title: Unmet contraceptive need among married Nigerian women: an examination of trends and drivers.
abstract: OBJECTIVE
  The aim of this study is to examine trends in and drivers of unmet need for contraceptives among married Nigerian women between 2003 and 2013.
  
  
  METHODS
  This analysis utilized combined data from the 2003, 2008 and 2013 cross-sectional Nigerian Demographic Health Surveys, resulting in a sample size of 54,873 currently married women. Multinomial logistic regression examined associations between trends in unmet need for spacing and limiting, and the demographic, socioeconomic, and reproductive profiles of the respondents.
  
  
  RESULTS
  Women in 2008 were 30% more likely to have an unmet need for spacing, relative to women in 2013. Despite these significant declines in unmet need to space fertility between 2008 and 2013, the adjusted results show that between 2003 and 2013, there was no significant change in the trends in unmet need to space fertility. Unmet need to limit fertility was significantly higher in 2003, adjusted, and 2008 relative to 2013. Younger, low-parity, Muslim women were significantly less likely than older, high-parity, non-Muslim women to have an unmet need to limit fertility. Women residing in the northeast and northwest of the country were significantly less likely than women residing in the south of the country to have an unmet need to limit fertility. Women whose most recent child had died were significantly less likely to have an unmet need to space and limit fertility.
  
  
  CONCLUSIONS
  These data suggest that interventions to increase the knowledge of modern contraceptives, to reduce child mortality, and to improve women's decision-making power would all serve to increase demand for contraceptives, even in areas with high-fertility preferences.
  
  
  CONCLUSIONS
  Nigeria has set a goal of a 36% contraceptive prevalence rate by 2018. With a current contraceptive prevalence rate of 15% reaching the additional 16% of women, who have articulated a demand for contraception, will almost reach that goal. Contraceptive use directly reduces maternal risk; implementing interventions to increase demand for contraception and meeting articulated demands for contraception would not only support women's (and men's) ability to realize their reproductive rights but also, ultimately, may reduce the burden of maternal deaths in Nigeria.
authors.affiliation: Maternal Health Task Force and Woman and Health Initiative, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA. Electronic address: aaustin@hsph.harvard.edu.
authors.forename: Anne
authors.initials: A
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception; D003268:Contraception Behavior / Q000208:ethnology / Q000639:trends; D003430:Cross-Sectional Studies; D003906:Developing Countries; D016656:Family Planning Policy; D005193:Family Planning Services / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D016015:Logistic Models; D020380:Needs Assessment; D009549:Nigeria; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D018454:Spouses / Q000208:ethnology; D055815:Young Adult
keywords: Fertility preferences; Maternal health; Maternal mortality; Nigeria; Unmet need for contraception