Spatial pattern and determinants of unmet need of family planning in Nigeria

Abstract

Background: Nigeria still grapples with low family planning (FP) use and a high fertility rate. This study explores the factors associated with the unmet need for FP and the coldspots of unmet need for FP in Nigeria.

Methods: The 2013 Nigerian Demographic Health Survey (NDHS) data was used to investigate the unmet need for FP in Nigeria. A geo-additive model was specified to simultaneously measure the fixed, nonlinear, spatial and random effects inherent in the data. The fixed effect of categorical covariates was modelled using the diffuse prior, the nonlinear effect of continuous variable was modelled using the P-spline with second-order random walk, the spatial effects followed Markov random field priors while the exchangeable normal priors were used for the random effect of the community. The binomial distribution was used to handle the dichotomous nature of the dependent variable.

Results: North East (OR: 1.8404, CI: 1.6170, 2.0941), North West (OR: 1.1145, CI: 1.1454, 1.1789), primary education (OR: 1.0441, CI: 0.9680, 1.1286), Hausa (OR: 2.7031, CI: 2.3037, 3.1513), birth interval greater than 12 months (OR: 1.0909, CI: 1.0447, 1.1379), community (OR: 1.6733, CI: 1.5261, 1.7899) and states (OR: 6.0879, CI: 2.5995, 29.6274) significantly increased the unmet need for FP.

Conclusion: The unmet need for FP in Nigeria is positively associated with the Northern region, low level of education and birth interval.

Keywords:

• Bayesian inference
• binomial
• family planning
• geo-additive model
• Nigeria

Acknowledgements

The authors appreciate the permission granted by http://www.measuredhs.com (cited July 2014) to use the Nigerian Demographic Health Survey (NDHS) 2013 data. Acknowledgement also goes to Dr Johnson F. Ajayi for his invaluable feedback on an earlier version of this paper.

Notes

1. Unmet need for FP as a woman who is fecund, sexually active, not using any contraceptive methods, and does not want a child for at least two years (‘spacers’) or does not want more children at all (‘limiters’) (USAID 2006).