Pluralistic Ignorance and Non-Use of Modern Contraceptives in Southwestern Nigeria: A Qualitative Study Using the Social Norms Theory

Background: The 2018 National Demographic Health Survey (NDHS) revealed that out of the current non-users of contraceptives amongst married women, only 38% of them made their own decision to abstain. The remaining 62% either decided jointly with their partner or the partner solely decided for them. This elicits the notion that social expectations within reference networks could influence the use of modern contraceptives (MCs) in Nigeria. Methods: 16 structured qualitative interviews were used to gather the beliefs, attitudes and social expectations of the respondents as regards the non-use of MCs between March and June 2020. Through snowballing sampling method, residents in the Ibadan Metropolis, southwest Nigeria responded to the hypothetical scenarios presented by the vignettes during interviews. Data were analysed using the Social Norms Analysis Plot framework. This framework serves as the checklist for the reporting of findings.  Basic ethical principles were upheld throughout the study. Results: Seven categories and five main themes emerged from this study. These categories include gender norms, social influence, peer pressure, myths, misconceptions, awareness and pluralistic ignorance. The themes were generated using the Social Norms Analysis Plot framework and they include empirical expectation, normative expectations, sanctions, sensitivity to sanctions and exceptions. The majority of the respondents strongly believe that most women in their community will not use contraceptives simply because of their male partners and friends. Out of those who do not use MCs due to social expectations, it was seen that the majority personally support its use. Conclusion: To promote the uptake of modern contraceptive use in Southwest Nigeria, it is important to update people’s social expectations. The findings of these study studies are relevant for policymakers and civil society organizations in designing effective intervention reproductive health programs in different regions of Nigeria (especially areas of lower use of modern contraceptives).