Prevalence, Patterns, and Determinants of Family Planning Uptake Among Women Attending a General Outpatient Clinic in Southern Nigeria: A Hospital-Based Cross-Sectional Study

Abstract

Background: Family planning remains one of the most effective and cost-efficient public health interventions for improving maternal and child health by preventing unintended pregnancies, reducing unsafe abortions, lowering maternal mortality, and promoting healthy birth spacing. Despite sustained governmental and international efforts to expand access to contraceptive services, uptake remains suboptimal in many low- and middle-income countries, including Nigeria. Persistent socioeconomic disparities, cultural norms, misconceptions regarding contraceptive safety, religious influences, and inadequate male involvement continue to limit utilization. Understanding the determinants of family planning uptake is essential for developing context-specific interventions aimed at improving reproductive health outcomes. This study assessed the prevalence, patterns, and determinants of family planning uptake among women attending the General Outpatient Clinic of Delta State University Teaching Hospital, Oghara, Southern Nigeria. Methods: A hospital-based analytical cross-sectional study was conducted among 370 women of reproductive age (15–49 years) attending the General Outpatient Clinic of Delta State University Teaching Hospital, Oghara, between September 2024 and March 2025. Participants were selected using systematic random sampling. Data were collected using a pretested interviewer-administered structured questionnaire covering socio-demographic characteristics, reproductive history, contraceptive utilization, and socio-cultural and clinical factors. Family planning uptake was defined as the current use of any modern or traditional contraceptive method at the time of the survey. Descriptive statistics summarized participant characteristics, while Pearson's chi-square test assessed associations between independent variables and family planning uptake. Variables with p < 0.05 at bivariate analysis were entered into a multivariable binary logistic regression model to identify independent predictors. Statistical significance was set at p < 0.05. Results: Of the 370 respondents, 204 (55.1%) were current users of family planning methods. Injectable contraceptives, oral contraceptive pills, and male condoms were the most frequently utilized methods. Family planning uptake was significantly associated with marital status, ethnicity, monthly income, parity, community influence, and misconceptions regarding contraceptive safety. Following multivariable logistic regression, monthly income and parity remained independent predictors of uptake. Women with higher monthly incomes were significantly more likely to utilize family planning than those with lower incomes, while women with one previous birth demonstrated greater contraceptive utilization than nulliparous women. Conclusion: Family planning uptake among women attending this tertiary healthcare facility was moderate but remains below the level required to achieve optimal reproductive health outcomes. Socioeconomic status and parity independently influenced contraceptive utilization, whereas persistent misconceptions and sociocultural barriers continued to hinder uptake. Strengthening community-based health education, improving male partner engagement, addressing contraceptive misconceptions, and ensuring equitable access to affordable family planning services are essential strategies for increasing contraceptive uptake and improving maternal and reproductive health outcomes in Nigeria.