Barriers to Contraceptive Use among Married Young Adults in Nigeria: A Qualitative Study

Abstract

Aims: Nigeria’s contraceptive prevalence is one of the lowest in sub-Saharan Africa. The majority of married women in Nigeria is not currently using contraceptives and has no intention of doing so in the near future. This study was aimed at exploring the key cultural and societal perceptions, beliefs and practices that impede the uptake of contraceptives among young married Nigerians. Study Design: Focus group discussions (FGDs); qualitative. Place and Duration of Study: The study took place in thirteen locations across Nigeria’s six geo-political zones between July 2010 and September 2010. Methodology: This is a qualitative study based on 30 focus group discussions held across 13 states in Nigeria’s six geo-political zones. Thirteen cities and towns were purposively selected to reflect the main ethnic and geographical variations in Nigeria. Focus groups were stratified, after initial screening, into four main groups: males, females currently using contraceptives, females not currently using contraception but with no unmet need; and females with unmet need. Local ‘mobilizers’ were enlisted to help in the recruitment. Trained FGD moderators and note takers used a semi-structured FGD guide to hold discussions in English or local languages. Results: Compared with women, men have poorer knowledge of family planning. Women currently using family planning do so for two main reasons. The first is for economic reasons at the family level and the second is for health reasons. The greatest impediment to women’s contraceptive use is lack of support from husbands and other significant others as well as the absence of inter-spousal communication. Real and perceived fear of side effects is a major barrier. Rumours, myths and misinformation about contraceptives often have a strong negative impact on use. Conclusion: The study confirms that even among young couples, inter-spousal communication is poor and contraceptive use in Nigeria is unlikely to improve without addressing men’s apparent lack of interest and involvement in family planning.