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Family Planning and Reproductive Health in Urban Nigeria: Levels, Trends and Differentials Technical Working Paper Your resource for urban reproductive health Family Planning and Reproductive Health in Urban Nigeria: Levels, Trends and Differentials Jean Christophe Fotso1; James Oluwakayode Ajayi2; Elizabeth E. Idoko2; Ilene Speizer3; David A. Fasiku2; Blessing Mberu1; Michael Mutua1 January 2011 © 2011 Measurement, Learning & Evaluation Project. All rights reserved. 1 African Population and Health Research Center (APHRC), Nairobi, Kenya; partner on the Measurement, Learning & Evaluation Project 2 National Population Commission (NPC), Abuja, Nigeria 3 Carolina Population Center (CPC), University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, USA; partner on the Measurement, Learning & Evaluation Project MLE Technical Working Paper 2-2010 www.urbanreproductivehealth.org Your resource for urban reproductive health This report presents the findings from an analysis of the urban samples of the 1990, 1999, 2003 and 2008 Nigeria Demographic and Health Surveys (DHS). It was designed and written by the Measurement, Learning & Evaluation (MLE) Project of the Urban Reproductive Health Initiative, in collaboration with the Nigeria National Population Commission (NPC). The MLE project is being implemented in Nigeria by the Carolina Population Center (CPC) at the University of North Carolina at Chapel Hill (UNC) and the African Population and Health Research Center (APHRC). The Nigeria Urban Reproductive Health Initiative (NURHI) is being implemented by a consortium led by Johns Hopkins University’s Center for Communication Programs (CCP). The opinions expressed in this report are those of the authors and do not necessarily reflect the views of the donor organization, the Bill & Melinda Gates Foundation. Additional information about this report may be obtained from: Dr. Jean Christophe Fotso, P.O. Box 10787, 00100, GPO Nairobi, Kenya Telephone: +254-20-272-0400 E-mail: [email protected] Information about the Urban Reproductive Health Initiative and the MLE project may be obtained at www.urbanreproductivehealth.org. Information about the Nigeria’s National Population Commission may be found at www.population.gov.ng Recommended citation: Fotso J.C., Ajayi J.O., Idoko E.E, Speizer I., Fasiku D.A., Mberu B. & Mutua M. (2011). Family Planning and Reproductive Health in Urban Nigeria: Levels, Trends and Differentials. Chapel Hill, NC: Measurement, Learning & Evaluation (MLE) Project [UNC, USA] and National Population Commission (NPC) [Nigeria]. MLE Technical Working Paper 2-2010 www.urbanreproductivehealth.org Your resource for urban reproductive health Family Planning and Reproductive Health in Urban Nigeria: Levels, Trends and Differentials Table of Contents Preface .................................................................................................................................... 1 Foreword ................................................................................................................................ 2 Map of Nigeria ....................................................................................................................... 3 List of Abbreviations .............................................................................................................. 4 Executive Summary ............................................................................................................... 5 Chapter 1: Introduction 1.1. Economy ......................................................................................................................... 7 1.2 Population and Urbanization .......................................................................................... 8 1.3. Overview of Population, FP and Reproductive Health Policies .................................... 9 1.4. Objectives and Organization of the Report ................................................................. 12 1.5. Data and Methods of Analysis ..................................................................................... 13 1.6. The Bill & Melinda Gates Foundation’s Reproductive Health Strategy ...................... 15 1.7. The Nigeria Urban Reproductive Health Initiative ...................................................... 16 1.8. Measurement, Learning & Evaluation for the URHI ................................................... 17 Chapter 2: Characteristics of Households and Respondents in Urban Nigeria 2.1. Age and Sex Structure of Nigeria’s Urban Population................................................. 19 2.2. Household Composition ............................................................................................... 20 2.3. Household Characteristics and Durable Goods ............................................................ 22 2.4. Household Wealth ........................................................................................................ 24 2.5. Background Characteristics of Respondents in Urban Nigeria .................................... 25 2.6. Educational Attainment ................................................................................................ 26 2.7. Exposure to Mass Media .............................................................................................. 28 2.8. Employment Status....................................................................................................... 30 2.9. Women’s Control over Earnings .................................................................................. 32 2.10. Women Participation in Decision Making .................................................................. 33 MLE Technical Working Paper 2-2010 www.urbanreproductivehealth.org Your resource for urban reproductive health Chapter 3: Fertility and Fertility Preferences 3.1. Total Fertility Rate ....................................................................................................... 35 3.2. Children Ever Born ...................................................................................................... 36 3.3. Birth Intervals ............................................................................................................... 37 3.4. Age at First Birth .......................................................................................................... 38 3.5. Teenage Pregnancy and Motherhood ........................................................................... 39 3.6. Ideal Number of Children ............................................................................................. 41 3.7. Unwanted Fertility ......................................................................................................... 43 Chapter 4: Family Planning and Other Proximate Determinants of Fertility 4.1. Knowledge of Modern Contraceptives ......................................................................... 47 4.2. Ever Use of Modern Contraceptives ............................................................................ 48 4.3. Current Use of Modern Contraceptive Methods .......................................................... 49 4.4. Number of Living Children at First Use of Contraception ........................................... 51 4.5. Source of Modern Contraceptives ................................................................................ 53 4.6. Future Intentions to Use Contraceptives ...................................................................... 55 4.7. Exposure to Mass Media on Family Planning .............................................................. 57 4.8. Discussion of Family Planning with Spouse ................................................................ 60 4.9. Attitudes Regarding Family Planning .......................................................................... 61 4.10. Age at First Marriage .................................................................................................. 62 4.11. Age at First Sex ........................................................................................................... 63 Chapter 5: Maternal and Child Health and Survival 5.1. Assistance during Delivery .......................................................................................... 65 5.2. Place of Delivery .......................................................................................................... 67 5.3. Child Immunization ...................................................................................................... 68 5.4. Prevalence of Diarrhea and Fever ................................................................................ 69 5.5. Nutritional Status of Children ...................................................................................... 71 5.6. Infant and Child Mortality ............................................................................................ 72 Chapter 6: Challenges Facing Reproductive Health and Family Planning In Nigeria 6.1. Internal Resistance to Family Planning and Use of Modern Contraceptives ............... 75 6.2. Unequal Gender Relations and Regional Variations .................................................... 75 6.3. Men’s Role and Responsibility in Family Planning and Reproductive Health ............ 76 6.4. External Dependence and Weak Internal Support ........................................................ 76 6.5. Structure and Delivery Services .................................................................................. 77 MLE Technical Working Paper 2-2010 www.urbanreproductivehealth.org Your resource for urban reproductive
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