Sociodemographic Characteristics of Study Population
As illustrated in Table 1, a majority of 54.27% of respondents were married and lived with their partners. This proportion was followed by the unmarried (never in union) category (37.40%). The lowest proportion of respondents were those who either were widowed, divorced, or separated (8.32%). Respondents aged between 15–24 years constituted the highest proportion (34.70%), while those aged between 25–34 constituted 31.74% of the study population, with those aged 35 or older comprising 33.56%. Almost a third of respondents (60.10%) had secondary education, and 20.60% had higher education qualifications. Sixteen percent had primary education, and 3.24% had no formal education. A majority of 46.72% had given birth to between 1–4 children, 33.52% had no children, while nearly 20% had five or more.
Almost two-thirds (72.06%) of the respondents had current employment, 27.94% had no work while 60.33% were among the highest wealth quintile. While 34.84% comprised the middle wealth quintile, only 14.83% fell within the lowest wealth index. Christians - both Catholics and other Christian denominations (93.65%) were dominant as against 6.14% who were either Muslims or Traditionalists. Most of the respondents were residents in rural (63.83%) than urban areas (36.17%). Finally, Rivers State provided the highest proportion of respondents (23.28%), followed by Akwa Ibom State with 18.21%. This was followed by Delta State (15.57%) and Bayelsa State (15.51%), with an almost similar proportion of respondents. Edo (13.29%) and Cross River (14.14%) States supplied the lowest number of respondents.
Variables
|
Frequency
|
Percent
|
Table 1
Sociodemographic characteristics of Respondents (N = 4,553)
Marital Status
|
Never in Union
|
1,703
|
37.40
|
Married living with a partner
|
2,471
|
54.27
|
Widowed /divorced/separated
|
379
|
8.32
|
Age
|
15–24
|
1,580
|
34.70
|
25–34
|
1,445
|
31.74
|
35 and above
|
1,528
|
33.56
|
Mean age
|
30
|
Education
|
No education
|
229
|
5.03
|
Primary
|
759
|
16.67
|
Secondary
|
2,892
|
63.52
|
Higher
|
673
|
14.78
|
Husband/partners education
|
No education
|
80
|
3.24
|
Primary
|
397
|
16.07
|
Secondary
|
1,485
|
60.10
|
Higher
|
509
|
20.60
|
Children ever born
|
0
|
1,526
|
33.52
|
1–4 children
|
2,127
|
46.72
|
5 children & above
|
900
|
19.77
|
Number of living children
|
0
|
1,554
|
34.13
|
1–4 children
|
2,230
|
48.98
|
5 children & above
|
769
|
16.89
|
Currently working
|
No
|
1,272
|
27.94
|
Yes
|
3,281
|
72.06
|
Wealth index
|
Lowest
|
675
|
14.83
|
Middle
|
1,131
|
24.84
|
Highest
|
2,747
|
60.33
|
Religion
|
Catholic & other Christians
|
4,264
|
93.65
|
Islam
|
94
|
2.06
|
Others
|
195
|
4.28
|
Type of place of residence
|
Urban
|
1,647
|
36.17
|
Rural
|
2,906
|
63.83
|
State of residence
|
Edo
|
605
|
13.29
|
Cross River
|
644
|
14.14
|
Akwa Ibom
|
829
|
18.21
|
Rivers
|
1,060
|
23.28
|
Bayelsa
|
706
|
15.51
|
Delta
|
709
|
15.57
|
Awareness of Contraceptives Methods and their Uses
Figure 1 illustrates the overall knowledge of contraceptives compared to the lack of knowledge about contraceptives. Overall, 82% of the study participants knew at least one contraceptive, while 18% of the study population reported no knowledge of any contraceptives. Additional data in Figure 2 further illustrate the various uses for contraceptives. Most respondents (63%) noted that contraceptives prevent unwanted pregnancies. Another 32% of respondents acknowledged that contraceptives served the purpose of spacing children. In addition, 5% of respondents noted that contraceptives helped to prevent STIs. This category of respondents referenced the dual use of male and female condoms in preventing unwanted pregnancies and protecting against sexually transmitted infections.
Prevalence of Contraceptives Use
Evidence from the data in Figure 3 illustrates the low adoption of contraception regardless of the overwhelming awareness of contraceptives among sexually active childbearing women in Nigeria’s South-south geopolitical zone. Essentially, in Figure 3, 81.70% of the respondents reported not using any form of contraceptives. Less than 15% of respondents acknowledged using modern contraceptives. Conversely, a little over 4% of the respondents used traditional contraceptives.
Pattern of Contraceptive Use by States in the South-south Geopolitical Zone, NDHS 2018
There seemed to be a trend in adopting contraceptives among sexually active childbearing women across the six states in the South-south geopolitical zone. As illustrated in Figure 4, available data indicate that Rivers and the Bayelsa States recorded the most and least contraceptive use rates respectively. In particular, Rivers State recorded the highest use of contraceptives (39.5%) in the entire South-south region. Akwa Ibom State (17.8%) and Cross River State (16.1%) ranked second and third respectively in contraceptive use. Conversely, among the South-south states, Bayelsa State (3.8%) and Delta State (10.6%) had the lowest prevalence of contraceptive use.
The most common contraceptives among women of reproductive ages in South-south region
Figure 5 shows the most common forms of contraceptives among women of reproductive ages in the South-south geopolitical zone. Pills, intrauterine devices (IUDs), injections, male condoms, implants/Norplant, lactational amenorrhea, emergency contraception, and the standard-days-methods are among the several forms of contraception. As illustrated in Figure 5, the male condom (36.4%), implants/Norplant (21.4%), injections (16.9%), and pills (14.1%) continued to be the most frequently used modern contraceptives among sexually active childbearing women in the South-south zone. Conversely, the standard-days-method (0.3%), IUD (1.9%), emergency contraception (3.4%), and lactational amenorrhea (4.4%), among others, were the least mentioned contraceptive methods.
Bivariate Association of Contraceptive Use with all the Explanatory Variables
The result of the test of associations between the main explanatory variables as well as co-variables and the use of contraceptives using bivariate analysis are presented in Table 2. As illustrated in the table, data indicate that all explanatory variables were significantly associated with contraceptive use save for marital status (P = 0.080) and type of place of residence (P = 0.169). The Chi-square statistics reveal a good spread of the use of both contraceptive categories across the different ages of women. Hence, woman’s age and contraceptive use were significantly associated (P = 0.000). Similarly, at P = 0.000, education was significantly related to the use of contraceptives. In this case, having higher education was related to the prevalent use of modern contraceptives than lower education which is significantly associated with the uptake of traditional contraceptives. The association between education and contraceptive use extended to husbands/partners of women (P = 0.000). In this case, women with husband's/partner with higher educational status were more likely to use modern contraceptives than their counterparts whose husbands/partners had lower education and tended to use more traditional contraceptives.
Similarly, there were significant associations between work status (P = 0.000), wealth index (P = 0.000), religion (P = 0.000), knowledge of contraceptive methods (P = 0.000), the desire for children (P = 0.000) and use of contraceptives. While working women are more likely to use modern contraceptives, those without work tended to use traditional contraceptives the more. Likewise, women with a higher wealth index (P = 0.000) were more likely to adopt modern contraceptives than their counterparts with a lower wealth index who were likely to use traditional methods of modern contraceptives. In terms of religion (P = 0.000), contrary to the fact that Catholics often are admonished to refrain from modern contraceptives, our findings in the present study suggest that more Catholics were open to the use of modern contraceptives than the traditional methods.
Also, as expected, women with more knowledge about contraceptives (P = 0.000) were more likely to adopt modern traditional contraceptives than their counterparts with lower contraceptive knowledge. Additionally, women who wanted no more children (P = 0.000) were more likely to use modern contraceptives than traditional methods. Similarly, husbands/partners who wanted no more children (P = 0.000) were also more likely to adopt the use of modern contraceptives than those who wanted more children.
Table 2: Unadjusted Bivariate Analysis of Contraceptive Adoption in South-south Nigeria
Background characteristics
|
Current use by method
|
X2 (P-Value)
|
|
Traditional method
|
Modern method
|
|
Current marital status
|
|
|
|
Never in union
|
1,489(38.05%)
|
214 (33.44%)
|
5.0497 (0.080)
|
Married
|
2,103 (53.74%)
|
368 (57.50%)
|
Widowed/Divorced
|
321(8.20%)
|
58 (9.06%)
|
Age
|
15-24
|
1,415 (36.16%)
|
165 (25.78%)
|
30.6715 (0.000)
|
25-34
|
1,194 (30.51%)
|
251 (39.22%)
|
35 and above
|
1,304 (33.32%)
|
224 (35.00%)
|
Highest education
|
No education
|
216 (5.52%)
|
13 (2.03%)
|
26.6293 (0.000)
|
Primary
|
656 (16.76%)
|
103 (16.09%)
|
Secondary
|
2,495 (63.76%)
|
397 (62.03%)
|
Higher
|
546 (13.95%)
|
127 (19.84%)
|
Husband/partner’s education level
|
No education
|
79 (3.76%)
|
1 (0.27%)
|
22.3573 (0.000)
|
Primary
|
355 (16.88%)
|
42 (11.41%)
|
Secondary
|
1,234 (58.68%)
|
251 (68.21%)
|
Higher
|
435 (20.68%)
|
74 (20.11%)
|
Currently working
|
No
|
1,156 (29.54%)
|
116 (18.13%)
|
35.6156 (0.000)
|
Yes
|
2,757 (70.46%)
|
524 (81.88%)
|
Wealth index
|
Lowest
|
606 (15.49%)
|
69 (10.78%)
|
15.3653 (0.000)
|
Middle
|
988 (25.25%)
|
143 (22.34%)
|
Highest
|
2,319 (59.26%)
|
428 (66.88%)
|
Religion
|
Catholic
|
3,637 (92.95%)
|
627 (97.97%)
|
24.3400 (0.000)
|
Islam
|
87 (2.22%)
|
7 (1.09%)
|
Others
|
189 (4.83%)
|
6 (0.94%)
|
Type of place of residence
|
Urban
|
1,400 (35.78%)
|
247 (38.59%)
|
1.8886 (0.169)
|
Rural
|
2,513 (64.22%)
|
393 (61.41%)
|
Knowledge of contraceptive methods
|
No
|
780 (19.93%)
|
38 (5.94%)
|
73.1063 (0.000)
|
Yes
|
3,133 (80.07%)
|
602 (94.06%)
|
Woman’s desire for children
|
Wants no more children
|
937 (23.95%)
|
203 (31.72%)
|
17.7058 (0.000)
|
Wants more children
|
2,976 (76.05%)
|
437 (68.28%)
|
Husband’s desire for children
|
Wants no more children
|
937 (82.19%)
|
203 (17.81%)
|
17.7058 (0.000)
|
Wants more children
|
2976 (87.20%)
|
437 (12.80%)
|