Contextual Determinants of Repeat Unintended Pregnancy among Women of Reproductive Age in Nigeria: A Population-Based Cross-Sectional Study
DOI:
https://doi.org/10.30442/Keywords:
Contextual determinants, Cross-sectional study, Multilevel analysis, Nigeria, Repeat unintended pregnancy, Women of reproductive ageAbstract
Background: Repeat unintended pregnancy (RUP) is a significant public health concern in Nigeria which contributes to maternal morbidity, mortality, and socioeconomic disadvantage among women of reproductive age.
Objective: This study examined the contextual determinants of RUP among women of reproductive age in Nigeria.
Methods: The study employed a cross-sectional analysis of population-based data involving 21792 women of reproductive age drawn from the 2018 Nigeria Demographic and Health Survey (NDHS). The study adopted a multilevel mixed-effects logistic regression model to assess individual and community-level predictors of RUP.
Results: The national prevalence of RUP was 2.2%. Women with primary education had over twice the odds of experiencing RUP compared to those with no education (AOR = 2.15; 95% CI: 1.14–4.06). Similarly, the use of modern contraceptives was associated with increased likelihood of RUP, potentially due to improper use or method failure (AOR = 2.14;95% CI: 1.04-2.25). At the community level, women residing in the South-south region were over three times more likely to experience RUP compared to other regions. Bivariate analysis revealed significant associations with union status, religion, ethnicity, parity, and exposure to family planning messages. The multilevel model indicated significant clustering effects, with 30% of the variance in the null model attributable to community-level differences.
Conclusion: Regionally tailored strategies addressing both individual behaviors and systemic barriers are essential for effective prevention.
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