Contextual Determinants of Modern Contraceptive Use among Sexually Active Female Adolescents in Nigeria: A Multilevel Analysis of Nationally Representative Data

Hassan Ogunwemimo, University of Medical Sciences, Ondo City, Nigeria

Sexually active adolescents in Nigeria face peculiar challenges in accessing modern contraceptives (mCP). Their environments can facilitate or limit this access. Potentially inadequate access or lack of it increases the risks of unintended pregnancies among girls age 15-19 years, often leading to unsafe abortions. Despite the importance of these contextual factors, little is known about how adolescents' contexts influence their contraceptive use, and this study aims to fill that knowledge gap. This cross-sectional study analyzes nationally representative data from the Nigeria Demographic and Health Surveys, with a weighted sample of 2,052 female adolescents aged 15-19. It examines both individual/household and community characteristics. Frequencies and percentages describe respondents' contexts, while Multilevel Binary Logistic Regression is used to assess the association between various factors and mCP use, fitting four models. Preliminary results show that the prevalence of mCP use among adolescents is 9%. Fixed effects, at individual/household level shows age, sexual debut age, education, and religion as mCP use important determinants. Region, community poverty, and community education are also important predictors of mCP use at community level. Despite the influence of individual, household, and community factors, a significant portion of the variability in mCP use remains unexplained between communities.

Keywords: Family Planning and Contraception, Neighbourhood/contextual effect analysis, Multi-level modeling , Sexual and Reproductive Health and Rights

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