dc.description.abstract | The prevalence of modern contraceptive use still remains low in Nigeria with wide variations in
different geopolitical zones. While researchers have devoted considerable attention to the impact
of individual-level factors on contraceptive use, not much is known about how community
characteristics affect contraceptive use in married women. The objective of this study was to
assess the effects of community level variables on family planning use using a multilevel
modeling approach.
"'The study is based on data collected from Nigeria Demographic and Health Survey (NDHS)
2008. Random effects multilevel logistic regression analyses of 23479 married women of
reproductive age nested within 888 clusters was carried out to assess the role of selected
individual (socio demographic and other family planning related factor) and community level
factors (childbearing, wealth index, education, high parity, exposure to family planning
messages) in the use of modern contraceptives. The regression model was fitted to analyze the
variable using GLLAMM command in STATA-10. Level of significance was at 5% level.
The mean age of the women studied was 31.2 years (8.8), with about 72.6% in rural areas. Only
about 10% of married women were using a modern contraceptive method in 2008. In the
individual only model there was a significant higher odds of contraception among those with
exposure to family planning messages, secondary school or higher education, urban dwellers,
respondents in highest wealth quantile, those with fewer number of children, Christian
respondent, monogamous settings, southwest region, currently working respondents and those
between age group 20-29.In the community only model, the odds of modern contraceptive use
was higher among those in the upper wealth index (OR=1.55,CI=1.2-2.0), those with at least
primary school education (OR=9.67,CI=7.l-13.07) and those with an ideal family size of ≥4
children (OR=5.25,CI=3.29-8.37). In the model which included both individual and community level variables proportion of women with an ideal family size of :≥4 children(OR=2.02,CI=1.14-
3.58) and proportion with at least primary school education (OR=l.67,CI=l.05-2.92) remained
significant. Also significant variation in family planning use between communities remained
after adjusting for individual and community variables.
The community contraceptive use was lowest in communities with low level of education and
communities with ideal number of more than four children. Overall, the results of this study
suggest that the challenge to increase contraceptive use goes beyond addressing individual
factors, and requires a better understanding of contextual factors. Special attention needs to be
paid, in particular to the communities, while formulating family planning policies in Nigeria, for
better success rate of modern contraceptive use. | en_US |