Factors influencing contraceptive use among women of advanced reproductive age in Nigeria

Abstract

BACKGROUND: Contraceptive adoption is crucial for reducing unplanned pregnancies and maternal mortality and improving reproductive health outcomes. However, the unmet need for family planning remains high in developing countries. This study examines the prevalence and factors influencing contraceptive use and non-use among women of advanced reproductive age (35-49) in Nigeria. METHODS: This was a cross-sectional study of 11,248 women of advanced reproductive age (35-49 years), from the most recent Nigeria Multiple Indicator Cluster Survey (MICS). This study utilised secondary data and information on socio-demographic characteristics, reproductive history, and contraceptive use. We employed a multinomial logistic regression in examining the bivariate relationship between the use and non-use of contraceptives and explanatory variables. Relative risk ratios (RRR) were calculated to indicate influence of the selected socio-demographic variables on the use and non-use of contraceptives. Analysis was performed using Stata version 17. RESULTS: The prevalence of contraceptive non-adoption among women of advanced reproductive age was 71%. Among those who use contraceptives, 21% practice modern methods, and 7% rely on traditional methods. Factors such as ethnicity, region, marital status, media exposure and experience of child mortality all had a significant positive association with contraceptive adoption rate. Additionally, a significant positive association was found between age, education, parity, wealth index, fertility desire and contraceptive use. At the multivariate level, education (RRR = 1.49; p = 0.050), ethnicity (RRR = 0.298; p = 0.001), region (RRR = 4.173; p < 0.001), and wealth status (RRR = 0.568; p = 0.002) were significantly associated with contraceptive non-use. CONCLUSIONS: The study highlighted a high prevalence of contraceptive non-adoption among women of advanced reproductive age, with more than two-thirds not using any method of family planning. Socio-demographic factors, importantly, maternal education consistently emerged as a strong predictor of contraceptive use, underscoring the critical role of female empowerment and access to education in improving reproductive health outcomes. These findings suggest the need for targeted interventions that address regional and socio-cultural disparities, strengthen health education, and promote equitable access to family planning services to reduce unmet needs and enhance reproductive health among older women in Nigeria. CLINICAL TRIAL NUMBER: Not applicable.