Examining the North-South contraceptive divide in urban Nigeria: The importance of geography and religion

The demographic transition observed in many parts of the world has largely bypassed Nigeria. Total fertility rates have remained consistently high for the past twenty years and the population, already the largest in Africa, is expected to double between 2010 and 2050, with much of that growth projected to occur in cities. Many attribute these high fertility rates to the low acceptance of contraceptive methods in the northern half of the country, particularly among Muslim households. Using data from the 2008/9 Nigeria Demographic and Health Survey, this analysis explores the combined effect of geography and religion on contraceptive use in urban areas and seeks to identify factors that moderate these effects. Muslim women living in the urban North were significantly less likely to use a contraceptive method compared to Christian women living in either the urban North or South or Muslim women in the urban South. Participation in household decision-making moderated these differences in contraceptive use. Among only northern Muslim women, those who participated in household decisions had significantly higher levels of contraceptive use than those who did not participate in these decisions. Exposure to family planning messages and desired family size were not effect modifiers. These findings highlight the variability in religious norms' influence on contraceptive use. In Northern urban Nigeria, religious norms appear to limit contraceptive adoption primarily by limiting women's involvement in household decisions, rather than by motivating higher desired fertility or by limiting their exposure to family planning information.