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. 2024 Oct 10;21(10):1343.
doi: 10.3390/ijerph21101343.

Food Insecurity and Women's Choice of Reversible Contraceptives: Differential Effects by Maternal Age

Otobo I Ujah  1 , Pelumi Olaore  2 , Russell S Kirby  2
Affiliations

Food Insecurity and Women's Choice of Reversible Contraceptives: Differential Effects by Maternal Age

Otobo I Ujah et al. Int J Environ Res Public Health. .

Abstract

We investigated the relationships between food insecurity (FI) and women's choice of reversible contraceptives, overall and according to the level of method effectiveness, among partnered women of reproductive age in Nigeria. This population-based cross-sectional analysis used nationally representative data from Round 6 of the UNICEF-supported Multiple Indicator Cluster Survey (MICS) conducted in Nigeria. The sample included married or in-union women aged 15-49 years who reported a live birth in the last 2 years preceding the survey (unweighted N = 8496). Survey-weighted multivariable binomial and multinomial logistic regression analyses were performed to generate estimates of the association between FI (none, moderate, and severe) and reversible contraceptive use (overall and by method effectiveness). A Bonferroni correction was used to account for multiple testing. We stratified the models by maternal age to describe the experiences of women aged 15-24 years, 25-34 years, and 35-49 years. Overall, 6438 (74.1%) of the women in the sample experienced food insecurity (moderate, n = 2559, 30.7%; severe, n = 3879, 43.4%). In the adjusted model, we observed no statistically significant association between experiencing MFI and SFI and the use of reversible contraceptives (overall and specific) after adjustment for multiple testing. The stratified analyses showed that among women aged 25-34 years in the sample, those experiencing SFI in the past 12 months, compared to their food-secure counterparts, had significantly lower odds of reporting the use of a least effective contraceptive method (OR, 0.53; 95% CI, 0.34-0.83; p = 0.0052). However, this failed to reach the significance threshold upon adjustment for multiple testing. We found no significant association between the FI levels and use of reversible contraceptives (overall and specific) among partnered women (15-49 years) in Nigeria who were 2 years postpartum following a live birth and who were at risk of pregnancy.

Keywords: Food Insecurity Experience Scale (FIES); Multiple Indicator Cluster Survey (MICS); Nigeria; contraception; material hardship.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of participants in the 2021 MICS who were included in the analysis. Note: since women can display more than one of these exclusion criteria, the sum of the subsets was greater than the total excluded. The weighted size of the analytic sample was derived by adjusting for appropriate sample weight, stratification, and clustering in order to account for the complex survey design as recommended in the methodology of the MICS.
Figure 2
Figure 2
Total Food Insecurity Experience Scale (FIES) score and contraceptive method use.
Figure 3
Figure 3
Weighted proportions showing the relationships between women’s choice of reversible contraceptive method and food insecurity category according to age groups, Nigeria, MICS, 2021.
See this image and copyright information in PMC

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