Publications Summary

Document Type
Working Papers
Publication Topic(s)
Family Planning
Recommended Citation
Adedini, S. A., L. F. C. Ntoimo, and C. A. Alex-Ojei. 2023. Sub-national Analysis of Contraceptive Discontinuation among Women in Nigeria: Evidence from the Demographic and Health Survey. DHS Working Papers No. 194. Rockville, Maryland, USA: ICF.
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Publication Date
August 2023
Publication ID

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Despite efforts to increase contraceptive use in Nigeria, the relevant indicators have remained poor. Nigeria’s modern contraceptive prevalence rate (mCPR) of 12% is one of the lowest in the world. The contraceptive discontinuation rate among women in Nigeria is high at 41%. A sub-national analysis of Nigeria’s mCPR reveals a dismal situation, with mCPR ranging from 2% in Sokoto State (North West) and Yobe State (North East) to 29% in Lagos State (South West). This study examined the reasons and determinants of contraceptive discontinuation across sub- national levels in Nigeria. Data for the study came from the individual women’s recode of the 2018 Nigeria Demographic and Health Survey, with a weighted total of 180,999 events (birth, pregnancy, termination, and contraceptive use) in the 5 years before the survey; 10,384 episodes of contraceptive use; and 6,365 episodes of discontinuation among 4,974 women age 15–49. Relationships between the dependent variable (contraceptive discontinuation) and the explanatory variables were explored with the Cox proportional hazards model. The results show a substantial disparity in contraceptive discontinuation episodes across the six regions of Nigeria – highest in the South West (28.0%), and lowest in the North East (11.1%). The discontinuation rate for all methods was lowest in the South West (32.5%) and highest in the North West (50.1%). Across most regions, the highest discontinuation rate was attributed to pregnancy or fertility-related reasons. The Cox models indicate that, when compared to the South West Region, the risks of discontinuing contraceptives were significantly higher in North Central and North West (hazard ratio (HR) = 1.4, 95% confidence interval (CI) [1.2, 1.7] p < .001), South East (HR = 1.5, 95% CI [1.2, 1.9] p < .001), and North East (HR = 1.3, 95% CI [1.0, 1.5] p < .05). The study suggests the need for context-specific family planning programming that considers the country’s diversity when addressing the problem of contraceptive discontinuation in order to ensure better reproductive health outcomes in Nigeria.


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