Impact of Health Literacy on Contraceptive Knowledge, Attitude and Use among the Nigerian Adult Population

Document Type : Original Article

Authors

1 Department of Adult Education, University of Ibadan.

2 Department of Continuing Education and Developmental Studies

3 Department of Adult Education, University of Ibadan

Abstract

Background and Objectives: Many studies have explored associated and determining factors regarding contraceptive prevalence and use as well as the disparities in contraceptive use based on different regions in Nigeria but none has made effort to establish the influence of health literacy on contraceptive knowledge, attitude and use. This study, therefore, attempted to examine the impact of health literacy on Nigerian adults’ contraceptive knowledge, attitude and use. 

Material and Methods: The study adopted a descriptive cross-sectional research design and the population of the study consisted of Nigerians who are 18 years and above and reside in any part of the country.  A non-probability sampling technique was adopted and a questionnaire was the main instrument of data collection for this study. A total of 426 participants participated in the study. Frequency count, simple percentages, mean, standard deviation, T-test, one-way ANOVA, regression and correlational analysis were used to analyse the data generated from the study.

Results: The study indicated that 90.6% of the Nigerian adult population has adequate health literacy, and 53.8% of them have poor contraceptive knowledge. Similarly, 65.7% of the participants have positive attitudes towards contraception while 58.2% of the participants’ contraceptive use is high. Further, health literacy was shown to have a significant but weak positive impact on contraceptive knowledge (r = 0.345, p<0.001), attitudes toward contraception (r = 0.362, p<0.001), and contraceptive use (r = 0.218, p<0.001).

Conclusion: The study’s results imply that many other factors aside from health literacy affect people’s contraceptive knowledge, attitude and use. Hence, addressing the health literacy of adult Nigerians is only one aspect of improving contraceptive knowledge, attitude and use.

Keywords

Availability of data and materials: Data will be available upon request from the corresponding author

Conflict of Interest: The authors have no conflicting interest in the current study

Ethical consideration: Informed consent from the participants was obtained and they were assured of the confidentiality of the information provided before participating in the study

Funding: No financial support was received for the conduct of this study

Authors' contributions: Sunday Itasanmi: Conceived, collected data, analyse and prepared the manuscript. Helen Andong: collected and analyse data, review the manscript. Omobola Adelore: Supervised, review and edited the manuscript

References

1. Centers for Disease Control and Prevention. Understanding Health Literacy [Internet]. Centers for Disease Control and Prevention. 2019. Available from: https://www.cdc.gov/healthliteracy/learn/Understanding.html
 
2. Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Services Research. 2022 Sep 12;22(1).
https://doi.org/10.1186/s12913-022-08527-9
PMid:36096793 PMCid:PMC9465902  
 
3. Nutbeam D, Muscat DM. Health Promotion Glossary 2021. Health Promotion International. 2021 May 12;36(6).
https://doi.org/10.1093/heapro/daaa157
PMid:33822939  
 
4. Kantor E. The importance of health literacy [Internet]. www.antidote.me. Available from: https://www.antidote.me/blog/the-importance-of-health-literacy  
 
5. Jafari A, Nejatian M, Momeniyan V, Barsalani FR, Tehrani H. Mental health literacy and quality of life in Iran: a cross-sectional study. BMC psychiatry. 2021;21:1-11.
https://doi.org/10.1186/s12888-021-03507-5
PMid:34641793 PMCid:PMC8507341  
 
6. Singh SG, Aiken J. The effect of health literacy level on health outcomes in patients with diabetes at a type v health centre in Western Jamaica. International Journal of Nursing Sciences. 2017 Jul;4(3):266-70.
https://doi.org/10.1016/j.ijnss.2017.06.004
PMid:31406751 PMCid:PMC6626165  
 
7. Tavakoly Sany SB, Doosti H, Mahdizadeh M, Orooji A, Peyman N. The Health Literacy Status and Its Role in Interventions in Iran: A Systematic and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021 Apr 17;18(8):4260.
https://doi.org/10.3390/ijerph18084260
PMid:33920508 PMCid:PMC8073744  
 
8. World Health Organization. Reproductive Health: Draft strategy to accelerate progress towards the attainment of international development goals and targets [Internet]. 2003. Available from: https://apps.who.int/gb/ebwha/pdf_files/EB113/eeb11315a1.pdf  
 
9. World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A global handbook for providers [Internet]. 2018. Available from: https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf  
 
10. Bongaarts J, Bruce J. The Causes of Unmet Need for Contraception and the Social Content of Services. Studies in Family Planning. 1995 Mar;26(2):57.
https://doi.org/10.2307/2137932
PMid:7618196  
 
11. Baraka J, Rusibamayila A, Kalolella A, Baynes C. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania. African Journal of Reproductive Health / La Revue Africaine de la Santé Reproductive [Internet]. 2015 [cited 2023 Feb 10];19(4):23-30. Available from: http://www.jstor.org/stable/24877606  
 
12. Alo OD, Daini BO, Omisile OK, Ubah EJ, Adelusi OE, Idoko-Asuelimhen O. Factors influencing the use of modern contraceptive in Nigeria: a multilevel logistic analysis using linked data from performance monitoring and accountability 2020. BMC Women's Health. 2020 Sep 3;20(1).
https://doi.org/10.1186/s12905-020-01059-6
PMid:32883259 PMCid:PMC7650288  
 
13. Akor O, Shuaibu F, Agabi C, Clement PS. Experts worry as Nigeria becomes 6th most populous country [Internet]. Daily Trust. 2022 [cited 2023 Feb 10]. Available from: https://dailytrust.com/experts-worry-as-nigeria-becomes-6th-most-populous-country/  
 
14. World Bank. World Development Indicators | DataBank [Internet]. databank.worldbank.org. Available from: https://databank.worldbank.org/reports.aspx?source=2&country=SSF  
 
15. Fadeyibi O, Alade M, Adebayo S, Erinfolami T, Mustapha F, Yaradua S. Household Structure and Contraceptive Use in Nigeria. Frontiers in Global Women's Health. 2022 May 10;3.
https://doi.org/10.3389/fgwh.2022.821178
PMid:35620301 PMCid:PMC9128017  
 
16. Ashraf QH, Weil DN, Wilde J. The Effect of Fertility Reduction on Economic Growth. Population and Development Review. 2013 Mar;39(1):97-130.
https://doi.org/10.1111/j.1728-4457.2013.00575.x
PMid:25525283 PMCid:PMC4267474  
 
17. Adewole IF. Trends in postabortal mortality and morbidity in Ibadan, Nigeria. International Journal of Gynecology & Obstetrics. 1992 Jun;38(2):115-8.
https://doi.org/10.1016/0020-7292(92)90046-L
PMid:1356841  
 
18. UNFPA. FP 2030- UNFPA Nigeria and partners Launch Policy documents [Internet]. UNFPA Nigeria. 2022 [cited 2023 Feb 10]. Available from: https://nigeria.unfpa.org/en/events/fp-2030-unfpa-nigeria-and-partners-launch-policy-documents  
 
19. Omo-aghoja LO, Omo-aghoja VW, Aghoja CO, Okonofua FE, Aghedo O, Umueri C, et al. Factors associated with the knowledge, practice and perceptions of contraception in rural southern Nigeria. Ghana Medical Journal. 2010 Jun 8;43(3).
https://doi.org/10.4314/gmj.v43i3.55326
PMid:20126323 PMCid:PMC2810247  
 
20. Ladi C, Dahiru E, Aliyu A. Contextual Factors Influencing Modern Contraceptive Use in Nigeria [Internet]. 2015. Available from: https://dhsprogram.com/pubs/pdf/WP120/WP120.pdf  
 
21. Blackstone SR, Iwelunmor J. Determinants of contraceptive use among Nigerian couples: evidence from the 2013 Demographic and Health Survey. Contraception and Reproductive Medicine. 2017 Jan 17;2(1).
https://doi.org/10.1186/s40834-017-0037-6
PMid:29201414 PMCid:PMC5683226  
 
22. Durowade KA, Omokanye LO, Elegbede OE, Adetokunbo S, Olomofe CO, Ajiboye AD, et al. Barriers to contraceptive uptake among women of reproductive age in a semi-urban community of Ekiti State, Southwest Nigeria. Ethiopian Journal of Health Sciences [Internet]. 2017 Mar 15 [cited 2021 Feb 13];27(2):121-8. Available from: https://www.ajol.info/index.php/ejhs/article/view/153144
https://doi.org/10.4314/ejhs.v27i2.4
PMid:28579707 PMCid:PMC5440826  
 
23. Onyekpa IJ, Odugu BU, Nevo CO. Prevalence and Barriers to Contraceptive Uptake among Reproductive Age Women in Achi, Enugu State, Southeast, Nigeria. Gynecology & Reproductive Health. 2022 Dec 31;6(6).
https://doi.org/10.33425/2639-9342.1208  
 
24. Adefalu AA, Ladipo OA, Akinyemi OO, Popoola OA, Latunji OO, Iyanda O. Awareness and opinions regarding contraception by women of reproductive age in North-West Nigeria. Pan African Medical Journal. 2018;30.
https://doi.org/10.11604/pamj.2018.30.65.12975
PMid:30344849 PMCid:PMC6192713  
 
25. Itasanmi SA, Ekpenyong VO, Andong HA. Examining Health literacy levels and its Association with Demographic Dynamics among Intra-City Commercial Drivers: Results from a Survey in Nigeria. Journal of Health Literacy. 2022;6(4):9-21.  
 
26. Agyei WKA, Migadde M. Demographic and Sociocultural Factors Influencing Contraceptive Use in Uganda. Journal of Biosocial Science. 1995 Jan;27(1):47-60.
https://doi.org/10.1017/S0021932000006994
PMid:7876295  
 
27. Smitha MV, Das M, Patwal K, Parichita P, Seervi V, Sharma C. Knowledge, attitude, and practices on contraceptives in married women of Odisha. Manipal Journal of Nursing and Health Sciences [Internet]. 2021;7(2):1-7. Available from: https://impressions.manipal.edu/mjnhs/vol7/iss2/2/  
 
28. Kuyinu YA, Femi-Adebayo TT, Adebayo BI, Abdurraheem-Salami I, Odusanya OO. Health literacy: Prevalence and determinants in Lagos State, Nigeria. Lavorgna L, editor. PLOS ONE. 2020 Aug 13;15(8):e0237813.
https://doi.org/10.1371/journal.pone.0237813
PMid:32790756 PMCid:PMC7425911  
 
29. Garcia-Codina O, Juvinyà-Canal D, Amil-Bujan P, Bertran-Noguer C, González-Mestre MA, Masachs-Fatjo E, et al. Determinants of health literacy in the general population: results of the Catalan health survey. BMC Public Health. 2019 Aug 16;19(1).
https://doi.org/10.1186/s12889-019-7381-1
PMid:31420029 PMCid:PMC6698033  
 
30. Svendsen MT, Bak CK, Sørensen K, Pelikan J, Riddersholm SJ, Skals RK, et al. Associations of health literacy with socioeconomic position, health risk behavior, and health status: a large national population-based survey among Danish adults. BMC Public Health [Internet]. 2020 Apr 28;20(1). Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08498-8
https://doi.org/10.1186/s12889-020-08498-8
PMid:32345275 PMCid:PMC7187482  
 
31. Meier C, Vilpert S, Borrat-Besson C, Jox RJ, Maurer J. Health literacy among older adults in Switzerland: cross-sectional evidence from a nationally representative population-based observational study. Swiss Medical Weekly. 2022 Mar 28;152(13-14).
https://doi.org/10.4414/SMW.2022.w30158
PMid:35429235  
 
32. Arriaga M, Francisco R, Nogueira P, Oliveira J, Silva C, Câmara G, et al. Health Literacy in Portugal: Results of the Health Literacy Population Survey Project 2019-2021. International Journal of Environmental Research and Public Health. 2022 Apr 1;19(7):4225.
https://doi.org/10.3390/ijerph19074225
PMid:35409905 PMCid:PMC8998262  
 
33. Said Bodur A, Filiz E, Kalkan I, Professor A. Original Article Factors Affecting Health Literacy in Adults: A Community Based Study in Konya, Turkey. International Journal of Caring Sciences [Internet]. 2017;10(1):100-9. Available from: http://www.internationaljournalofcaringsciences.org/docs/11_kalkan_original_10_1.pdf
https://doi.org/10.17362/DBHAD.2017.2.01  
 
34. Sun X, Shi Y, Zeng Q, Wang Y, Du W, Wei N, et al. Determinants of health literacy and health behavior regarding infectious respiratory diseases: a pathway model. BMC Public Health. 2013 Mar 22;13(1).
https://doi.org/10.1186/1471-2458-13-261
PMid:23521806 PMCid:PMC3621712  
 
35. Bhusal S, Paudel R, Gaihre M, Paudel K, Adhikari TB, Pradhan PMS. Health literacy and associated factors among undergraduates: A university-based cross-sectional study in Nepal. Nazif-Munoz JI, editor. PLOS Global Public Health. 2021 Nov 8;1(11):e0000016.
https://doi.org/10.1371/journal.pgph.0000016
PMid:36962072 PMCid:PMC10022320  
 
36. Ritter T, Dore A, McGeechan K. Contraceptive knowledge and attitudes among 14-24-year-olds in New South Wales, Australia. Australian and New Zealand Journal of Public Health. 2015 Apr 22;39(3):267-9.
https://doi.org/10.1111/1753-6405.12367
PMid:25904387  
 
37. Fayehun F. Contraceptive use in Nigeria is incredibly low. A lack of knowledge may be why [Internet]. The Conversation. 2017. Available from: https://theconversation.com/contraceptive-use-in-nigeria-is-incredibly-low-a-lack-of-knowledge-may-be-why-81453  
 
38. Ukoji VU, Anele PO, Imo CK. Assessing the relationship between knowledge and the actual use of contraceptives among childbearing women in South-South Nigeria: evidence from the 2018 Nigeria demographic and health survey. BMC Public Health. 2022 Nov 29;22(1).
https://doi.org/10.1186/s12889-022-14728-y
PMid:36447222 PMCid:PMC9710025  
 
39. Okafor KC, Omeiza DV, Idoko LO, Inyangobong EA, Unubi OE, Bassi AP. Attitude, Practice, and Factors Affecting Contraceptive Use among Women Attending Postnatal Care in a Tertiary Health Facility in Jos North LGA, Plateau State, Nigeria. Open Journal of Obstetrics and Gynecology. 2022;12(08):814-31.
https://doi.org/10.4236/ojog.2022.128069  
 
40. Ifeanyichukwu O, Adetunji L. Contraception Usage: Knowledge, Attitude and Associated Factors among Women of Reproductive Age Attending a Health Facility in Benin City, Nigeria. British Journal of Medicine and Medical Research. 2015 Jan 10;9(7):1-13.
https://doi.org/10.9734/BJMMR/2015/16282  
 
41. Ehiaghe AD, Barrow A. Parental Knowledge, Willingness, and Attitude towards Contraceptive Usage among Their Unmarried Adolescents in Ekpoma, Edo State, Nigeria. Deng S, editor. International Journal of Reproductive Medicine. 2022 Jun 23;2022:1-13.
https://doi.org/10.1155/2022/8533174
PMid:35783251 PMCid:PMC9246590  
 
42. Adegboyega LO. Attitude of married women towards contraceptive use in Ilorin Metropolis, Kwara State, Nigeria. African Health Sciences. 2019 Aug 19;19(2):1875.
https://doi.org/10.4314/ahs.v19i2.10
PMid:31656470 PMCid:PMC6794523  
 
43. Jeremiah I, Dambo N, Wallymahmed A. Determinants of contraceptive use by women in the central senatorial zone of Bayelsa State, Nigeria: A cross-sectional survey. Nigerian Medical Journal. 2017;58(1):26.
https://doi.org/10.4103/0300-1652.218409
PMid:29238125 PMCid:PMC5715563  
 
44. National Population Commission (NPC). Nigeria - Demographic and Health Survey 2018 [Internet]. microdata.worldbank.org. 2019. Available from: https://microdata.worldbank.org/index.php/catalog/3540  
 
45. Ekholuenetale M, Olorunju S, Fowobaje KR, Onikan A, Tudeme G, Barrow A. When Do Nigerian Women of Reproductive Age Initiate and What Factors Influence Their Contraceptive Use? A Contextual Analysis. Open Access Journal of Contraception. 2021 Jul;Volume 12:133-47.
https://doi.org/10.2147/OAJC.S316009
PMid:34285601 PMCid:PMC8286125  
 
46. Liddelow C, Mullan B, Boyes M. Adherence to the oral contraceptive pill: the roles of health literacy and knowledge. Health Psychology and Behavioral Medicine. 2020 Jan 1;8(1):587-600.
https://doi.org/10.1080/21642850.2020.1850288
PMid:34040887 PMCid:PMC8114408  
 
47. El-Ibiary SY, Youmans SL. Health literacy and contraception: A readability evaluation of contraceptive instructions for condoms, spermicides and emergency contraception in the USA. The European Journal of Contraception & Reproductive Health Care. 2007 Jan;12(1):58-62.
https://doi.org/10.1080/13625180601092537
PMid:17455046  
 
48. Väisänen H, Moore AM, Owolabi O, Stillman M, Fatusi A, Akinyemi A. Sexual and Reproductive Health Literacy, Misoprostol Knowledge and Use of Medication Abortion in Lagos State, Nigeria: A Mixed Methods Study. Studies in Family Planning. 2021 May 27;52(2):217-37.
https://doi.org/10.1111/sifp.12156
PMid:34043236 PMCid:PMC8362169  
 
49. Kim TY, Haider M, Hancock GR, Boudreaux MH. The Role of Health Literacy in Family Planning Use among Senegalese Women. Journal of Health Communication. 2019 Mar 4;24(3):244-61.
https://doi.org/10.1080/10810730.2019.1601299
PMid:30958224  
 
50. Rietveld CA, van Kippersluis H, Thurik AR. Self-Employment and Health: Barriers or Benefits? Health Economics [Internet]. 2014 Jul 22;24(10):1302-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767688/
https://doi.org/10.1002/hec.3087
PMid:25048640 PMCid:PMC4767688  
 
51. Aljbli L, Aladham M, Turkistany H, Masud N, Alaqeel F, Alharbi R, et al. Differences in knowledge about contraception among Saudi males and females at tertiary hospitals in Riyadh. Journal of Family Medicine and Primary Care. 2020;9(12):6254.
https://doi.org/10.4103/jfmpc.jfmpc_1526_20
PMid:33681073 PMCid:PMC7928162  
 
52. Ayoub A. Effects of Women's Schooling on Contraceptive Use and Fertility in Tanzania. African Population Studies [Internet]. 2004;19(2). Available from: http://www.bioline.org.br/pdf?ep04016  
 
53. Shapiro D, Tambashe BO. The impact of women's employment and education on contraceptive use and abortion in Kinshasa, Zaire. Studies in Family Planning [Internet]. 1994 Mar 1 [cited 2022 Nov 15];25(2):96-110. Available from: https://pubmed.ncbi.nlm.nih.gov/8059449/
https://doi.org/10.2307/2138087
PMid:8059449  
 
54. Goni A, Rahman M. The impact of education and media on contraceptive use in Bangladesh: A multivariate analysis. International Journal of Nursing Practice. 2012 Nov 26;18(6):565-73.
https://doi.org/10.1111/ijn.12013
PMid:23181958  
 
55. Tehrani FR, Farahani FKA, Hashemi M. Factors influencing contraceptive use in Tehran. Family Practice. 2001 Apr 1;18(2):204-8.
https://doi.org/10.1093/fampra/18.2.204
PMid:11264273  
 
56. Okezie CA, Ogbe A o., Okezie CR. Socio-economic determinants of contraceptive use among rural women in Ikwuano Local Government Area of Abia State, Nigeria. International NGO Journal [Internet]. 2010;5(4):74-7. Available from: https://academicjournals.org/journal/INGOJ/article-full-text-pdf/FE607DE40583  

Files

Share

How to cite

Statistics