Ideation and intention to use contraceptives in Kenya and Nigeria

BACKGROUND: Contraceptive use remains low to moderate in most African countries. Ideation, or the ideas and views that people hold, has been advanced as a possible explanation for differences in contraceptive use within and across countries. OBJECTIVES: In this paper, we sought to identify the relevant dimensions of ideation and assess how these dimensions relate to contraceptive use intentions in two illustrative countries, Kenya and Nigeria. METHODS: Using factor analysis, we first identified the relevant dimensions of ideation from a set of cognitive, emotional, and social interaction items. Subsequently, we examined the relationships of these dimensions with intention to use contraceptives. RESULTS: The data revealed four dimensions of contraceptive ideation in both countries: perceived self-efficacy, myths and rumors related to contraceptives, social interactions and influence, and contraceptive awareness. All four dimensions of ideation are strongly associated with contraceptive use intention in Nigeria. Only perceived self-efficacy was significantly associated with contraceptive use intention in Kenya. CONCLUSION: The ideation model is relevant for contraceptive use research and programing. Programs seeking to increase contraceptive use and help women to attain their desired family size should prioritize promotion of contraceptive self-efficacy. In addition, in countries with low contraceptive prevalence, programs should seek to identify ways to correct prevailing myths and rumors, increase contraceptive awareness, and promote positive social interactions around contraceptive use.