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Need and Use of FP A secondary analysis of the 2008 Nigeria DHS

Need and Use of FP A secondary analysis of the 2008 Nigeria DHS. Nigerian Urban Reproductive Health Initiative. Goal : In 5 years, increase the contraceptive prevalence rate (CPR) by 20 percentage points in six selected cities in Nigeria Three approaches for increasing CPR

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Need and Use of FP A secondary analysis of the 2008 Nigeria DHS

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  1. Need and Use of FPA secondary analysis of the 2008 Nigeria DHS

  2. Nigerian Urban Reproductive Health Initiative • Goal: In 5 years, increase the contraceptive prevalence rate (CPR) by 20 percentage points in six selected cities in Nigeria • Three approaches for increasing CPR • Increase the proportion of women that want to delay or limit childbearing • Convert unmet need to met need for FP • Reduce method discontinuation

  3. Need for, and use of, FP among sexually active, non-menopausal women, 2008 NDHS

  4. Conceptual Approach to Analysis EDUCATION EXPOSURE TO FP MESSAGES QUALITY OF FP COUNSELING DISTAL FACTORS Poverty Cultural norms PROXIMATE FACTORS Desired family size Female autonomy Gender preference Knowledge OUTCOMES Need for FP Use of FP Duration of use of FP

  5. Do proximate factors affect outcomes? EDUCATION EXPOSURE TO FP MESSAGES QUALITY OF FP COUNSELING DISTAL FACTORS Poverty Cultural norms PROXIMATE FACTORS Desired family size Female autonomy Gender Preference Knowledge OUTCOMES Need for FP Use of FP Duration of use of FP

  6. Percent of sexually active, non-menopausal urban women with a stated need for FP, by proximate factors Source: 2008 Nigeria DHS Adjusting for Age and Parity P-values: *p<0.05; **p<0.01; ***p<0.001

  7. Percent of urban women with a need for FP currently using a modern FP method, by proximate factors Source: 2008 Nigeria DHS Adjusting for Age and Parity P-values: *p<0.05; **p<0.01; ***p<0.001

  8. Percent of urban women currently using a modern method for at least 2 years, by proximate factors Source: 2008 Nigeria DHS Adjusting for Age and Parity P-values: *p<0.05; **p<0.01; ***p<0.001

  9. Summary • These analyses suggest which factors you may consider when seeking to increase contraceptive use among urban women in general. • Both ideal family size and FP knowledge are important for both need for, and use of, FP • HH decision-making may affect need for FP but does not appear to effect use. • These analyses do not support the role of gender preference in FP decisions.

  10. Do distal factors affect the outcomes through the proximate factors? EDUCATION EXPOSURE TO FP MESSAGES QUALITY OF FP COUNSELING DISTAL FACTORS Poverty Cultural norms PROXIMATE FACTORS Desired family size Female autonomy Gender preference Knowledge OUTCOMES Need for FP Use of FP Duration of use of FP

  11. Percent of urban women with favorable proximate factors, by wealth status Source: 2008 Nigeria DHS P-values: *p<0.05; **p<0.01; ***p<0.001

  12. Percent of urban women with favorable proximate factors, by religion and region of residence Source: 2008 Nigeria DHS P-values: *p<0.05; **p<0.01; ***p<0.001

  13. Direct and Indirect effects of Distal Factors on Need for FP Source: 2008 Nigeria DHS * Significantly different from 0

  14. Direct and Indirect effects of Distal Factors on Current use of a modern method Source: 2008 Nigeria DHS * Significantly different from 0

  15. Direct and Indirect effects of Distal Factors on use of a modern method for 2 or more years Source: 2008 Nigeria DHS * Significantly different from 0

  16. Summary • The analyses in this section suggest which factors you may consider when seeking to increase contraceptive use among wealth or cultural groupings. • To increase need for FP among urban poor or muslim women in the North, focus on decreasing ideal family size • To increase use of FP, among urban poor or muslim women in the North, focus on increasing knowledge of FP. • However, many other factors exist that are unmeasured in these data. • Wealth status and cultural norms do not have a strong effect on duration, once a woman adopts FP.

  17. Does education and exposure moderate the effect of the distal factors on the proximate factors? EDUCATION EXPOSURE TO FP MESSAGES QUALITY OF FP COUNSELING DISTAL FACTORS Poverty Cultural norms PROXIMATE FACTORS Desired family size Female autonomy Son preference Knowledge OUTCOMES Need for FP Use of FP Duration of use of FP

  18. Percent of urban women with favorable proximate factors, by wealth status and exposure to FP messages Source: 2008 Nigeria DHS P-values: *p<0.05; **p<0.01; ***p<0.001

  19. Percent of urban women with favorable proximate factors, by religion and exposure to FP messages Source: 2008 Nigeria DHS P-values: *p<0.05; **p<0.01; ***p<0.001

  20. Percent of urban women with favorable proximate factors, by region and exposure to FP messages Source: 2008 Nigeria DHS P-values: *p<0.05; **p<0.01; ***p<0.001

  21. Summary • The analyses in this section suggest that exposure to FP messages can have an effect on FP knowledge and possibly household decision-making. • Given the importance of fertility preferences in the preceding analyses, it is important to learn whether prior messages sought to decrease ideal family size (and failed) or did not target this factor.

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