Akinyemi Joshua O, Dipeolu Oluwafemi I, Adebayo Ayodeji M, Gbadebo Babatunde M, Ajuwon Grace A, Olowolafe Tubosun A, Adewoyin Yemi, Odimegwu Clifford O
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Infectious Diseases Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Contracept Reprod Med. 2022 Aug 2;7(1):14. doi: 10.1186/s40834-022-00181-0.
Emerging evidence from high income countries showed that the COVID-19 pandemic has had negative effects on population and reproductive health behaviour. This study provides a sub-Saharan Africa perspective by documenting the social consequences of COVID-19 and its relationship to fertility preference stability and modern contraceptive use in Nigeria.
We analysed panel data collected by Performance Monitoring for Action in Nigeria. Baseline and Follow-up surveys were conducted before the COVID-19 outbreak (November 2019-February 2020) and during the lockdown respectively (May-July 2020). Analysis was restricted to married non-pregnant women during follow-up (n = 774). Descriptive statistics and generalized linear models were employed to explore the relationship between selected social consequences of COVID-19 and fertility preferences stability (between baseline and follow-up) as well as modern contraceptives use.
Reported social consequences of the pandemic lockdown include total loss of household income (31.3%), food insecurity (16.5%), and greater economic reliance on partner (43.0%). Sixty-eight women (8.8%) changed their minds about pregnancy and this was associated with age groups, higher wealth quintile (AOR = 0.38, CI: 0.15-0.97) and household food insecurity (AOR = 2.72, CI: 1.23-5.99). Fertility preference was inconsistent among 26.1%. Women aged 30-34 years (AOR = 4.46, CI:1.29-15.39) were more likely of inconsistent fertility preference compared to 15-24 years. The likelihood was also higher among women with three children compared to those with only one child (AOR = 3.88, CI: 1.36-11.08). During follow-up survey, 59.4% reported they would feel unhappy if pregnant. This was more common among women with tertiary education (AOR = 2.99, CI: 1.41-6.33). The odds increased with parity. The prevalence of modern contraceptive use was 32.8%. Women aged 45-49 years (AOR = 0.24, CI: 0.10-0.56) were less likely to use modern contraceptives than those aged 15-24 years. In contrast, the odds of contraceptive use were significantly higher among those with three (AOR = 1.82, CI: 1.03-3.20), four (AOR = 2.45, CI: 1.36-4.39) and at least five (AOR = 2.89, CI: 1.25-6.74) children. Unhappy disposition towards pregnancy (AOR = 2.48, CI: 1.724-3.58) was also a significant predictor of modern contraceptive use.
Some social consequences of COVID-19 affected pregnancy intention and stability of fertility preference but showed no independent association with modern contraceptive use.
来自高收入国家的新证据表明，新冠疫情对人口和生殖健康行为产生了负面影响。本研究通过记录新冠疫情在尼日利亚的社会后果及其与生育偏好稳定性和现代避孕方法使用的关系，提供了撒哈拉以南非洲地区的视角。
我们分析了尼日利亚行动绩效监测收集的面板数据。在新冠疫情爆发前（2019年11月至2020年2月）和封锁期间（2020年5月至7月）分别进行了基线调查和随访调查。分析仅限于随访期间已婚未怀孕的妇女（n = 774）。采用描述性统计和广义线性模型来探讨新冠疫情的选定社会后果与生育偏好稳定性（基线与随访之间）以及现代避孕方法使用之间的关系。
报告的疫情封锁的社会后果包括家庭收入完全损失（31.3%）、粮食不安全（16.5%）以及对伴侣的经济依赖增加（43.0%）。68名妇女（8.8%）改变了怀孕的想法，这与年龄组、较高的财富五分位数（调整后比值比[AOR]=0.38，置信区间[CI]：0.15 - 0.97）和家庭粮食不安全（AOR = 2.72，CI：1.23 - 5.99）有关。26.1%的人生育偏好不一致。与15 - 24岁的妇女相比，30 - 34岁的妇女（AOR = 4.46，CI：1.29 - 15.39）生育偏好不一致的可能性更高。与只有一个孩子的妇女相比，有三个孩子的妇女这种可能性也更高（AOR = 3.88，CI：1.36 - 11.08）。在随访调查中，59.4%的人表示如果怀孕会感到不开心。这在受过高等教育的妇女中更为常见（AOR = 2.99，CI：1.41 - 6.33）。随着子女数增加，这种可能性也增加。现代避孕方法的使用率为32.8%。与15 - 24岁的妇女相比，45 - 49岁的妇女（AOR = 0.24，CI：0.10 - 0.56）使用现代避孕方法的可能性较小。相比之下，有三个（AOR = 1.82，CI：1.03 - 3.20）、四个（AOR = 2.45，CI：1.36 - 4.39）和至少五个（AOR = 2.89，CI：1.25 - 6.
