Abstract
Background: Low contraceptive use among women in Niger is one of main causes of early childbearing and unwanted pregnancies, which affect maternal and child health. Education and place of residence have been cited as factors affecting modern contraceptive use. Methods: We investigated the separate and joint effects of the place of residence and education on the time to modern contraceptive uptake among women aged 15-24 in Niger. The study used data from the second round of the 2016 Niger Performance Monitoring and Accountability 2020 (PMA2020) project. Survival analysis was applied for 830 women. Results: Nelson-Aalen curves show that urban women had higher hazards of (and shorter delays in) modern contraceptive uptake as compared to their rural counterparts. Also, the higher the level of education, the higher the hazards of (and the shorter the delays in) modern contraceptive uptake. Findings from the multivariate (survival) analysis confirms these figures and provides the net effect of the place of residence on modern contraceptive uptake. Whether living in urban or rural areas of Niger, what matters more is the level of education. Conclusions: Family planning programmes concerning adolescent and young women should focus more on women with no education and those that are illiterate.
Highlights
Niger presents worrying characteristics for youth sexual reproductive health
The hazard ratio (HR) of modern contraceptive uptake was higher among women with primary education (HR = 1.80, p < 0.01, 95% CI: 1.20–2.72) and women with at least secondary education (HR = 2.30, p < 0.01, 95% CI: 1.43–3.70) compared with their peers with no education
Findings from the analysis show that residing in urban areas, having a high educational level and living in the richest wealthy tertile are associated with higher hazard rates of and shorter delays in modern contraceptive uptake
Summary
Niger presents worrying characteristics for youth sexual reproductive health. The country has the highest fertility rate as well as the lowest age for marriage and childbearing in Africa and the world (Barroy et al, 2015). The maternal mortality rate in Niger was 553 per 100,000 live births in 2015 (Roser & Ritchie, 2019b) and the under-five mortality rate was 84.5 deaths per 1,000 live births in 2017 (Roser, 2019a) These figures reflect the poor health of both mother and child in Niger. Low contraceptive use among women in Niger is one of main causes of early childbearing and unwanted pregnancies, which affect maternal and child health. Methods: We investigated the separate and joint effects of the place of residence and education on the time to modern contraceptive uptake among women aged 15-24 in Niger. Findings from the multivariate (survival) analysis confirms these figures and provides the net effect of the place of residence on modern contraceptive uptake. Conclusions: Family planning programmes concerning adolescent and young women should focus more on women with no education and those that are illiterate
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