Factors explaining the North–South differentials in contraceptive use in Nigeria: A nonlinear decomposition analysis

Background: Northern Nigeria has some of the worst reproductive health indicators worldwide. Conspicuous North–South variations exist in contraceptive use; not much is known about the drivers of contraceptive use disparities in the North compared to the South. Objective: In this study, we examine the relative weights of the factors that contribute to this North–South gap in contraceptive prevalence. Methods: Using the women’s 2013 Demographic Health Survey dataset, we applied a nonlinear decomposition technique to determine the contribution of sociodemographic and socioeconomic characteristics, conjugal relationship dynamics, intimate partner violence, ideational variables, and Islamic culture to the North–South disparities in contraceptive use. Results: There was a gap of 12.4 percentage points in contraceptive prevalence between the north and south of Nigeria (5.2% vs 17.6%). The largest contributors to the gap were ideational characteristics (explaining 42.0% of the gap) and socio-economic profiles (explaining 42.6%). Patterns of conjugal relationship dynamics (11.1%), socio-demographic characteristics (‒11.0%), Islamic religious culture (7.6%), and exposure to family planning messaging (6.1%) were also significant contributors. Conclusions: Effective interventions to increase contraceptive use in northern Nigeria should aim at addressing socioeconomic disadvantage in the North, impacting ideational characteristics and specifically targeting poor women and those with low levels of education. Working with Islamic religious leaders is also critical to bridging the gap. Contribution: This paper broadens the knowledge on the determinants of contraceptive use in Nigeria by identifying contextual factors that operate differently in the North compared to the South.