A vignette-based approach to understanding social norms around family planning in three Nigerian cities

ABSTRACT

Understanding the mechanisms through which social norms shape contraceptive use can help prevent unintended pregnancies in low-income countries. The Nigerian Urban Reproductive Health Initiative (NURHI) aimed to increase contraceptive uptake through advocacy, service delivery, and demand generation. Using data from focus group discussions, we examined whether social norms around family planning (FP), and specifically use of modern contraception (MC), varied among women and girls of reproductive age exposed to varying levels of the programme in three Nigerian cities. Injunctive social norms were generally unfavourable of unmarried adolescent girls’ use of MC, though participants often shared exceptions for certain types of adolescents whose use of MC would be acceptable. There was greater acceptability for MC use by women who wanted to space or limit pregnancies. Participants reported that norms around FP and MC use have become more accepting in their communities over time. Normative differences between cities were identified. Participants’ perceptions of religious leaders’ support for FP use may have contributed to positively influencing social norms.

KEYWORDS:

• Family planning
• social norms
• contraception
• Nigeria
• vignettes

Acknowledgements

The authors acknowledge the data collectors at the Centre for Population and Reproductive Health, University of Ibadan, and the study participants. Under the grant conditions of the Bill & Melinda Gates Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported, in whole or in part, by the Bill and Melinda Gates Foundation [OPP1161858]. We are also grateful to the Carolina Population Center and its NIH Center grant [P2C HD050924] for general support.