A quantitative survey on potential barriers to the use of modern contraception among married women of high parity attending an antenatal clinic in Kaduna, Northern Nigeria

Abstract

Background: Nigeria has high maternal mortality ratios, and women of high parity are at higher risk of obstetric complications. Understanding barriers to the uptake of contraception is thus important. Methodology: A cross-sectional quantitative survey was done at the antenatal and postnatal clinics of Barau Dikko Teaching Hospital between September and December 2015. Questionnaires were administered to 400 married consenting women of high parity (five or more deliveries). The questionnaire extracted general and demographic information, history of contraception, and possible barriers to contraceptive uptake. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Descriptive analysis was done using frequencies, percentages, and cross-tabulation. Chi-square test was used as a test of association where relevant, and P< 0.05 was considered statistically significant. Results: About 353 questionnaires were retrieved; respondents were mainly aged between 30 and 39 years, educated up to secondary level, Hausa and Muslims, and homemakers or traders. Women had a mean parity of 7 deliveries and highest, 15. There was high level of awareness of contraception, adequate spousal communication, and approval but a perception of high risk and side effects with contraceptive use. Conclusion: Fear of side effects was a major barrier to contraceptive use. However, a window of opportunity exists because they would be willing to use contraception in future. Hence, specific and individualized contraceptive counseling and patient selection is needed, as well as further education of women.