Federal Republic of Nigeria -adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE NIGERIA DEMOGRAPHIC AND HEALTH SURVEY (NDHS), 2013 FE D E R A L R E PU B LI C O F N I G E R I A What can be done to support Nigerian adolescents to prevent unintended pregnancy? Plan for how, when and where different groups of sexually active adolescents (married and unmarried, boys and girls, rural and urban) use and do not use contraception. Learn the reasons why adolescents are not using contraception, and develop policies and programmes to better address their needs. Understand that adolescents may get contraception from a variety of sources and ensure that each of these sources can provide high quality services for adolescents. COMPILED IN 2016 | UPDATED NOVEMBER 2016 Adolescent population: who are they? In the Federal Republic of Nigeria, there are 41 million adolescents aged 10–19 years – 22.5% of the country’s total population.i Just over half of adolescents live in rural areas, 50.4% of adolescent girls and 50.6% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 8.0, while for adolescent boys it is 9.2.ii Among adolescents who become parents before age 20, the average age at which Nigerian adolescent girls have their first baby is 16.7 years, while the average age at which adolescent boys first become fathers is 17.8.ii Sexual activity and marital status Analysis of data from the NDHSii shows that over 4.7 million Nigerians aged 15–19 are currently sexually active – they are either unmarried and have had sex in the last three months or they are in a union (i.e. married or living together). On average, among adolescents who had sex before age 20, adolescent girls first have sexual intercourse at age 15.9 years and adolescent boys at 17.0 years. Among unmarried adolescents, 21.0% of adolescent girls report ever having sex and 11.9% are currently sexually active; among adolescent boys, 15.5% report ever having sex, while 9.1% are currently sexually active. Among all Nigerian adolescents, 28.8% of adolescent girls and 1.1% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 15.6 years for adolescent girls and 17.7 for adolescent boys. Contraceptive use and non-use among adolescent girls FIGURE 1. Use and non-use of contraception: unmarried sexually active adolescent girls, aged 15–19 years (%) Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives IUD FIGURE 2. Use and non-use of contraception: adolescent girls in union, aged 15–19 years (%) LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE Unmarried, sexually active According to NDHSii analyses, 74.9% of unmarried, sexually active adolescent girls report not wanting a child in the next two years and 64.3% are currently using a contraceptive method. The main reasons these adolescents report for not using a contraceptive method include: • infrequent sex (36.1%) • not married (19.3%) • she is opposed (19.0%) Among all unmarried, sexually active adolescent girls aged 15–19, 44.9% are not using a method of contraception. Male condoms and pills are the most common modern methods used (36.9% and 4.8% of these adolescent girls, respectively). IUDs, which are considered to be one of the most effective methods, are used by 0.1%. Withdrawal and periodic abstinence, traditional methods, are used by 8.2% of these adolescent girls (see Figure 1). In union According to NDHSii analyses, 21.9% adolescent girls in a union report not wanting a child in the next two years, yet only 4.5% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (43.2%) • she is opposed (13.9%) • religious prohibition (12.0%) Among all adolescent girls in a union aged 15–19, 97.9% are not using a method of contraception. Less than 1% are using male condoms, pills, injectable contraceptives or lactational amenorrhea (LAM) (see Figure 2). i Urban and rural population by age and sex, 1980–2015 [online database]. New York (USA): United Nations Department of Economic and Social Affairs, Population Division; 2014 (https://esa. un.org/unpd/popdev/urpas/urpas2014.aspx, accessed 4 November 2016). ii National Population Commission (NPC) [Nigeria], ICF International. Nigeria Demographic and Health Survey 2013 [Datasets]. NGIR6a.DTA and NGMR6a.DTA. Rockville (MD): ICF International; 2014 (http://dhsprogram.com/data/dataset/Nigeria_Standard-DHS_2013.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) 0.20.6 0.20.3 0.30.3 97.9 44.9 3.9 4.3 36.9 0.10.64.8 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of NDHS 2013ii Source: analysis of NDHS 2013ii Unmarried, sexually active adolescents who are using a modern method most often get it from a pharmacy (68.7%) or friends (19.4%). Adolescents in a union who are using a modern method most often get it from a pharmacy (56.9%) or a government facility (26.9%). Adolescent contraceptive use F E D E R A L R E P U B L I C O F N I G E R I A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 41 15.9 years for adolescent girls 17.0 years for adolescent boys Among adolescents who had sex before age 20, the average age at first sex is Among adolescents who become parents before age 20, the average age at first birth is What can be done to support Nigerian adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years Sexually active, unmarried In union 74.9% sexually active, unmarried adolescent girls 21.9% adolescent girls in union 68.7% from a pharmacy 56.9% from a pharmacy 19.4% from friends 26.9% from a government facility Understand that adolescents may get modern contraception from a variety of sources. Learn the reasons why adolescents are not using contraception. Plan for how, when, and where different groups of adolescents use or don’t use contraception. ANALYSIS OF THE NIGERIA DEMOGRAPHIC AND HEALTH SURVEY, 2013 COMPILED IN 2016 | UPDATED NOVEMBER 2016 National Population Commission (NPC) [Nigeria], ICF International. Nigeria Demographic and Health Survey 2013 [Datasets]. NGIR6a.DTA and NGMR6a.DTA. Rockville (MD): ICF International; 2014 (http://dhsprogram.com/data/ dataset/Nigeria_Standard-DHS_2013.cfm?flag=0, accessed 4 November 2016). 16.7 17.8 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 36.1% infrequent sex 43.2% breastfeeding 19.3% not married 13.9% she is opposed 19.0% she is opposed 12.0% religious prohibition Method Sexually active, unmarried In union Not using 44.9% 97.9% Withdrawal 4.3% 0.6% Periodic abstinence 3.9% 0.3% Male condom 36.9% 0.3% Pill 4.8% 0.3% Injectable contraceptives 0.6% 0.2% Lactational amenorrhea (LAM) -- 0.2% IUD 0.1% -- REASONS FOR NON-USE: Not married Not having sex Infrequent sex Menses has not returned after birth Breastfeeding Fatalistic (up to god) She is opposed Husband/partner is opposed Religious prohibition Knows no method Knows no source Fear of side effects/health concerns Inconvenient to use Others opposed Lack of access/too far SOURCE OF METHOD: Government facility Private facility Pharmacy Shop Friends or parents Other Community Health Worker Icon Directory METHODS: Not using Withdrawal Periodic abstinence Rhythm/calendar Female condom Male condom Standard days/cycle beads Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants IUD Male sterilization Female sterilization © WHO 2016. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/RHR/16.38

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