|Maternal grand multiparity and intention to use modern contraceptives in Nigeria|
||Bola Lukman Solanke, Olufunmilola Olufunmilayo Banjo, Bosede Odunola Oyinloye, and Soladoye Sunday Asa
||BMC Public Health, 18:1207; DOI: 10.1186/s12889-018-6130-1
||Background: Grand multiparity and low contraceptive prevalence are dominant among Nigerian women. These
elevate the risk of unintended pregnancies, high-risk fertility and adverse maternal and child health outcomes
among women in the country, particularly grand multiparous women. Studies have examined predictors of
intention to use modern contraceptives among women of reproductive age. However, these studies did not
ascertain the extent to which grand multiparity is associated with intention to use modern contraceptives. This
study examined association between grand multiparity and intention to use modern contraceptives in Nigeria.
Methods: The study pooled data from 2003 to 2013 Nigeria Demographic and Health Surveys. The weighted
sample size analysed was 34,302 women. The outcome variable was intention to use contraceptive. The main
explanatory variable was parity with specific attention to grand multiparity. Unadjusted multinomial logistic
regression coefficients were used to examine association between specific explanatory or control variables and
intention to use contraceptives while the adjusted multinomial logistic regression was applied to further examine
associated factors of intention to use contraceptives relative to being uncertain about future contraceptive use.
Four multinomial logistic regression models were fitted using Stata 14.
Results: More than half of respondents do not intend to use contraceptives, while less than one-fifth of
respondents intend to use contraceptives in the future. Across the four fitted models, the relative risks of intention
to use compared with being uncertain about future contraceptive use were significantly lower among grand
multiparous women. Results further revealed pregnancy termination, fertility planning status, exposure to mass
media family planning messages, knowledge of modern contraceptives, ideal family size, remarriage, household
power relations, and maternal education as other key factors influencing expected risk of intention to use
contraceptives relative to being uncertain about future contraceptive use.
Conclusion: Maternal grand multiparity is significantly associated with intention to use contraceptives among
women in Nigeria. The development of a specific population and health programme to target grand multiparous
women is imperative in the country. Such programme could be integrated into existing national family planning
programme through specific contraceptive education, counselling and information for high parous women.
Keywords: Parity, Multiparity, Grand multiparity, Contraceptive use, Reproductive health, Nigeria