DOI: 10.5064/f600cmlo
title: Demand for Modern Contraception in Sub-Saharan Africa: New Methods, New Evidence

description: &lt;h3&gt;Project Overview&lt;/h3&gt;
 
&lt;p&gt;West and Central Africa have the highest fertility rates in the world. These high birthrates are largely a function of desired fertility and continued allegiance to large families. Recent survey data on the desired number of children for 41 countries in sub-Saharan Africa (SSA) shows a median value of 4.8 children, with only one-quarter of the countries characterized by a mean value under 4.0 and more than one-quarter with a mean value above 5.0. From survey data we know nothing about what satisfactions and returns men and women seek in childbearing, and how they assess the costs and benefits of large versus small families.&lt;/p&gt;

&lt;p&gt;Despite the high demand for children, unintended pregnancy is common in SSA. Between two and three pregnancies per woman on average (including induced abortions) over the entire reproductive career are unintended. The unintended pregnancy rate is twice as high in SSA as it is in Europe, North America, and Asia.&lt;/p&gt;

&lt;p&gt;The advantages of using modern contraception are recognized, but perceptions of the advantages of use co-exist with uncertainties about whether taking this step is prudent, all things considered. There are competing rationales, in tension with one another. Moreover, there are multiple actors – both the woman and her male partner, and possibly other near-kin, as well as influential community leaders – whose views figure into contraception decision-making.&lt;/p&gt;

&lt;p&gt;By comparison with the large volume of research on how to strengthen family planning services in this region, there has been relatively little probing research on the demand for modern contraception. This qualitative data collection conducted as part of a larger program of research aimed to correct this imbalance through a multi-faceted investigation of fertility desires and their bearing on the demand for modern contraception.&lt;/p&gt;

&lt;p&gt;The objective of the qualitative data collection was to explore men’s and women’s fertility desires and demand for modern contraception through in-depth investigation of the complex set of factors that argue for and against avoiding pregnancy in the Nigerian context, and the social, psychological and dyadic processes that translate the desire to avoid pregnancy into decisions to use (or not use) modern contraception.&lt;/p&gt;
description: &lt;p&gt;&lt;h3&gt;Data and Data Collection Overview&lt;/h3&gt;&lt;/p&gt;

&lt;p&gt;The qualitative data in this research project were collected in two phases:&lt;/p&gt;

&lt;p&gt;• Phase I: Semi-structured in-depth interviews with Nigerian men and women, which included one-on-one individual interviews (IDI), as well as joint couple interviews (JI) with a subset of participants, in six states&lt;/p&gt;

&lt;p&gt;• Phase II: Cognitive interviews (CI) with Nigerian women in Lagos State&lt;/p&gt;

&lt;p&gt;Phase I: This component involved 166 adult Nigerian men and women (74 men and 92 women) of reproductive age who had been in stable unions (i.e., married, consensual unions) for at least two years. Participants were recruited from six states across Nigeria–Akwa Ibom, Anambra, Gombe, Lagos, Nasarawa, and Sokoto–representing each of Nigeria’s six geopolitical zones, with two sites in each state (one urban and one rural). The study sample was stratified along three dimensions: state, community of residence (urban/rural), and gender. Within each stratum, we used purposive sampling to ensure diversity of participants in terms of socioeconomic status, age, parity (number of children), union type (monogamous, polygynous), union duration, and religion. The sample consisted of both matched couples (the husband and wife/wives were all recruited and interviewed) and unmatched individuals (only the husband or wife was recruited and interviewed).&lt;/p&gt;

&lt;p&gt;Each of the 166 participants completed a one-on-one semi-structured in-depth interview (IDI) conducted by a gender-matched interviewer. In addition, a subset of 27 couples completed a joint couple interview (JI). In the case of matched polygynous unions, one wife was selected for the joint interview with the husband (although all wives were interviewed individually).&lt;/p&gt;

&lt;p&gt;All interviews were conducted using a semi-structured interview guide. Interviews were conducted in one of four languages (English, Hausa, Igbo, Yoruba) or a combination of the languages based on participants’ preferences. Interviews lasted from about 30 minutes to over 2 hours. All interviews were audio-recorded and transcribed (and translated as appropriate) verbatim, after which they were de-identified.&lt;/p&gt;

&lt;p&gt;Phase II: The cognitive interviews for the second component were conducted as part of an exploratory research project testing four variants of a survey question on the wanted status of the most recent birth. This phase involved 40 women ages 18-44 years who had had a live birth in the preceding 3-year period, recruited from the immunization or family planning clinics of three public primary health care facilities in Lagos, Nigeria. All interviews were conducted using a semi-structured interview guide. There were four interview guides – one for each variant of the ‘wanted status of recent births’ question. Interviews were conducted in one of three languages (English, Yoruba, Pidgin) or a combination of the languages based on participants’ preferences. Interviews lasted from 17 minutes to 50 minutes. All interviews were audio-recorded and transcribed (and translated as appropriate) verbatim, after which they were de-identified.&lt;/p&gt;
description: &lt;p&gt;&lt;h3&gt;Selection and Organization of Shared Data&lt;/h3&gt;&lt;/p&gt;

&lt;p&gt;The data shared here are the de-identified transcripts of both data collection phases. There are 166 individual interviews and 27 joint couple interviews from Phase I and 40 cognitive interviews from Phase II.&lt;/p&gt;

&lt;p&gt;The data from Phase I are organized by the type of interview (individual vs. joint). Each interview is named based on the type of interview (IDI, JI), followed by a two-letter code indicating the state where the interview was conducted (AK, AN, GO, LA, NA, SO), followed by a one-letter code indicating whether the interview was conducting in a rural or urban community (R, U) and a one-letter code indicating the sex of participant (M,F,B [for both]) followed by the interview number. For example, IDI-AK-R-M-5.&lt;/p&gt;

&lt;p&gt;The data from Phase II, the cognitive interviews, are organized by the version (V1-V4) of the question regarding “wanted status of recent births”. Each interview is named based on the type of interview (CI), followed by the version of the “wanted status of recent births” question, and a two-letter code indicating who conducted the interview followed by the interview number. For example, CI-V2-MB-007.&lt;/p&gt;
 
&lt;p&gt;Additional documentation provided includes a data narrative, the informed consent scripts used, all interview guides used and tables containing descriptive statistics for the study sample of each phase.&lt;/p&gt;