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Changing patterns of unmet needs for family planning among women of reproductive age in Nigeria.

Introduction

Unplanned pregnancy poses a major public health challenge to women of reproductive age worldwide, especially in developing countries. It has been estimated that about 80 million (38%) of the 210 million pregnancies that occur annually worldwide, are unplanned, and about 46 million (22%) end up in abortion (1).

In developing countries especially in Africa, reproductive health has been a great concern to many stakeholders as access to quality maternal health services is generally poor with significant negative health consequences such as high maternal mortality and morbidity. Family planning has been identified as a way of thinking and living which affects the decisions made by couples in order to promote the health and welfare of family groups. However, the acceptability and voluntary adoption of this practice which affects the health and social development of a country is poor in most developing nations including Nigeria.

Appropriate reproductive health knowledge, belief and confidence of women to accept and access quality family planning services are essential for improvement of reproductive health in women. It is clear that the practice of family planning would have helped individuals or couples to avoid unwanted births, regulate the intervals between pregnancies, control the time at which births occur in relation to the age of parents and determine the number of children in the family which would eventually reduce reproductive ill health (2).

Several strategies have been introduced worldwide to improve access to family planning services, but the unmet needs continue to increase. Unmet need for family planning have been explained as the extent and composition of potential demand for modern family planning methods. Reports have shown a high number of fecund married women who would not like to have children now and like to wait till later but are not using any form of family planning methods (4). This has been attributed to lack of access to a full range of modern family planning methods, dearth of convincing information on family planning or fear of side effects and therefore these women are unable to meet their reproductive health needs (3).

The World Health Organization in 2012 highlighted that 12% of women aged between 15-49 years who were married or in union wanted to avoid pregnancy but had no access to or were not using an effective method of contraceptives (4). However, many of these women either rely on traditional and less effective methods of contraception or fail to use any method at all due to one barrier or another. These barriers include lack of awareness, lack of access, cultural factors, religious beliefs, opposition to use by partners or family members, and fear of health risks and side effects of contraceptives (2,4).

As at today, the UN has estimated Nigeria to be 187 million thus urgent steps need to be taken to avoid the danger of over-population with its attendant consequences such as poor living conditions, poor infrastructures and poor health. The findings of 2013 National Demographic Health Survey (NDHS) in Nigeria revealed that about 16% of married women have a total unmet need for family planning, 12% have unmet need for spacing and 4% need to limit family size. These unmet needs signify the gap between the reproductive intentions of couples and their actual contraceptive behaviour and this proportion may just be a tip of the iceberg in the burden of unmet needs for family planning in Nigeria (5).

Besides, the Total Fertility Rate (TFR) in Nigeria has remained high with a value of 5.5 from the results obtained from the 2013 Nigeria Demographic and Health Survey (6). One of the major reasons for the high fertility level is the pronatalistic attitude of the population and low use of contraceptive methods thus leading to high rate of unwanted pregnancies, unsafe abortion, abandoned babies, child abuse and ultimately indicating a high percentage of unmet need for family planning (5). An effective intervention on family planning unmet needs is more likely to facilitate the rapid reduction in the current rates of mortality and morbidity among women of reproductive age in Nigeria.

It has been documented that the cost savings in meeting the Millennium Development Goals (MDGs) by satisfying unmet family planning needs far outweighs the additional cost of investing in other family planning services by a factor of almost three to one (3). However, in view of the paradigm shift to the post 2015 agenda, a focus on unmet needs of family planning in Nigeria cannot only facilitate reduction in the costs of meeting these needs but can also cause a reduction in maternal deaths by one third thereby contributing to achieving the Sustainable Development Goal three (4,7).

Several studies have been carried out on the awareness of family planning methods, its usage and factors affecting its use in sub-Saharan Africa including Nigeria, but the studies are limited in scope and geographical coverage. (10,14) There have been few reports of studies that examined the regional, environmental, socio-cultural differences that may affect the use of the family planning methods and factors associated with unmet need for family planning among women of reproductive age in the different regions of Nigeria. Therefore, this study aimed to explore the changing pattern of unmet need for family planning and associated factors among rural and urban Nigerian women of reproductive age over a five year period using secondary data analysis. The information obtained could reduce the gap in knowledge and practice of family planning methods in Nigeria and inform policy makers in decision making of appropriate health service interventions to promote healthy living especially among women.

Methods

The data source for this study was from the National HIV/AIDS and Reproductive Health Survey (NARHS) carried out in 2007 and 2012 respectively. The NARHS is a cross-sectional household survey of individuals covering all the 36 states of Nigeria and the Federal Capital Territory (FCT) among men aged between 15 to 64 years and women of reproductive age group (15-49years). The main objective of the NARhS was to obtain accurate HIV prevalence estimates and current reproductive health behaviours along key programmes at the national, zonal and at state levels. A nationally representative sample was selected using a four-level multi-stage stratified cluster sampling procedure to select 6,161 males and 5,360 females in the 2007 survey while 15,596 males and 15,639 females living in households in rural and urban areas in Nigeria were selected in the 2012 survey. The households were selected from an updated master sampling frame of rural and urban localities developed and maintained by the National Population Commission (7). This gave all eligible persons a known probability of selection. Data was collected from the respondents using a semi structured questionnaire by trained interviewers and supervisors who ensured quality of data collected. Only women of reproductive age group were extracted as database for this study. The main dependent variables of interest were (a) whether the woman had ever been pregnant, (b) at the time they became pregnant did they want the pregnancy and (c) were they using any form of contraceptives at this period. Independent variables include socio demographic characteristics of the women, knowledge of family planning methods, perception of men supporting family planning and fear of side effects of family planning. The unmet need for family planning was computed using the formula below (4,5).

[Number of married women who are fecund, married and do not want children now or do not want children again and are not using any form of contraceptive method/Number of married women in the reproductive age group] x 100

Data Analysis for this study was done at geopolitical and locality levels for all selected variables using SPSS version 20.0. Descriptive statistics was used to describe the socio demographic characteristics of the women of child bearing age. Chi-square test was used to investigate the significance of the association between unmet need for family planning and each independent variable. Independent predictors of unmet need were explored using binary logistic regression models. All tests were carried out at the 5% level of statistical significance. The Federal Ministry of Health of Nigeria has permitted researchers to re-analyse any component of the NARHS database for any intellectual information as done in this study.

Results

A total of 5,132 women of child bearing age (1549yrs) with mean age of 26.9[+ or -]8.56 years and 15,634 women with a mean age of 29.0[+ or -]9.54 years were extracted from the 2007 and 2012 survey respectively. Table 1 shows the socio demographic characteristics of the women of reproductive age group by urban and rural locations.

The highest proportion of women interviewed were aged between 15-24 years (44.3% and 35.7%) respectively in both surveys and more than 60 % were currently married (63.3% and 66.3%) in 2007 and 2012 respectively. Likewise, about a sixth of the women in both surveys (63% and 63.2%) had at least secondary education with preponderance in the urban areas. The proportion of Muslims and Christians was slightly different as there were a higher proportion of Muslims (50.2%) in 2007 as compared to 41.7% in 2012 survey. However, most of the women interviewed in both surveys were from the northern part of the country (56.5% and 53.3%) with those from the North West being in the highest proportion (25.4% and 19.4% respectively).

Furthermore, about a third of the women interviewed in both surveys were unemployed including housewives while those involved in farming activities increased between 2007 and 2012 with a rural preponderance (8.6%, 14.4% respectively).

Contraceptive Use

Majority of the women had never used any form of family planning method and this proportion increased from 77.8% in 2007 to 80.4% in 2012 with a higher proportion of them from the rural areas. Furthermore, just above sixty percent of the women who had ever used any form of family planning method are currently using a method with a slight urban preponderance in 2012(p<0.05) but no urban-rural differential in the 2007 survey. Most common form of family planning method used by these women were modern contraceptive methods (male condoms, IUDs, implants, OCPs, 71.6% and 77%) as compared to traditional methods (natural, rhythm and abstinence method, 28.4% and 23%) in the 2007 and 2012 survey respectively. The use of modern contraceptive methods increased over the 5 year study period with the condoms (58.8%, 58.9%) remaining the most common form of modern method used, although with an urban preponderance.

Prevalence and patterns of unmet needs for family planning

The total unmet need for family planning was found to be 9.1% in 2007 and this increased to 11.4% in 2012 survey. There was a higher preponderance in the urban areas as compared to the rural areas which was found to be statistically significant in 2007 survey but however was not statistically significant in 2012 (p=0.03, p=0.08 respectively) (See Figure. 1). On socio demographic determinants of unmet need for family planning, there was no association between the age distribution, religion, education and occupation, although unmet need was found to be highest among students (18.5%) in the 2007 survey. (p>0.05). Furthermore, urban dwellers were found to have a higher percentage of unmet need for family planning over the five year period. Respondents in the North Western part of the country had a higher proportion (32.3% and 24.7%) of women with unmet need for family planning in the Northern region and this was consistent over the five year period. In the southern region, women in the South western (12.%) zone had the highest proportion in 2007 survey while the South South (17.6%) had the highest proportion of women with unmet need for family planning by 2012. Nevertheless, location (p=0.034) and zone (p=0.00) were found to be statistically significantly associated with unmet need for family planning in 2007 while only location was significant in 2012(p=0.000). In addition, women who had discussed family planning method with their spouses and did not fear any side effects of modern family planning had a lower proportion with unmet need, however only fear of side effects was found to be statistically significant in the 2012 survey(p<0.05). From the 2012 survey, women aged 35-44yrs (OR: 1.3, 95%CI: 1.0-15) and feared side effects of family planning methods (OR:1.3,95%CI:1.1-1.6) were about 2 times more likely to have an unmet need for family planning. Whilst in the 2007 survey, students were 3 times more likely to have an unmet need for family planning (OR: 2.7, 95%CI: 1.2-6.0).

In addition, rural dwellers were about 2 times less likely to have unmet needs for family planning methods, though this did not change between 2007 (OR: 0.7, 95% CI: 0.6-0.9) and 2012(OR: 0.8, 95% CI: 0.6-0.9) respectively.

Discussion

Unmet needs for family planning has remained a major indicator for monitoring the progress towards reduction of maternal mortality worldwide. Findings from this study revealed an overall prevalence of total unmet need for family planning to be 9.1% and 11.4% over the five year period. These values are lower compared to the 20.2% and 16% reported in the 2008 and 2013 NDHS respectively and in contrast to the increasing pattern (6,7). This could be due to selection of study population and the primary objective of these surveys. But the finding of 9.1% in 2007 was similar to a study carried out in Botswana using demographic health data of 2007.23 This shows that the reported global prevalence of unmet needs in these study locations might have been overestimated probably due to denominators used in calculation.

Furthermore, older women were more likely to have unmet need probably due to confidence gained with previous experiences of pregnancy and child birth.

This is however, is in line with most studies done in Nigeria as well as other sub-Saharan countries 2,9,12,13). Interestingly, the northern part of the country has been identified as having lesser prevalence of unmet need and this is in consonance with the demographic health survey. However, in the southern part, there has been a change in the unmet needs from the South West to the South South, this could probably be due to the improved education and westernized life styles in South Western Nigeria. This was also similar to some studies done in Uganda which reported regional differences (12,24).

The marginal difference in the prevalence of unmet need in the urban and rural areas as observed might be due to the industrialization and busy schedules in the urban cities which is in consonance with other studies in Sub Saharan Africa (24,25,26).

Conclusion

Unmet need for family planning has increased over the five year period. It is marginally higher in urban areas and southern part of Nigeria. Fear of side effects of family planning methods and increasing age were major barriers which changed over the five year period. A combination of adequate family planning information during antenatal care for the pregnancy of first born child and encouraging the presence of the spouse or other relatives at least once during the antenatal visits may further help reduce unmet need for family planning.

References

(1.) WHO, Safe Abortion: Technical and Policy Guidance for Health Systems, World Health Organization, Geneva, Switzerland, 2nd edition, 2012,http:// apps.who.int/iris/bitstream/10665/70914/1/9789241 548434_eng.pdf.

(2.) Monjok E, Smesny A, Ekabua JE et al: Contraceptive practices in Nigeria: Literature review and recommendation for future policy decisions: Open Access Journal of Contraception 2010:1:9-22.

(3.) World Health Organization, May 2011: Fact Sheet: www.who.int/mediacenter/factsheets/fs348/en/inde x.htm.Accessed, June 2011.

(4.) Westoff Charles F. Unmet Need at the End of the Century: DHS Comparative Reports No.1. Calverton, Maryland: ORC Macro; 2001.

(5.) Westoff, Charles F. 2006. New Estimates of Unmet Need and the Demand for Family Planning. DHS Comparative Reports No. 14. Calverton, Maryland, USA. Macro International Inc.

(6.) Nigerian Demography Health Survey Report. 2013.

(7.) Nigerian Demography Health Survey Report. 2008.

(8.) National Population Commission (NPC) [Nigeria] and ORC Macro. 2004. Nigeria Demographic and Health Survey 2003. Calverton, Maryland: National Population Commission and ORC Macro.

(9.) Health 2011: Maternal and Reproductive Health Issues. www.cdc.org/reproductivehealth/index.htm. Accessed May 2011 .

(10.) Igwegbe AO, Ugboaja JO, Monago EN: Prevalence and determinants of unmet need for family planning in Nnewi, South East Nigeria: Int. Journal of Med and Med Sci. 2009: 1(8): 325-329.

(11.) Srivastava DK, Goutam P, Goutam R, Gour N, Bansal M : A study to assess the unmet need of family planning in Gwalior district and to study the factors that helps in determining it. National Journal of Community Medicine. 2011; 2(1): 28-31.

(12.) Khan, Shane, Sarah E.K. Bradley, Joy Fishel, and Vinod Mishra. 2008. Unmet Need and the Demand for Family Planning in Uganda: Further Analysis of the Uganda Demographic and Health Surveys, 19952006. Calverton, Maryland, USA: Macro International Inc.

(13.) Abdel Aziem A, Duria A Rayis, Mona Mamoune: Use of family planning methods in Kassala, Eastern Sudan: BMC Res Notes. 2011:4(43).

(14.) Adetokunbo T, Oluwarotimi A, Abiola et al: Contraceptive knowledge and usage amongst female secondary school students in Lagos, South West Nigeria: Journal of Public Health and Epidemiology 2011: 3(1):34-37.

(15.) Alan Guttmacher Institute. International Family Planning Perspectives; Fertility Transition. New York: University of North Carolina; 2004.

(16.) Bongrats, J. and Bruce, J.: The causes of unmet need for contraception and the social content of services, Studies in Family Planning. 1995: 26(2), 57-75.

(17.) Casterline, JB and Sinding, SW: Unmet need for family planning in developing countries and implications for population policy. Popul and Dev. Review. 2000; 26: 691-723.

(18.) Center for Communication Programmes. Population Reports. Johns Hopkins Bloomberg School of Public Health: Baltimore; 2003: 3-30.

(19.) Nazzar A., Adongo Philip B., Binka Fred N. et al. Developing a culturally appropriate Family planning program for the Navrongo Experiment; Studies in Family planning. New York: Population Council. 1995;.26( 6).

(20.) Phillips James F., Hossain Bazle M., Kuenning Arends M., The Long-term Demographic Role of Community-based Family Planning in Rural Bangladesh; Studies in Family Planning. New York: Population Council. 1996; 27( 4): 204-219

(21.) Prata N: The need for family planning. Popul Environ .2007; 28:212-222.

(22.) Subhash B: Socio-economic and Demographic Determinants of Unmet Need for Family Planning in India and its Consequences. Research on Humanities and Social Sciences . 2013; 3(3):22222863.

(23.) Letamo, G. and K. Navaneetham (2015). "Levels, trends and reasons for unmet need for family planning among married women in Botswana: a crosssectional study." BMJ Open 5(3): e006603.

(24.) Vohra R, Vohra A, Sharma S, Rathore MS, Sharma BN, Sharma MP : Determinants of the unmet need for family among women of Jaipur, Rajasthan. Int J Adv Med Res. 2014; 1:20-5.

(25.) Kisaakye, P. (2013). "Determinants of unmet need for contraception to space and limit births among various groups of currently married women in Uganda. " European Scientific Journal.

(26.) Ajong, A. B., et al. (2016). "Determinants of unmet need for family planning among women in Urban Cameroon: a cross sectional survey in the BiyemAssi Health District, Yaounde." BMC women's health 16(1): 1.

(27.) Oginni, A. B., et al. (2015). "Trend and Determinants of Unmet Need for Family Planning Services among Currently Married Women and Sexually Active Unmarried Women Aged 15-49 in Nigeria (2003-2013)." Etude de la Population Africaine 29(1): 1483.

(28.) Adebowale, S. A. and M. E. Palamuleni (2014). "Determinants of unmet need for modern contraception and reasons for non-use among married women in rural areas of Burkina Faso." Etude de la Population Africaine 28(1): 499.

Bamgboye E.A and Ajayi I.

Department of Epidemiology & Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan

* For correspondence: Email: dr_enip@yahoo.co.uk; Phone: 08029537711
Table 1: Socio Demographic Characteristics of Women Within
Reproductive Age Group by Urban and Rural Location
(NARHS 2007-2012).

                                      2007

                        URBAN        RURAL        TOTAL
                        (N=1769)     (N=3363)     (N=5132)
                        n(%)         n(%)         n(%)

Age (Yrs)

15-24                   769(43.5)    1504(44.7)   2273(44.3)
25-34                   599(33.9)    1078(32.1)   1677(32.7)
35-44                   360(20.4)    669(19.9)    1029(20.1)
45-49                   41(2.3)      112(3.3)     153(3.0)

Marital status

Currently married       991(56.0)    2258(67.1)   3249(63.3)
Living with a sexual    67(3.8)      107(3.2)     174(3.4)
partner
Never married           640(36.2)    819(24.4)    1459(28.4)
Separated/Divorced      39(2.2)      74(2.2)      113(2.2)
Widowed                 32(1.8)      105(3.1)     137(2.7)

Education

No formal Education     324(18.3)    1576(46.9)   1900(37.0)
Secondary and below     1156(65.3)   1662(49.4)   2818(54.9)
Higher                  289(16.3)    125(3.7)     414(8.1)

Occupation

Professional/Civil      214(12.1)    157(4.7)     371(7.2)
Servant
Self Employed_skilled   500(28.3)    752(22.4)    1252(24.4)
Self                    111(6.3)     223(6.6)     334(6.5)
Employed_unskilled
Farming                 58(3.3)      384(11.4)    442(8.6)
Student                 519(29.3)    608(18.1)    1127(22.0)
Unemployed              367(20.7)    1239(36.8)   1606(31.3)

Religion

Islam                   780(44.1)    1796(53.4)   2576(50.2)
Christianity            980(55.4)    1543(45.9)   2523(49.2)
Others                  9(0.5)       24(0.7)      33(0.6)

Zone

North Central           263(14.9)    639(19.0)    902(17.6)
North East              178(10.1)    516(15.3)    694(13.5)
North West              331(18.7)    972(28.9)    1303(25.4)
South East              224(12.7)    376(11.2)    600(11.7)
South South             244(13.8)    521(15.5)    765(14.9)
South West              529(29.9)    339(10.1)    868(16.9)

                                      2012

                        URBAN        RURAL        TOTAL
                        (N=4911)     (N=10723)    (N=15634)
                        n(%)         n(%)         n(%)

Age (Yrs)

15-24                   1614(32.9)   3967(37.0)   5581(35.7)
25-34                   1792(36.5)   3456(32.2)   5248(33.6)
35-44                   1043(21.2)   2279(21.3)   3322(21.2)
45-49                   462(9.42)    1021(9.5)    1483(9.5)

Marital status

Currently married       3063(62.4)   7303(68.1)   10366(66.3)
Living with a sexual    140(2.9)     291(2.7)     431(2.8)
partner
Never married           1438(29.3)   2498(23.3)   3936(25.2)
Separated/Divorced      138(2.8)     263(2.5)     401(2.6)
Widowed                 132(2.7)     368(3.4)     500(3.2)

Education

No formal Education     942(19.2)    4809(44.8)   5751(36.8)
Secondary and below     3036(61.8)   5360(50.0)   8396(53.7)
Higher                  993(19.0)    554(5.2)     1487(9.5)

Occupation

Professional/Civil      459(9.3)     308(2.9)     767(4.9)
Servant
Self Employed_skilled   1571(32.0)   1697(15.8)   3268(20.9)
Self                    484(9.9)     642(6.0)     1126(7.2)
Employed_unskilled
Farming                 169(3.4)     2088(19.5)   2257(14.4)
Student                 1071(21.8)   1665(15.5)   2736(17.5)
Unemployed              1157(23.6)   1323(40.3)   5480(35.1)

Religion

Islam                   2049(41.7)   4472(41.7)   6521(41.7)
Christianity            2830(57.6)   6096(56.8)   8926(57.1)
Others                  32(0.7)      155(1.4)     187(1.2)

Zone

North Central           909(18.5)    2043(19.1)   2952(18.9)
North East              488(9.9)     1860(17.3)   2348(15.0)
North West              649(13.2)    2386(22.3)   3035(19.4)
South East              317(6.5)     1941(18.1)   2258(14.4)
South South             663(13.5)    1868(17.4)   2531(16.2)
South West              1885(38.4)   625(5.8)     2510(16.1)

Table 2: The Relationship Between Demographic Characteristics and
Need for Family Planning Among Women of Reproductive Age Group in
Nigeria (2007-2012).

                                          YEAR

                                          2007

                                         N=3249
                                          n(%)

                         MET NEED               UNMET NEED  TOTAL

AGE(YRS)

15-24                    845(91.0)              84(9.0)     929(28.6)
25-34                    1222(91.4)             115(8.6)    1337(41.1)
35-44                    784(90.2)              85(9.8)     869(26.7)
45-49                    103(90.4)              11(9.6)     114(3.5)
                         [chi square]= 0.935;   p=0.817

Education

No formal Education      1467(91.3)             140(8.7)    1607(49.4)
Secondary and below      1305(90.2)             142(9.8)    1447(44.5)
Higher                   182(93.3)              13(6.7)     195(6.0)
                         [chi square]= 2.582;   p=0.275

Religion

Islam                    1772(90.7)             182(9.3)    1954(60.2)
Christianity             1162(91.3)             111(8.7)    1273(39.1)
Others                   20(90.9)               2(9.1)      22(0.7)
                         [chi square]= 0.330;   p=0.848

Occupation

Employed                 237(91.5)              22(8.5)     259(7.9)
Self employed_skilled    902(91.4)              85(8.6)     987(30.3)
Self employed_unskilled  233(91.7)              21(8.3)     254(7.8)
Farming                  303(90.4)              32(9.6)     335(10.3)
Student                  53(81.5)               12(18.5)    65(2.0)
Unemployed               1226(90.9)             123(9.1)    1349(41.5)
                         [chi square]= 7.595;   p=0.180

Locality

Urban                    885(89.3)              106(10.7)   991(30.5)
Rural                    2069(91.6)             189(8.4)    2258(69.5)
                         [chi square]= 4.514;   p=0.034

Zone

North West               972(92.5)              79(7.5)     1051(32.3)
North East               443(88.6)              57(11.4)    500(15.3)
North Central            548(91.9)              48(8.1)     596(18.3)
South West               415(87.9)              57(12.1)    472(14.5)
South South              322(89.0)              40(11.0)    362(11.1)
South East               254(94.8)              14(5.2)     268(8.2)
                         [chi square]= 18.794;  p= 0.002

                                         YEAR

                                        2012

                                       N=10366
                                         n(%)

                         MET NEED               UNMET NEED  TOTAL

AGE(YRS)

15-24                    1992(89.5)             233(10.5)   2225(21.4)
25-34                    3762(89.1)             459(10.9)   4221(40.7)
35-44                    2442(87.7)             344(12.3)   2786(26.8)
45-49                    991(87.4)              143(12.6)   1134(10.9)
                         [chi square]= 7.181;   p=0.066

Education

No formal Education      4306(88.8)             542(11.2)   4848(46.7)
Secondary and below      4162(88.1)             560(11.9)   4722(45.5)
Higher                   719(90.3)              77(9.7)     796(7.6)
                         [chi square]= 3.569;   p =0.168

Religion

Islam                    4687(89.2)             565(10.8)   5252(50.7)
Christianity             4394(88.1)             596(11.9)   4990(48.1)
Others                   106(85.5)              18(14.5)    124(1.2)
                         [chi square]= 4.801;   p=0.091

Occupation

Employed                 475(90.5)              50(9.5)     525(5.1)
Self employed_skilled    2180(88.5)             283(11.5)   2463(23.7)
Self employed_unskilled  664(87.8)              92(12.2)    756(7.3)
Farming                  1512(88.3)             201(11.7)   1713(16.5)
Student                  156(87.6)              18(10.3)    174(1.7)
Unemployed               4200(88.7)             535(11.3)   4735(45.7)
                         [chi square]= 2.720;   p=0.743

Locality

Urban                    2689(87.8)             374(12.2)   3063(29.5)
Rural                    6498(89.0)             805(11.0)   7303(70.5)
                         [chi square]= 3.018;   p=0.082

Zone

North West               2268(88.6)             293(11.4)   2561(24.7)
North East               1564(86.6)             241(13.4)   1805(17.4)
North Central            1854(92.8)             143(7.2)    1997(19.2)
South West               1412(89.5)             166(10.5)   1578(15.2)
South South              1107(82.4)             236(17.6)   1343(12.9)
South East               982(90.8)              100(9.2)    1082(10.4)
                         [chi square]= 99.39;   p= 0.000

Table 3: The Relationship Between Selected Characteristics and Need
For Family Planning (FP) Among Married Women of Reproductive Age
Group in Nigeria.

                                     Year

                                     2007
                                    N=3249
                                     n(%)

                        MET NEED               UNMET NEED

Know where to
obtain FP method

Yes                     1538(91.1)             150(8.8)
No                      1416(90.7)             145(9.3)
                        [chi square]=0.153     p= 0.690

Fear of side effect
of any modern FP

Yes                     396(91.0)              39(9.0)
No                      2558(90.9)             256(9.1)
                        [chi square]= 0.007    p=0.929
Believe men support FP

Yes                     837(90.8)              85(9.2)
No                      2117(91.0)             210(9.0)
                        [chi square]= 0.030    p=0.862
Ever discussed FP
with husband/spouse

Yes                     704(91.5)              65(8.5)
No                      2250(90.7)             230(9.3)
                        [chi square]=0.480     p=0.488

                                     Year

                                     2012
                                    N=10366
                                      n(%)

                        MET NEED               UNMET NEED

Know where to
obtain FP method

Yes                     4352(88.9)             546(11.1)
No                      4835(88.4)             633(11.6)
                        [chi square]=0.471     p=0.492

Fear of side effect
of any modern FP

Yes                     7716(89.1)             945(10.9)
No                      1040(85.9)             171(14.1)
                        [chi square]=10.915    p=0.001
Believe men support FP

Yes                     2443(89.1)             300(10.9)
No                      6626(88.6)             855(11.4)
                        [chi square]=0.485     p=0.486
Ever discussed FP
with husband/spouse

Yes                     2092(89.0)             260(11.0)
No                      6437(88.7)             818(11.3)
                        [chi square]=0.086     p=0.768

Table 4: Independent Predictors Of Unmet Need for Family Among Women
of Reproductive Age in Nigeria (NARHS, 2007-2012).

Selected Characteristics                 2007

                            [beta]    OR      p-value   95%CI

Age group

15-24                       1
25-34                       0.0       1.0     0.946     0.7-1.4
35-44                       1.0       1.1     0.317     0.8-1.7
45-49                       0.5       1.2     0.575     0.6-2.4

Education

Primary                     1
Secondary and below         0.6       1.1     0.517     0.8-1.5
Higher                      -1.3      0.6     0.183     0.3-1.2

Religion

Islam                       1
Christianity                -1.5      0.7     0.128     0.5-1.1
Traditional/Others          -0.4      0.7     0.675     0.2-3.2

Occupation

Government Employed         1
Self Employed_ Skilled      -0.5      0.9     0.595     0.5-1.5
Self Employed_ Unskilled    -0.6      0.8     0.577     0.4-1.6
Farming                     0.5       1.2     0.619     0.6-2.1
Student                     2.5       2.7     0.013     1.2-6.0
Unemployed                  0.1       1.0     0.933     0.6-1.7

Location

Urban                       1
Rural                       -2.1      0.7     0.034     0.6-0.9

Zone

North Central               1
North East                  1.4       1.3     0.163     0.8-2.0
North West                  -0.8      0.8     0.422     0.6-1.2
South East                  -1.0      0.7     0.303     0.4-1.4
South South                 1.8       1.5     0.069     0.9-2.6
South West                  2.1       1.6     0.030     1.0-2.5

Know where to obtain FP

Yes                         1
No                          0.8       1.1     0.378     0.8-1.5

Fear Side effect of FP

Yes                         1
No                          0.2       1.0     0.843     0.7-1.5

Men Support FP

Yes                         1
No                          0.3       1.0     0.778     0.8-1.4

Discussed FP with spouse

Yes                         1
No                          0.7       1.1     0.472     0.8-1.5

Selected Characteristics                  2012

                            [BETA]    OR      p-value   95%CI

Age group

15-24                       1
25-34                       0.66      1.0     0.508     0.9-1.3
35-44                       2.20      1.3     0.028     1.0-1.5
45-49                       1.65      1.2     0.099     0.9-1.6

Education

Primary                     1
Secondary and below         0.89      0.9     0.895     0.8-1.2
Higher                      0.29      0.8     0.286     0.6-1.6

Religion

Islam                       1
Christianity                1.8       1.1     0.064     0.9-1.5
Traditional/Others          1.5       1.6     0.138     0.8-2.8

Occupation

Government Employed         1
Self Employed_ Skilled      0.6       1.1     0.528     0.7-1.6
Self Employed_ Unskilled    1.3       1.3     0.193     0.8-2.0
Farming                     0.7       1.1     0.441     0.7-1.7
Student                     1.2       1.5     0.201     0.8-2.8
Unemployed                  0.9       1.2     0.334     0.8-1.8

Location

Urban                       1
Rural                       -2.9      0.8     0.004     0.6-0.9

Zone

North Central               1
North East                  6.9       2.4     0.000     1.8-3.0
North West                  5.4       2.0     0.000     1.5-2.6
South East                  2.4       1.4     0.014     1.0-1.9
South South                 8.0       2.8     0.000     2.2-3.7
South West                  2.7       1.4     0.007     1.1-1.9

Know where to obtain FP

Yes                         1
No                          1.8       1.1     0.070     0.9-1.3

Fear Side effect of FP

Yes                         1
No                          2.7       1.3     0.006     1.1-1.6

Men Support FP

Yes                         1
No                          0.3       1.0     0.792     0.8-1.2

Discussed FP with spouse

Yes                         1
No                          0.4       1.0     0.683     0.0-0.1

Figure 1: Prevalence of Unmet Need for Family Planning by
Location and Year of Survey.

Unmet need for        Percentage
family planning
                     2007      2012
Total                 9.1      11.4
Urban                10.7      12.2
Rural                 8.4      11

Note: Table made from bar graph.
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Article Details
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Title Annotation:ORIGINAL RESEARCH ARTICLE
Author:Bamgboye, E.A.; Ajayi, I.
Publication:African Journal of Reproductive Health
Geographic Code:6NIGR
Date:Sep 1, 2016
Words:5534
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