Abstract
BackgroundStudies have shown that motivation to avoid pregnancy is associated with contraceptive use and continuation. These motivations can change, however, even within a short period of time. This paper uses longitudinal data to look at women’s motivation to avoid pregnancy at two time points, and how changes in motivation influence contraceptive continuation.MethodsData for this analysis came from an evaluation of the IntegratE project which seeks to expand access to family planning (FP) in Nigeria through community pharmacies and drug shops. 491 women were interviewed within 10 days after receiving a FP service from these sources and again approximately 9 months later. The dependent variable was contraceptive continuation at the follow-up interview. A categorical independent variable was used to represent changes in motivation to avoid pregnancy from enrollment to the follow-up interview. Univariate and multivariate logistic regression models were used to assess the association between changes in motivation and contraceptive continuation.Results89% of women continued using contraception approximately 9 months after the enrollment interview. Women who remained highly motivated to avoid pregnancy were significantly more likely to continue using contraception compared to women who became more motivated (AOR 2.5; 95% CI 1.0–6.0). Women who became less motivated were 64% less likely to continue using contraception compared to who became more motivated (AOR 0.36 95% CI 0.1–0.9).ConclusionFP providers, including private sector pharmacists and drug shop owners, should continuously check-in with women about their motivations around pregnancy to support continuation among those who wish to avoid pregnancy.
Highlights
Studies have shown that motivation to avoid pregnancy is associated with contraceptive use and continuation
This paper looks at whether changes in motivation to avoid pregnancy are associated with continued use of contraception in Nigeria
We used data from a larger evaluation of the IntegratE project which seeks to expand access to family planning (FP) in Nigeria through community pharmacies and drug shops. 491 women were interviewed within 10 days after receiving a FP service from these sources and again 9 months later
Summary
Studies have shown that motivation to avoid pregnancy is associated with contraceptive use and continuation. These motivations can change, even within a short period of time. Studies have identified non-method related factors associated with contraceptive continuation These factors include experiencing an unintended pregnancy, having partner’s support, being older in age, achieving a desired number of children, higher number of living children, higher number of male children, being in school or working, and discussing FP with a friend [6, 7, 9, 11,12,13]. A longitudinal study in India has found that among women who reported wanting a child in two or more years, only 5% of those women consistently reported that preference during subsequent interviews [17]
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