Background: Reducing unintended pregnancies among adolescents and youth ages 15-24 would lower global maternal mortality rates and improve health and well-being opportunities for young women. Despite calls to increase contraceptive use among this population, large gaps still exist, creating an unmet need for family planning. Past research has focused on barriers to seeking a method. There is less understanding of the types of methods young women want and who and what influences these decisions. This study examines what method characteristics young Nigerian women prioritize when choosing a method to inform future family planning programming.
Methods: In 2018, eight focus group discussions (FGD) were conducted in the Nigerian cities of Ilorin and Jos with 83 young women ages 15-24. The discussion guide utilized a vignette structure to understand the participants’ perceptions of social norms on contraceptive behavior. The FGDs were undertaken by members of the University of Ibadan Centre for Population and Reproductive Health (CPRH) and analyzed by researchers at the University of North Carolina-Chapel Hill’s Carolina Population Center. A thematic analysis was performed on the transcripts with the objective of identifying what and who influence the type of contraceptive methods young women are choosing.
Results: The method characteristics associated with young women’s contraceptive decisions include: side effects, reliability, length of coverage, privacy, cost, and accessibility. Side effects, reliability, and privacy were described as negatively linked to short-acting methods whereas easy accessibility and low cost were positive characteristics of these methods. Long-acting methods were generally viewed as positive. That said, the results find that the characteristics prioritized by individuals change throughout their adolescence. Providers, peers, parents, and partners were all found to have an influence over method choice in different ways. The role of these influencers also changes over the adolescent years. \
Conclusion: This study demonstrates that programs should prioritize expanding method choice to increase the number of available options to ensure all young women can access a method that fits their desired method characteristics. Programming should ensure that medically accurate information is widely distributed to harness providers, peers, parents and partners as a resource for information about specific methods.