Utilization, Correlates and Predictors of Contraceptive Use among Married Women in Amassoma, Bayelsa State, Nigeria

Abstract

Background: Nigeria's national modern contraceptive prevalence rate among married women remains low, at roughly 12% to 20%, with wide sub-national variation, and a recurring explanation is that awareness of contraceptives does not reliably translate into use. This study determined the prevalence and pattern of contraceptive use among married women in Amassoma, Bayelsa State, Nigeria, and tested whether knowledge of contraceptives and socio-demographic factors (age, education, occupation and parity) are associated with, and independently predictive of, use. Methods: A descriptive cross-sectional study was conducted in 2024 among 400 married women using a structured, interviewer-administered questionnaire (100% response rate). Prevalence and pattern of use were summarised as frequencies and percentages. Five bivariate hypotheses linking knowledge, age, education, occupation and parity to contraceptive use were tested using the Chi-square test of association, and a multivariable binary logistic regression model, adjusted for age, education, parity and knowledge, was fitted to identify independent correlates of use. Significance was set at p<0.05, and key distributions are presented as pie and bar charts. Results: Of the 400 respondents, 281 (70.3%) were current contraceptive users. Among users, implants were by far the most commonly used method (65.1%), followed by pills (11.0%), withdrawal (7.5%), calendar/rhythm method (5.0%), condoms (4.3%), lactational amenorrhoea method (3.9%) and injections (3.2%). More than one-third of users (37.7%) had used their current method for about five years, while 28.1% had started within the past year. Contraceptive use was significantly associated with knowledge of contraceptives (X²=52.261, p<0.001), age (X²=25.145, p<0.001), education (X²=15.575, p=0.004), occupation (X²=15.993, p=0.007) and parity (X²=15.828, p=0.003) at the bivariate level. In the adjusted logistic regression model, knowledge of contraceptives remained a strong, independent predictor of use (adjusted odds ratio [aOR]=6.53, 95% CI: 3.39-12.60, p<0.001), and women aged 31-36 years had significantly higher odds of use than the youngest reference group (aOR=3.14, 95% CI: 1.16-8.47, p=0.024). Education, occupation and parity did not retain independent significance after adjustment. Conclusion: Contraceptive utilisation among married women in Amassoma is considerably higher than national and several sub-national averages, driven substantially by a strong preference for implants. All five hypothesised correlates were supported at the bivariate level, but knowledge of contraceptives emerged as the dominant, independent driver of use even after accounting for socio-demographic factors, indicating that closing the knowledge gap is likely to be the single most impactful lever for improving contraceptive uptake in this community.