Dataset Information

State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

ABSTRACT: According to the 2014 World Population Data Sheet, Nigeria has one of the highest fertility and lowest contraceptive prevalence rates around the world. However, research suggests that national contraceptive prevalence rate overshadows enormous spatial variations in reproductive behavior in the country.I examined the variations in women's socioeconomic status and modern contraceptive use across states in Nigeria.Using the 2013 Nigeria Demographic and Health Survey data (n = 18,910), I estimated the odds of modern contraceptive use among sexually active married and cohabiting women in a series of multilevel logistic regression models.The share of sexually active, married and cohabiting women using modern contraceptives widely varied, from less than one percent in Kano, Yobe, and Jigawa states, to 40 percent in Osun state. Most of the states with low contraceptive prevalence rates also ranked low on women's socioeconomic attributes. Results of multilevel logistic regression analyses showed that women residing in states with greater shares of women with secondary or higher education, higher female labor force participation rates, and more women with health care decision-making power, had significantly higher odds of using modern contraceptives. Differences in women's participation in health care decisions across states remained significantly associated with modern contraceptive use, net of individual-level socioeconomic status and other covariates of modern contraceptive use.Understanding of state variations in contraceptive use is crucial to the design and implementation of family planning programs. The findings reinforce the need for state-specific family planning programs in Nigeria.

SUBMITTER: Lamidi EO

PROVIDER: S-EPMC4530895 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

Lamidi Esther O EO

PloS one 20150810 8

<h4>Background</h4>According to the 2014 World Population Data Sheet, Nigeria has one of the highest fertility and lowest contraceptive prevalence rates around the world. However, research suggests that national contraceptive prevalence rate overshadows enormous spatial variations in reproductive behavior in the country.<h4>Objective</h4>I examined the variations in women's socioeconomic status and modern contraceptive use across states in Nigeria.<h4>Methods</h4>Using the 2013 Nigeria Demograph ...[more]

PMID: 26258578

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Project description:ImportanceDigital breast tomosynthesis (DBT) has reduced recall and increased cancer detection compared with digital mammography (DM), depending on women's age and breast density. Whether DBT screening access and use are equitable across groups of women based on race/ethnicity and socioeconomic characteristics is uncertain.ObjectiveTo determine women's access to and use of DBT screening based on race/ethnicity, educational attainment, and income.Design, setting, and participantsThis cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, at which a total of 2 313 118 screening examinations were performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 13, 2019, to August 18, 2020.ExposuresWomen's race/ethnicity, educational level, and community-level household income.Main outcomes and measuresAccess to DBT (on-site access) at time of screening by examination year and actual use of DBT vs DM screening by years since facility-level DBT adoption (≤5 years).ResultsAmong the 2 313 118 screening examinations included in the analysis, the proportion of women who had DBT access at the time of their screening appointment increased from 11 558 of 354 107 (3.3%) in 2011 to 194 842 of 235 972 (82.6%) in 2017. In 2012, compared with White women, Black (relative risk [RR], 0.05; 95% CI, 0.03-0.11), Asian American (RR, 0.28; 95% CI, 0.11-0.75), and Hispanic (RR, 0.38; 95% CI, 0.18-0.80) women had significantly less DBT access, and women with less than a high school education had lower DBT access compared with college graduates (RR, 0.18; 95% CI, 0.10-0.32). Among women attending facilities with both DM and DBT available at the time of screening, Black women experienced lower DBT use compared with White women attending the same facility (RRs, 0.83 [95% CI, 0.82-0.85] to 0.98 [95% CI, 0.97-0.99]); women with lower educational level experienced lower DBT use (RRs, 0.79 [95% CI, 0.74-0.84] to 0.88 [95% CI, 0.85-0.91] for non-high school graduates and 0.90 [95% CI, 0.89-0.92] to 0.96 [95% CI, 0.93-0.99] for high school graduates vs college graduates); and women within the lowest income quartile experienced lower DBT use vs women in the highest income quartile (RRs, 0.89 [95% CI, 0.87-0.91] to 0.99 [95% CI, 0.98-1.00]) regardless of the number of years after facility-level DBT adoption.Conclusions and relevanceIn this cross-sectional study, women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use when available over time. Future efforts should address racial/ethnic, educational, and financial barriers to DBT screening.

Project description:BackgroundEvidence suggests that gender equality positively influences family planning. However, the evidence from urban Africa is sparse. This study aimed to examine the association between changes in gender norms and modern contraceptive use over time among women in urban Nigeria.MethodsData were collected in 2010/2011 from 16,118 women aged 15-49 living in six cities in Nigeria (Abuja, Benin, Ibadan, Ilorin, Kaduna, and Zaria) and again in 2014 from 10,672 of the same women (34% attrition rate). The analytical sample included 9933 women living in 480 neighborhoods. A four-category outcome variable measured their change in modern contraceptive use within the study period. The exposure variables measured the changes in the level of gender-equitable attitudes towards: a) wife beating; b) household decision-making; c) couples' family planning decisions; and d) family planning self-efficacy. Multilevel multinomial logistic regression models estimated the associations between the exposure variables at the individual and neighborhood levels and modern contraceptive use controlling for the women's age, education, marital status, religion, parity, household wealth, and city of residence.ResultsThe proportion of women who reported current use of modern contraceptive methods increased from 21 to 32% during the four-year study period. At both surveys, 58% of the women did not report using modern contraceptives while 11% reported using modern contraceptives; 21% did not use in 2010/2011 but started using by 2014 while 10% used in 2010/2011 but discontinued use by 2014. A positive change in the gender-equitable attitudes towards household decision-making, couples' family planning decisions, and family planning self-efficacy at the individual and neighborhood levels were associated with increased relative probability of modern contraceptive use (adoption and continued use) and decreased relative probability of modern contraceptive discontinuation by 2014. No such associations were found between the individual and neighborhood attitudes towards wife beating and modern contraceptive use. Accounting for the individual and neighborhood gender-equitable attitudes and controlling for the women's demographic characteristics accounted for 55-61% of the variation between neighborhoods in the change in modern contraceptive use during the study period.ConclusionInterventions that promote gender equality have the potential to increase modern contraceptive use in Nigerian cities.

Project description:Women's empowerment has been identified as an important strategy for improving children's nutrition outcomes in many settings. Empowerment indexes that are built from cross-country routine surveys are increasingly being developed, and further disaggregated analyses of such indexes are needed to examine in-depth, the relationship between women's empowerment and outcomes including children's nutrition. The Demographic and Health Surveys across five countries in South-Central Asia was used to examine the relationship between women's empowerment and children's nutrition outcomes. Empowerment was measured using the three domains (attitude to violence, social independence, and decision-making) in the Survey-based Women's emPowERment (SWPER) index. Main and interaction effects between the SWPER domains and women's wealth index were examined to check if there is a differential positive impact of empowerment for poorer women on children's nutrition outcomes. Outcome measures were children's height-for-age, weight-for-age, and weight-for-height z-scores. Marginal effects of logistic regression and OLS were used to examine main effects and linear probability models and OLS for interaction effects. Analyses were cluster-adjusted, sample-weighted, and important control variables were included. Significance was established at 95% and 99% confidence intervals. In South-Central Asia, to reduce stunting wasting and underweight rates, empowering women through improving their social independence and decision-making power might be important. Furthermore, targeting poorer women for empowerment in social independence and decision-making appears to confer positive benefits towards the reduction of stunting, wasting, and underweight rates in children. However, the main and interaction effects of women's empowerment and wealth index on children's nutrition outcomes vary across the countries examined. These variations suggests that exogenous contextual factors might play a role in the empowerment-nutrition and empowerment-wealth-nutrition associations and interactions. Highlights • Social independence & Decision-making vital for child's nutrition in South-Central Asia.• Empowering poorer women important for reducing stunting and underweight rates.• Associations point to variation in empowerment needs in different settings.• Empowerment initiatives need to be tailored on identified contextual gaps and needs.

Dataset Information

State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

Publications

State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

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