Examining Contraceptive Ideational Disparities Among Adolescents and Young Women in Nigeria

Download Article

DOI: 10.21522/TIJPH.2013.11.04.Art031

Authors : Oluwayemisi Ishola, Amitabye Luximon-Ramma, Lekan Ajijola

Abstract:

Nigeria faces a demographic challenge with a growing youth population and increasing fertility rate. However, the use of modern contraceptives among adolescent girls and young women has been declining. The young population emerges as a pivotal group in the country’s efforts to achieving the pledge of 27% modern contraceptive rate by the year 2030. This study aims to explore the disparities in contraceptive ideation among adolescents and young women in Nigeria, focusing on the role of ideational factors. The data for this study were collected through a cross-sectional household survey in four Nigerian states, involving 2,857 sexually active women aged 15-24 years. Using an ideational framework of behavior that highlights psychosocial influences, nine distinct ideational variables were examined. Multivariate logistic regression analyses were used to assess associations between ideational factors and contraceptive use among the total sample, adolescents, and youth. Statistical significance was defined as P<0.05. The study’s results revealed significant associations between the ideational variables and contraceptive use in all groups, ranging from p < .05 to p < .001. Cognitive and emotional domains were found to be the strongest predictors of contraceptive use compared to social domains in the general sample and among both groups. This study’s findings highlight the complex interplay of social, cognitive, and emotional factors in contraceptive use. Understanding these dynamics is crucial in developing effective strategies to overcome barriers and improve access to contraceptive services among young women in Nigeria.

Keywords: Adolescents, Contraception, Ideation, Youth.

References:

[1] United Nations. (2022). World Population Prospects 2022. Retrieved from UN: https://population.un.org/wpp/Graphs/DemographicProfiles/Pyramid/566.

[2] Olowolafe, T. A., Adebowale, A. S., Fagbamigbe, A. F., Bolarinwa, O. A., & Akinyemi, J. O. (2023). Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018. PloS one, 18(1), e0279365. https://doi.org/10.1371/journal.pone.0279365.

[3] National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

[4] Mandal, M., Calhoun, L., McGuire, C., & Speizer, I. (2022). Using structural equation modeling to examine the influence of family planning social norms on modern contraceptive use in Nigeria. Front. Social, 7. https://doi.org/10.3389/fsoc.2022.866254.

[5] OlaOlorun, F. M., Hindin, M. J., & Akinlo, A. D. (2014). Intention to use contraceptives and subsequent contraceptive behavior in Nigeria: does facility-level access matter?. Open Access Journal of Contraception, 5, 1-8.

[6] Babalola, S., John, N., Ajao, B., & Speizer, I. (2015). Ideation and intention to use contraceptives in Kenya and Nigeria. Demographic research, 33, 211-242. doi: 10.4054/DemRes.2015.33.8.

[7] Babalola S. (2017). Changes in Ideational Profiles of Women of Reproductive Age in Urban Nigeria: The Role of Health Communication. Health education & behavior : the official publication of the Society for Public Health Education, 44(6), 907–917. https://doi.org/10.1177/1090198117699510.

[8] Ezenwaka, U., Ibekwe, P. C., & Anozie, C. (2020). A qualitative study of ecological factors constraining adolescent’s access to contraception in southeast Nigeria. BMC public health, 20(1), 1-14. doi: 10.1186/s12889-020-09533-5.

[9] Health Communication Capacity Collaborative (HC3). (2014). Ideation: An HCS Research Primer. Baltimore, MD: HC3, Johns Hopkins Center for Communication Programs. https://healthcommcapacity.org/hc3resources/ideation-hc3-research-primer/.

[10] Sobotka, T., Zeman, K., & Kantorová, V. (2003). Demographic shifts in the Czech Republic after 1989: A second demographic transition view. European Journal of Population/Revue européenne de démographie, 19(3), 249–277. https://doi.org/10.1023/A:1024913321935.

[11] Leroy-Beaulieu. (1896). Traité Théorique et Pratique d’ Économie Politique. Paris: Librairie Guillaumin et Cie.

[12] Okigbo CC, Speizer IS, Domino ME, Curtis SL, Halpern CT, Fotso JC. (2018) Gender norms and modern contraceptive use in urban Nigeria: A multilevel longitudinal study. BMC Womens Health. Oct 29;18(1).

[13] Adedini SA, Babalola S, Ibeawuchi C, Omotoso O, Akiode A, Odeku M.(2018). Role of religious leaders in promoting contraceptive use in Nigeria: Evidence from the Nigerian Urban reproductive health initiative. Glob Heal Sci Pract. Oct 1;6(3):500–14.

[14] Moreira L.R, Ewerling F, Barros A.J.D, Silveira M.F. (2019). Reasons for nonuse of contraceptive methods by women with demand for contraception not satisfied: An assessment of low and middle-income countries using demographic and health surveys. Reprod Health [Internet]. Available from: https://reproductive-healthjournal.biomedcentral.com/articles/10.1186/s12978-019-0805-7.

[15] Fayehun F. (2017). Contraceptive use in Nigeria is incredibly low. A lack of knowledge may be why [Internet]. The conversation. Available from: https://theconversation.com/contraceptive-use-in-nigeria-is-incredibly-low-a-lack-of knowledge-may-be-why-81453.

[16] Gueye A, Speizer IS, Corroon M, Okigbo CC. (2015). Belief in family planning myths at the individual and community levels and modern contraceptive use in Urban Africa. Int Perspect Sex Reprod Health [Internet].

[17] Zavala, A. R., Palma, S. M., & Kollath-Cattano, C. L. (2020). The role of communication in contraceptive use among Hispanic young adults: A mixed-methods study. BMC Public Health, 20(1), 1-12. https://doi.org/10.1186/s12889-020-09312-5.

[18] Khadduri, R., Reece, M., Barakat, S., & Berenson, A. (2019). Examining the relationship between sexual communication and contraceptive use in young women. Journal of Women’s Health, 28(7), 940-947. https://doi.org/10.1089/jwh.2018.7139.

[19] Boyle, C., & Conrad, M. (2020). Communication about contraception and sexual risk behaviors among college students. Journal of American College Health, 68(7), 700-708. https://doi.org/10.1080/07448481.2019.1664399.

[20] Tschann, J. M., & Adler, N. E. (1997). Sexual self-acceptance, communication with partner, and contraceptive use among adolescent females: a longitudinal study. Journal of research on adolescence: the official journal of the Society for Research on Adolescence, 7(4), 413-430.

[21] Kincaid, D. L. (2000). Mass Media, Ideation, and Behavior: A Longitudinal Analysis of Contraceptive Change in the Philippines. Communication Research, 27(6), 723–763. https://doi.org/10.1177/009365000027006003.

[22] Arisukwu, O., Igbolekwu, C.O., Efugha, I., Nwogu, J., Osueke, N., & Eyitayo, O. (2021). Knowledge and Perception of Emergency Contraceptives Among Adolescent Girls in Imo State, Nigeria. Sexuality & Culture 24, 273–290. https://doi.org/10.1007/s12119-019-09639-x.

[23] Calhoun, L. M., Mirzoyants, A., Thuku, S., Benova, L., Delvaux, T., van den Akker, T., McGuire, C., Onyango, B., & Speizer, I. S. (2022). Perceptions of peer contraceptive use and its influence on contraceptive method use and choice among young women and men in Kenya: a quantitative cross-sectional study. Reproductive health, 19(1), 16. https://doi.org/10.1186/s12978-022-01331-y.

[24] Ochako, R., Mbondo, M., Aloo, S., Kaimenyi, S., Thompson, R., Temmerman, M., & Kays, M. (2015). Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC public health, 15, 118. https://doi.org/10.1186/s12889-015-1483-1.

[25] Agyemang, J., Newton, S., & Danso, K. A. (2019). Determinants of modern contraceptive use among teenagers in Ghana: Analysis of the 2014 Ghana Demographic and Health Survey. Journal of Public Health in Africa, 10(2), 949. doi: 10.4081/jphia.2019.949.

[26] Shahabuddin, A. S., Nöstlinger, C., Delvaux, T., Sarker, M., Bardají, A., Brouwere, V. D., & Broerse, J. E. (2016). What Influences Adolescent Girls’ Decision-Making Regarding Contraceptive Methods Use and Childbearing? A Qualitative Exploratory Study in Rangpur District, Bangladesh. PloS one, 11(6), e0157664. https://doi.org/10.1371/journal.pone.0157664.


[27] Crawford, E. E., Atchison, C. J., Ajayi, Y. P., & Doyle, A. M. (2021). Modern contraceptive use among unmarried girls aged 15-19 years in South Western Nigeria: results from a cross-sectional baseline survey for the Adolescent 360 (A360) impact evaluation. Reproductive health, 18(1), 6. https://doi.org/10.1186/s12978-020-01056-w.

[28] Fehintola, F., Okoro, N., Adedibu, D., Adeniyi, K.D., Adeniyi, C., & Folorunso, O. (2022). Predictors of Willingness to Use Modern Contraceptives among female undergraduate students in a tertiary institution in Nigeria: The Health Belief Approach. Journal of Community Medicine and Primary Health Care, 34(3). DOI: 10.4314/jcmphc.v34i3.12.

[29] Boamah-Kaali, E. A., Ruiter, R. A. C., Owusu-Agyei, S., Asante, K. P., & Mevissen, F. E. F. (2023). Social-psychological determinants of hormonal contraceptive use intentions among adolescent girls in the Bono East Region of Ghana. Frontiers in public health, 11, 1110112. https://doi.org/10.3389/fpubh.2023.1110112.

[30] Agha, S., Morgan, B., Archer, H., Paul, S., Babigumira, J. B., & Guthrie, B. L. (2021). Understanding how social norms affect modern contraceptive use. BMC public health, 21(1), 1061. https://doi.org/10.1186/s12889-021-11110-2.

[31] Sanchez, E. K., Speizer, I. S., Tolley, E., Calhoun, L. M., Barrington, C., & Olumide, A. O. (2020). Influences on seeking a contraceptive method among adolescent women in three cities in Nigeria. Reproductive health, 17(1), 167. https://doi.org/10.1186/s12978-020-01019-1.

[32] Challa, S., Shakya, H. B., Carter, N., Boyce, S. C., Brooks, M. I., Aliou, S., & Silverman, J. G. (2020). Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger. Plos one, 15(8), e0237512. https://doi.org/10.1371/journal.pone.0237512.