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A Longitudinal Multilevel Analysis of the Effects of Contraceptive Failures on Unintended Pregnancies among Women in Urban Nigeria

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Abstract

Unintended pregnancy is a global public health concern. However, the effect of contraceptive failure on unintended pregnancy remains unclear in Nigeria. We undertook a longitudinal analysis to examine the effect of contraceptive failure on unintended pregnancy among urban women in Nigeria. We used panel data from the Nigerian Urban Reproductive Health Initiative. The Measurement, Learning and Evaluation program conducted the surveys among a cohort of women aged 15–49 who were first interviewed at baseline in 2010/2011 and followed up at endline in 2014/2015. Analytic sample was 4140 women aged 15–49 who ever used contraceptives. We fitted three-level multilevel binary logistic regression models estimated with GLLAMM. The study established evidence that there is a significant effect of contraceptive failure on unintended pregnancy among urban women in Nigeria. The positive effect of between-person contraceptive failure indicates that respondents who experienced more contraceptive failure than the average in the sample had 5.26 times higher odds of unintended pregnancy (OR = 5.26; p-value < 0.001). Results also established a significant effect of within-person contraceptive failures among the respondents. Findings suggest there is evidence of a significant longitudinal effect of contraceptive failure on unintended pregnancy in urban Nigeria. Efforts to reduce unintended pregnancy must include interventions to address the problem of contraceptive failure among urban women in Nigeria.

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Data Availability

Since we signed a data-use agreement with Carolina Population Center (CPC), we are not allowed to share these data with other researchers who might want to replicate or expand our studies. To access these data, users must submit a request for access to the CPC for review and approval. Information on how to secure access to this data is available at the CPC data portal (data.cpc.unc.edu).

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Acknowledgements

The data analyzed for this research was made possible with support from the Bill & Melinda Gates Foundation (BMGF) under the Measurement, Learning & Evaluation (MLE) project for the Urban Reproductive Health Project, coordinated by JHU-CCP. The authors’ views are not necessarily those of the BMGF or the MLE project. Research reported in this study has been supported by the National Institute of Child Health and Human Development under Award Number T32HD101390. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Center for Safe & Healthy Children, College of Health and Human Development, The Pennsylvania State University, 201 Henderson Building University Park, State College, PA, 16802, USA

    Olusola A. Omisakin

  2. Department of Demography and Social Statistics, Faculty of Social Sciences, Federal University, Oye-Ekiti, Nigeria

    Sunday A. Adedini

  3. Programme in Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Sunday A. Adedini

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  1. Olusola A. Omisakin
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Omisakin, O.A., Adedini, S.A. A Longitudinal Multilevel Analysis of the Effects of Contraceptive Failures on Unintended Pregnancies among Women in Urban Nigeria. J Urban Health 101, 193–204 (2024). https://doi.org/10.1007/s11524-023-00819-7

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