Understanding how social norms affect modern contraceptive use
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways A critical social norms insight from this study is that norms which discourage contraceptive use likely function primarily by decreasing women’s practical abilities (mental effort, social embarrassment, access confidence) to use contraception. This finding suggests that programs aimed at shifting social norms or mitigating their negative impacts on contraception should prioritize reducing practical barriers rather than merely attempting to change motivational attitudes towards contraception.
Objectives This study aimed to explore whether social norms that discourage premarital sex and modern contraceptive use among young Nigerian women affect their behavior through influencing their motivation or their ability to use contraception. The research leveraged the Fogg Behavior Model (FBM), a novel approach in public health, to distinguish between these pathways.
Methods Data was drawn from a cross-sectional household survey of 618 sexually active Nigerian women aged 14–24. The survey included questions about socio-economic characteristics, contraceptive use, and social norms (descriptive and injunctive) regarding premarital sex and contraception. Logistic regression analyses were conducted to test associations and pathways within the FBM framework, explicitly differentiating between motivation and ability.
Results Social norms negatively associated with contraception use were statistically significant after controlling for motivation (aOR = 0.90, p < 0.001), but this association was not significant after controlling for ability. Women with higher ability scores were more likely to use modern contraception (aOR = 1.08, p < 0.001). The analysis highlighted that socio-economic disparities, particularly wealth, significantly influenced contraceptive use, mediated through women's ability rather than their motivation. Conclusions: The study concluded that social norms appear to impact contraceptive use predominantly through affecting women's practical ability to use contraception (e.g., ease of discussing contraception, confidence in accessing methods) rather than through motivational factors. The implication is that interventions aiming to increase modern contraceptive use among Nigerian youth should focus more on enhancing women's practical abilities related to contraceptive use.
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