A Multilevel Logit Estimation of Factors Associated With Modern Contraception in Urban Nigeria.

Abstract

This study aimed to estimate the multilevel determinants of modern contraceptive use among reproductive-age women living in six cities in Nigeria (Abuja, Benin, Ibadan, Ilorin, Kaduna, and Zaria). Data from cross-sectional surveys conducted between 2010 and 2011 were linked to provide information on five hierarchical levels of the Socioecological Framework. Multilevel logit models estimated the odds of modern contraceptive use among 9,473 non-pregnant married/cohabiting women aged 15–49 years living in 488 clusters. About 25 percent of the women reported using modern contraceptive methods at the time of survey. Individual-level factors found to have a positive association with modern contraceptive use were parity, family planning self-efficacy, and partner discussion about fertility desires while perception of negative attitudes from community member about contraceptive use was negatively associated with modern contraceptive use (p < 0.05). At the community level, media exposure to family planning messages and city of residence were significantly associated with modern contraceptive use in the studied sample (p < 0.05). The positive association between parity and modern contraceptive use was modified by the community's ideal family size. The results of this study support the evidence for multilevel interventions as a way to improve the prevalence of modern contraceptive use in urban Nigeria.