The Nigerian Urban Reproductive Health Initiative: a decomposition analysis of the changes in modern contraceptive use

Despite the implementation of several family planning (FP) programmes, uptake and use of modern contraception in Nigeria remains constrained by a limited access and weak service delivery especially among the poorest. Between 2009 and 2014 the Nigerian Urban Reproductive Health Initiative (NURHI) was initiated among urban Nigerian women in 6 states with the aim of increasing the use of modern contraceptive. The objective of this paper is to assess the changes in modern contraceptive use within the NURHI programme participants and understand the characteristics explaining the changes. We use data collected before and after the programme and apply the Fairlie decomposition method to evaluate the contribution of socioeconomic and other individual factors to the changes in contraceptive use over time. Results show an increase in modern contraceptive use in the programme areas over time. While wealth and education are important determining factors of modern contraceptive use pre-programme, their contribution post-programme reduces substantially. Pre-programme it is mainly women with higher education who use modern contraception because of greater autonomy, financial ability, social interaction and access to FP services however the programme appears to help close the socioeconomic gaps in modern contraceptive use over time. In particular, the NURHI reduces the strength of the link between contraceptive use, and education and wealth, and increases women’s empowerment and decision-making regarding contraception.