introduction: maternal mortality is high in low and middle-income countries due to limited access to maternal health services, including contraception. In Yobe State, modern contraceptive awareness and use are low among married women, particularly nomadic Fulani women. This study investigated barriers and predictors of contraception among these women. Methods: this cross-sectional mixed-methods study, conducted in June 2022, sampled 542 women using multistage and purposive techniques. Data were gathered via questionnaires, focus group discussions, and interviews. Descriptive statistics included means and standard deviations for continuous variables and frequencies for categorical variables. Chi-square tests assessed associations between sociodemographic (independent) and contraceptive use/unmet need (dependent) variables. Variables with p≤0.05 or p≤0.2 in bivariate analysis were included in a binary logistic regression to identify predictors of contraceptive use. Qualitative data, structured with hierarchical headings, were coded in NVivo, analyzed using data mining, and triangulated with quantitative results. Results: the study surveyed 542 nomadic Fulani women, with a mean age of 30.6 years (SD ± 8.31). Contraceptive unmet need was high (355 women, 76.5%), as was demand (390 women, 79.1%), but only 64 women (11.8%) used contraception. Antenatal care attendance was the sole significant predictor of ever-use (aOR = 5.5, 95% CI: 2.56-11.91, P<0.001). Qualitative findings identified cultural beliefs, knowledge gaps, cost, and transportation as key barriers. Conclusion: low contraceptive use persists despite high need. Addressing cultural beliefs, knowledge gaps, and barriers to access through targeted education, training of healthcare workers, loan programs, and mobile healthcare services is recommended.
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DOI: 10.11604/phcp.2025.1.7.46366
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