Barriers and enablers of modern contraceptive use among adolescent girls and young women in Nigeria: evidence from a multilevel mixed effect analysis
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20262225Keywords:
Adolescent girls and young women, Barriers, Enablers, Modern Contraceptive, Multilevel Mixed Effect analysis, Nigeria, EvidenceAbstract
Background: Modern contraceptive use among adolescent girls and young women in Nigeria remains low despite persistent high fertility and early childbearing. Understanding the ecological factors shaping contraceptive uptake is essential for addressing unmet needs and improving reproductive health outcomes.
Methods: This study analyzed data from the 2018 Nigeria Demographic and Health Survey (NDHS), including 8,825 adolescent girls and young women aged 15–24 years. Weighted descriptive statistics were used to examine the characteristics. Multilevel logistic regression models were fitted to assess individual, household and community predictors of modern contraceptive use, accounting for clustering at the primary sampling unit level.
Results: The prevalence of modern contraceptive use was 9.1%. Uptake was significantly higher among young women aged 20–24 years, those with secondary or higher education, unmarried respondents and higher wealth quintiles. Conversely, Muslim affiliation and Hausa ethnicity were associated with lower use compared to Catholic and other ethnic groups. Fertility factors such as parity and desire for more children were important determinants: women with higher parity and those desiring no more children reported greater use. Community-level influences persisted, with rural residence and northern regional location associated with lower contraceptive uptake.
Conclusions: Modern contraceptive use among Nigerian adolescents and young women is shaped by intersecting individual, socioeconomic and community factors. Addressing cultural and religious barriers, reducing regional inequities and strengthening youth-friendly reproductive health services are critical for improving uptake. Tailored interventions targeting younger, less educated, rural and socioeconomically disadvantaged women are urgently needed to reduce unmet need Nigeria.
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