Text box 1. Contributions to the literature | |
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• Research has shown how long-acting reversible contraceptives (LARCs) among women efficiently avert child and maternal adverse health outcomes. However, there is no specific study in Nigeria that has examined the use of LARCs among sexually active reproductive-age women using spatial analysis and multilevel analysis. • This study’s results showed an unequal distribution of LARC use across the regions in Nigeria. Cosmopolitan states were found to have low LARC utilisation. • Women with a prior history of pregnancy termination were less likely to use LARCs, indicating a need for closer investigation to understand context-specific factors associated with LARC use in these regions. |
Background
Method and materials
Data source
Variables
Outcome variable
Explanatory variables
Statistical analyses
Spatial analysis
Spatial autocorrelation analysis
Hot spot analysis (Getis-Ord Gi* statistic)
Spatial interpolation
Spatial scan statistical analysis
Multilevel analysis
Results
Socio-demographic characteristics of sexually active women of reproductive age currently using long-acting reversible contraceptives in Nigeria
Variables (n = 41,821) | Weighted frequency | Percent |
---|---|---|
Age | ||
15–24 | 424 | 10.66 |
25–34 | 1,757 | 44.17 |
35 and above | 1,797 | 45.17 |
Working status
| ||
No | 714 | 17.95 |
Yes | 3,264 | 82.05 |
Marital status
| ||
Never married | 187 | 4.68 |
Currently married | 3,791 | 95.32 |
Ever had terminated pregnancy
| ||
No | 3,360 | 84.47 |
Yes | 618 | 15.53 |
Educational level
| ||
No Education | 585 | 14.70 |
Primary | 699 | 32.28 |
Secondary & above | 2,694 | 67.72 |
Husband education level
| ||
No Education | 414 | 10.40 |
Primary | 527 | 13.24 |
Secondary & above | 3,037 | 76.36 |
Total children ever born
| ||
No child | 36 | 0.89 |
1–2 children | 1,043 | 26.23 |
3–4 children | 1,422 | 35.74 |
5 & above children | 1,477 | 37.14 |
Visited health facility last 12 months
| ||
No | 1,982 | 49.83 |
Yes | 1,996 | 50.17 |
Fertility preference
| ||
Want more | 2,087 | 52.46 |
Undecided | 289 | 7.26 |
Want no more | 1,602 | 40.28 |
Media
| ||
No | 588 | 14.78 |
Yes | 3,390 | 85.22 |
Religion
| ||
Christianity | 2,540 | 63.87 |
Islam | 1,431 | 35.99 |
Traditionalist & Others | 6 | 0.15 |
Ethnicity
| ||
Hausa | 708 | 17.80 |
Yoruba | 1,126 | 28.31 |
Igbo | 864 | 21.71 |
Others | 1,280 | 32.18 |
Residence
| ||
Urban | 2,526 | 63.52 |
Rural | 1,452 | 36.48 |
Wealth index
| ||
Poorest | 218 | 5.48 |
Poorer | 408 | 10.25 |
Middle | 657 | 16.53 |
Richer | 1,135 | 28.54 |
Richest | 1,559 | 39.20 |
Region
| ||
North central | 557 | 14.01 |
North east | 407 | 10.24 |
North west | 620 | 15.59 |
South east | 594 | 14.92 |
South-South | 494 | 12.41 |
South west | 1,306 | 32.83 |
Sex of household head
| ||
Male | 3,746 | 94.18 |
Female | 232 | 5.82 |
Community literacy level
| ||
Low | 1,246 | 31.33 |
Medium | 1,375 | 34.58 |
High | 1,356 | 34.09 |
Community socioeconomic status
| ||
Low | 1,426 | 5.86 |
Medium | 1,069 | 26.87 |
High | 1,483 | 37.28 |
Spatial distribution of long-acting contraceptive use among sexually active women of reproductive age in Nigeria
Spatial autocorrelations of long-acting reversible contraceptive use among women of reproductive age in Nigeria
Hotspot of long-acting reversible contraceptive use among women of reproductive age in Nigeria
Spatial interpolation of long-acting reversible contraceptive use among women of reproductive age in Nigeria
Multilevel analysis of factors associated with long-acting reversible contraceptive use among women of reproductive age in Nigeria
Variables | Model 0 | Model I AOR [95%CL] | Model II AOR [95%CL] | Model III AOR [95%CL] |
---|---|---|---|---|
Age | ||||
15–24 | 1 | 1 | ||
25–34 | 0.85(0.61–1.18) | 0.84(0.61–1.18) | ||
35 and above | 0.87(0.59–1.27) | 0.86(0.59–1.26) | ||
Working status | ||||
Yes | 1.28(1.00-1.64) | 1.28(1.00-1.63) | ||
No | 1 | 1 | ||
Marital status
| ||||
Never married | 1 | 1 | ||
Currently married | 1.08(0.69–1.68) | 0.98(0.63–1.52) | ||
Pregnancy termination
| ||||
Yes | 0.63(0.49–0.81) ** | 0.62(0.48–0.80) ** | ||
No | 1 | 1 | ||
Educational level
| ||||
No formal education | 1 | 1 | ||
Primary education | 1.37(0.99–1.90) | 1.37(0.99–1.90) | ||
Secondary education & above | 1.59(1.16–2.18) ** | 1.63(1.17–2.26) ** | ||
Husband education level
| ||||
No Education | 1 | 1 | ||
Primary | 0.94(0.64–1.38) | 0.95(0.65–1.39) | ||
Secondary education & above | 1.03(0.73–1.46) | 1.00(0.71–1.41) | ||
Total children ever born
| ||||
No child | 1 | 1 | ||
1–2 children | 9.66(1.18–78.7) | 9.47(1.17–76.5) | ||
3–4 children | 13.2(1.61–108.6) | 12.7(1.56–103.8) | ||
5 & above children | 15.4(1.86–127.5) | 14.8(1.80-121.8) | ||
visited health facility last 12 months
| ||||
no | 1 | 1 | ||
yes | 1.12(0.93 1.33) | 1.08(0.90–1.29) | ||
fertility preference
| ||||
want more | 1 | 1 | ||
Undecided | 1.46(1.01–2.09) | 1.48(1.04–2.12) | ||
want no more | 1.62(1.29–2.05) ** | 1.65(1.30–2.08) ** | ||
Media
| ||||
No | 1 | 1 | ||
Yes | 1.07(0.83–1.38) | 1.11(0.85–1.44) | ||
Religion
| ||||
Christianity | 1 | 1 | ||
Islam | 0.84(0.65–1.09) | 0.74(0.57–0.97) | ||
Traditionalist & Others | 1.65(0.36–7.57) | 2.50(0.56–10.9) | ||
Ethnicity
| ||||
Hausa | 1 | 1 | ||
Yoruba | 0.67(0.46–0.97) | 1.14(0.70–1.87) | ||
Igbo | 0.34(0.22–0.52) ** | 0.97(0.56–1.69) | ||
Others | 0.79(0.56–1.11) | 1.27(0.86–1.89) | ||
Household/Community level
| ||||
Residence
| ||||
Urban | 1 | 1 | ||
Rural | 0.82(0.64–1.04) | 0.77(0.60–0.98) | ||
Wealth index
| ||||
Poorest | 1 | 1 | ||
Poorer | 0.97(0.65–1.45) | 0.89(0.59–1.34) | ||
Average | 1.05(0.71–1.57) | 0.97(0.64–1.47) | ||
Richer | 1.05(0.69–1.60) | 0.99(0.63–1.55) | ||
Richest | 1.08(0.67–1.74) | 1.00(0.60–1.67) | ||
Geopolitical Zone
| ||||
North-Central | 1 | 1 | ||
North-East | 0.52(0.37–0.75) ** | 0.71(0.49–1.03) | ||
North-West | 1.21(0.86–1.69) | 2.07(1.36–3.16) ** | ||
South-East | 0.33(0.22–0.47) ** | 0.32(0.19–0.53) ** | ||
South-South | 0.63(0.44–0.90) | 0.56(0.38–0.81) ** | ||
South-West | 0.66(0.49–0.90) ** | 0.68(0.46-1.00) | ||
Sex of household head
| ||||
Male | 1 | 1 | ||
Female | 0.92(0.65–1.30) | 0.97(0.68–1.37) | ||
Community literacy level
| ||||
Low | 1 | 1 | ||
Medium | 1.12(0.86–1.47) | 0.99(0.75–1.31) | ||
High | 1.21(0.90–1.64) | 1.05(0.76–1.44) | ||
Community socioeconomic status
| ||||
Low | 1 | 1 | ||
Medium | 0.86(0.63–1.16) | 0.84(0.62–1.14) | ||
High | 0.64(0.44–0.94) | 0.66(0.45–0.97) * | ||
PSU Variance (95% CI) | 0.96[0.70–1.32] | 0.84[0.59–1.19] | 0.71[0.49–1.04] | 0.67[0.45–0.99] |
ICC | 0.23 | 0.20 | 0.18 | 0.17 |
LR Test | χ2 = 108.17 p < 0.001 | χ2 = 80.24, p < 0.001 | χ2 = 62.96, p < 0.001 | χ2 = 53.19, p < 0.001 |
Wald χ2 | Reference | 114.52*** | 62.79*** | 165.05*** |
Model fitness
| ||||
Log-likelihood | -2075.31 | -2010.97 | -2044.33 | -1982.74 |
AIC | 4154.62 | 4067.93 | 4122.66 | 4041.48 |
Number of clusters | 1042 | 1042 | 1042 | 1042 |