Dynamic patterns of preference-aligned contraceptive use among married adolescent girls in Northern Nigeria: Results from a longitudinal cohort study

Claire Rothschild, Population Services International
Alhassan Bulama, Society for Family Health
Roselyn Odeh, Society for Family Health, Nigeria
Julius Njogu, Population Services International
Katherine Tumlinson, University of North Carolina, Chapel Hill
Kelsey Holt, Univesity of California San Francisco
Abednego Musau, Population Services International (PSI)

Background: Rights-based measures are critical for advancing the Cairo agenda on sexual and reproductive health and rights (SRRH), yet – three decades later – rights-based SRHR measures remain limited. Methods: We collected data on a novel measure, preference-aligned fertility management (PFM), among married adolescent girls aged 15-19 initiating contraception in Kaduna and Nasarawa, Nigeria. PFM was captured over a 1-year follow-up at 15-week intervals. We describe trajectories and correlates of PFCU over follow-up. Results: Among 993/1,101 participants who completed all follow-up, 20% (195/993) reported not practicing PFM at least once. Prevalence of not practicing PFM ranged from 3.4% (wave 1) to 8% (wave 2). Among those not practicing PFM, unwanted contraceptive use was predominant in waves 1-2; in waves 3-4, most girls not practicing PFM were not using contraceptive but wanted to. Planned future analyses include identifying correlates of PFM over follow-up, as well as qualitative analysis of planned in-depth interviews with cohort participants exploring reasons for practicing and not practicing PFM over the course of nearly 2 years of follow-up. Discussion: Self-reported contraceptive want and use changed dynamically over the course the first year after method initiation in this cohort, with one-fifth reporting misaligned contraceptive use at least once.

Keywords: Longitudinal studies , Family Planning and Contraception, Children, Adolescents, and Youth, Mixed methods research

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