Regional disparities in family planning knowledge, attitudes, practices, and barriers among reproductive-age women in Nigeria: A comparative study of Kano and Bayelsa States

Abstract

Introduction: Family planning (FP) is crucial for maternal and child health, yet Nigeria has one of the lowest modern contraceptive prevalence rates globally, with marked regional disparities. Factors influencing low contraceptive prevalence include socio-cultural norms, religious beliefs, and geopolitical variations across Nigeria’s six geopolitical zones. In Kano State (Northwest), conservative gender norms and religious interpretations discourage contraception, while Bayelsa State (South-South) has relatively more liberal attitudes toward modern FP. This study compared FP knowledge, attitudes, practices, and barriers among reproductive-age women in Kano State (Northwest, predominantly Muslim) and Bayelsa State (South-South, predominantly Christian), and examined the influence of male partners and socio-cultural factors on contraceptive use. Methods: A comparative cross-sectional study was conducted among 404 women aged 15-49 years (205 from Kano, 199 from Bayelsa) using multistage sampling. Data were collected through interviewer-administered structured questionnaires and analyzed using SPSS version 25. Descriptive statistics, chi-square tests, and binary logistic regression were employed, with statistical significance set at p<0.05. Results: FP awareness was nearly universal (98.5%), with no significant difference between states. However, knowledge scores were significantly higher in Kano (Mean=4.60, SD=2.79) than Bayelsa (Mean=3.68, SD=2.24; p<0.001). Current contraceptive use was 47.3% in Kano versus 52.7% in Bayelsa (p=0.126). Partner accompaniment to facilities (OR=3.03, 95% CI:1.75-5.25, p<0.001) and spousal discussion (OR=2.37, 95% CI:1.14-4.95, p=0.021) significantly predicted use. Paradoxically, Kano women reported higher cultural/religious acceptance but lower actual use. Main barriers were fear of side effects (29.1%) and desire for more children (24.2%) Conclusion: Despite near-universal awareness, a clear knowledge practice gap persists, particularly in Kano, where higher knowledge does not translate into higher contraceptive use. Male partner involvement especially accompaniment to health facilities and spousal communication emerged as key drivers of uptake. Fear of side effects and the desire for more children remain the main barriers. These findings highlight the need for context-specific, culturally sensitive interventions that actively engage men and address misconceptions about contraceptive side effects.