Unmet need for family planning and barriers to contraceptive use in Kaduna, Nigeria: culture, myths and perceptions

In 2017, just one-fifth of all married women of reproductive age reported using contraception in Kaduna state, Nigeria, while many more experienced unmet need for contraception. These realities drive risky fertility behaviours and compromise reproductive rights. This study explored the determinants...

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Bibliographic Details
Published in:Culture, health & sexuality health & sexuality, 2020-11, Vol.22 (11), p.1253-1268
Main Authors: Sinai, Irit, Omoluabi, Elizabeth, Jimoh, Adenike, Jurczynska, Kaja
Format: Article
Language:English
Subjects:
Access
Birth control
Contraceptives
Family planning
Fertility
Folklore
Kaduna
Marriage
misconceptions
Northern Nigeria
Permission
Personal expenditure
Religious leaders
Reproductive rights
Social change
Stigma
unmet need
Uptake
Wives
Women
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Summary:In 2017, just one-fifth of all married women of reproductive age reported using contraception in Kaduna state, Nigeria, while many more experienced unmet need for contraception. These realities drive risky fertility behaviours and compromise reproductive rights. This study explored the determinants of low modern contraceptive uptake and persistent unmet need among women in the state. Nine focus group discussions were conducted with married women who met study criteria for unmet need, and who had different levels of access to contraception. Discussions confirmed that many women in Kaduna do not feel empowered to make contraceptive decisions. Yet there is a growing preference for smaller families and decreased stigmatisation of contracepting women. Barriers at home, in the community and in health facilities impose a ceiling on the extent to which women's fertility desires may be achieved. These include cultural, normative, social and financial factors, such as the need for husband's permission to access services, service providers' insistence on spousal consent, subtle and overt pressures to use folkloric approaches by religious leaders, and high real, or perceived, out-of-pocket costs. These findings suggest that Kaduna is on the cusp of social change and study findings can be translated into programmatic interventions to improve voluntary uptake of contraception.
ISSN:1369-1058
1464-5351
DOI:10.1080/13691058.2019.1672894