Couple asymmetries and its impact on modern contraceptive use among young (15-24) married women in Nigeria

A dissertation submitted in partial fulfillment of the requirement for the award of Master of Arts in Demography and Population Studies, University of the Witwatersrand, 2017BACKGROUND: Nigeria has a very low level of modern contraceptive use; with resultant effects of high fertility, and maternal and child mortality. It is Africa’s most populated country, and with a rapid growth rate. Modern methods of contraception is a crucial strategy to reduce the high fertility rate, halt population growth, lessen child mortality, and enhance maternal health. This study aims to assess partner’s economic and demographic asymmetries as barriers contributing to the uptake of modern contraceptives among young married and cohabiting women aged 15-24 years in Nigeria. METHOD: This study used data from the Nigerian Demographic and Health Survey 2013, with a sample of 4,981 young (15 – 24 years) married and cohabiting women. The Health Belief Model was used to explain partner’s socio-economic and demographic differences as barriers to the utilisation of modern contraceptives. Frequency distributions and binomial logistic regression were carried out using STATA v12 to answer the research questions. RESULTS: Only 6% of young married and cohabiting women use modern contraceptives. In the unadjusted analyses, women who were in less homogamous unions were less likely to practise modern method contraception. Respondents younger than their partners by 6-10 years and respondents younger by 11 or more years were less likely to use modern contraceptives (UOR= 0.357, CI 0.135-0.943; UOR= 0.223, CI 0.084-0.595). Respondents whose partners want more children were less likely to use modern contraceptives while respondents whose partners want fewer number of children compared to them were more likely to use modern contraceptives (UOR= 0.325, CI 0.240-0.439; UOR= 1.812 CI 1.1082.963 respectively). However, these associations were no longer significant after adjusting for women’s age, highest level of education, place of residence, religion, and region of residence and other differences. CONCLUSION: This study concluded that socio-economic and demographic differences between married partners are not associated with young women's contraceptive use in Nigeria, after adjusting for women’s characteristics. Further studies, especially qualitative studies, are needed to understand this finding. Keywords: Modern contraceptives, young married women, partner asymmetries, Health Belief Model, NigeriaGR201