article · PLoS ONE
A cross-sectional study of 24,281 women of reproductive age in Nigeria examined modern contraceptive use across different regions and identified key associated factors. Contraceptive use varied widely across the country, ranging from 0% to 75%. Lower use was concentrated in states including Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba, and Delta. Higher use clustered in areas such as Lagos, Oyo, Osun, Ekiti, Plateau, Adamawa, Imo, Bayelsa, and the Federal Capital Territory. At the individual level, higher education, mass media exposure, having four or more children, and belonging to the Yoruba ethnic group increased the odds of using modern contraceptives. Conversely, being married, aged 35 or older, or practising Islam lowered the likelihood. Household wealth and living in communities with higher literacy or medium contraceptive knowledge also boosted uptake, pointing to geographic and social factors shaping reproductive health decisions.
Promoting modern contraceptives can prevent substantial shares of maternal and child deaths in high-fertility settings. Identifying the specific geographic areas and demographic groups with low uptake allows public health programmes and healthcare systems to direct educational campaigns and resources where they are needed most, improving health outcomes and reproductive autonomy for underserved women.
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BACKGROUND: Evidence suggests that in countries with high fertility and fecundity rates, such as Nigeria, the promotion of modern contraceptive use prevents approximately 32% and 10% of maternal and child mortality, respectively. Therefore, this study aimed to assess the spatial distribution of modern contraceptive use and its predictors among women of reproductive age in Nigeria. METHODS: The study employed a cross-sectional analysis of population-based data involving 24,281 women of reproductive age in Nigeria. The study adopted both multilevel and spatial analyses to identify the predictors of modern contraceptive use and its spatial clustering among women in Nigeria. RESULTS: Modern contraceptive use among the study population in Nigeria ranged from 0% to 75%, with regional variations. The spatial analysis showed that areas with a low proportion of modern contraceptive use were Sokoto, Yobe, Borno, Katsina, Zamfara, Kebbi, Niger, Taraba and Delta. Areas with a high proportion of modern contraceptive use were Lagos, Oyo, Osun, Ekiti, Federal capital territory, Plateau, Adamawa, Imo, and Bayelsa. The multilevel analysis revealed that at the individual level, women with secondary/higher education, women from the Yoruba ethnic group, those who had four children and above, and those exposed to mass media had higher odds of using modern contraceptives. On the other hand, women who were 35 years and above, those who were married, and women who were practicing Islam were less likely to use modern contraceptives. At the household/community level, women from the richest households, those residing in communities with medium knowledge of modern contraceptive methods, and women residing in communities with a high literacy level were more likely to use modern contraceptives. CONCLUSION: There were major variations in the use of modern contraception across various regions in Nigeria. As a result, areas with low contraceptive rates should be given the most deserving attention by promoting contraceptive education and use as well as considering significant factors at the individual and household/community levels.
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DOI: 10.1371/journal.pone.0258844
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