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Journal of Urban Health

, Volume 91, Issue 1, pp 186–210 | Cite as

Assessing Gaps and Poverty-Related Inequalities in the Public and Private Sector Family Planning Supply Environment of Urban Nigeria

  • Jessica K. LevyEmail author
  • Sian Curtis
  • Catherine Zimmer
  • Ilene S. Speizer
Article

Abstract

Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas.

Keywords

Family planning Supply environment Access Availability Inequality Wealth distribution Urban Supply Contraception Service distribution Poverty Nigeria Public-sector Private-sector Community-level 

Notes

Acknowledgments

The data for this research were made possible by the support from the Bill & Melinda Gates Foundation (BMGF) under the terms of the Measurement, Learning & Evaluation for the Urban Reproductive Health Project (MLE). The author’s views expressed in this publication do not necessarily reflect the views of BMGF or the MLE project. The authors would also like to thank Meghan Corroon for her insights into the data collection and analysis process, as well as Karen Foreit, Ph.D., and Herbert Peterson, M.D., for their review of earlier versions of the paper.

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Copyright information

© The New York Academy of Medicine 2013

Authors and Affiliations

  • Jessica K. Levy
    • 1
    Email author
  • Sian Curtis
    • 1
  • Catherine Zimmer
    • 2
  • Ilene S. Speizer
    • 1
  1. 1.University of North Carolina Gillings School of Global Public HealthChapel HillUSA
  2. 2. University of North Carolina Howard W. Odum Institute and Department of SociologyChapel HillUSA

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