Gender Differences in Perceptions of
Family Planning and Fertility Preferences in Northern Nigeria
Harvard T H Chan School of Public Health, USA
Submission: January 05, 2021;Published: January 11, 2021
*Corresponding author: Ryoko Sato, Harvard T H Chan School of Public Health, USA
How to cite this article: Ryoko S. Gender Differences in Perceptions of Family Planning and Fertility Preferences in Northern Nigeria. J Gynecol Women’s
Health. 2021: 20(4): 556043.DOI: 10.19080/JGWH.2021.20.556043
Objective: We evaluate differences between women and men regarding information level, perceptions, preferences around fertility, and family planning use using a primary data collection method.
Methods: The study was conducted in Jada local government area of Adamawa state, the northeastern Nigeria among married women between 15 and 45 years or married men whose wives were between 15 and 45 years. We analyze the data to compare the differences in fertility preference and knowledge and preference regarding family planning between women and men.
Results: We find that married women prefer significantly fewer children than men. However, both men and women show high satisfaction with their spouses in terms of fertility choices. The level of understanding about family planning methods, as well as the intention to use family planning, was the same between women and men. Men qualitatively viewed women’s use of family planning more favorably than women themselves did.
Conclusion: Contrary to the findings from existing research, men’s opposition to women’s use of family planning is unlikely to be a major barrier to the demand for family planning among women in northern Nigeria. Gender Differences in Perceptions of Family Planning and Fertility Preferences in Northern Nigeria
Keywords: Gender differences; Family planning preferences; Fertility preferences; Nigeria
Nigeria has one of the highest fertility rates in the world at 5.53. This high fertility rate threatens the sustainable economic growth of the country, poverty alleviation efforts, and the improvement of maternal and child health outcomes . The unmet need for family planning, together with the high fertility rate, contributes to high rates of unintended pregnancies and unsafe abortions annually .
Promoting the use of family planning is an effective way to control the fertility rate and reduce the number of unwanted pregnancies . Despite this benefit, the use of family planning methods is limited in Nigeria, making slow progress over the last 15 years. The lack of information about the importance of birth spacing and the benefits of family planning has been cited as one of the important reasons for low uptake . According to the
Demographic Health Survey conducted in Nigeria in 2013, women in the northern part of the country were less likely to have heard of a family planning method. On the other hand, there were fewer differences in contraception knowledge among men across these categories .
In addition to examining knowledge of family planning methods, understanding fertility preference is important to assess women’s desire for children and the extent of unwanted pregnancies. In patriarchal African communities, men and husbands are important decision makers in regards to family planning use and fertility decisions . Therefore, explorations of barriers to contraception use, interventions to increase their use, and determinants of fertility choices should also include an understanding of the role of men.
A few studies have examined discordance in fertility
preferences and family planning between men and their
wives in Nigeria . However, no recent study has examined
these preferences in a community-based survey in northern
Nigeria with an emphasis on capturing factors that determine
differential demand for children between men and women and
their perceptions on family planning. Given the limited literature
available, it is important to fill the gap to deepen our knowledge
on the differences in preference by gender, as it can be one of
the main barriers to the uptake of family planning methods, as
suggested by extant studies .
The study was conducted in Jada local government area of
Adamawa state, where contraception use is extremely limited.
Individuals were eligible to participate in this study if they were
married women between 15 and 45 years or married men whose
wives were between 15 and 45 years and resided in one of the
four settlements within the catchment areas of two health clinics:
Jada Primary Health Clinic I and Kojoli Primary Health Clinic.
These settlements were selected to provide a range of contexts
around family planning. Households within each settlement were
visited to identify and interview eligible respondents until each
interviewer reached the target number of respondents: three
women and three men per day. The total number of participants in
this study was 95 women and 96 men.
Data were collected in October 2018. The interview instrument
was designed to elicit the following pieces of information via
a survey format: sociodemographic characteristics, fertility
preference, and knowledge and preference regarding family
planning, as well as its use. Interviews were held in a private
area, and respondents’ spouses were not around during the
interview. Men were asked about their wives. If a man had more
than one wife, specific questions were asked about his youngest
wife. This was to simplify the procedure of the data collection
for interviewers. Data were gathered by six locally based trained
health workers. The lead author of the study supervised the data
collection to ensure quality control.
Data were checked for completeness and inconsistencies after
the data collection. CSPro version 6.1 was used for data entry, and
data were exported to Stata version 15. Descriptive statistics were
computed for characteristics collected during the baseline survey,
and OLS regression analysis was used to compare the differences
in fertility preference and knowledge and preference regarding
family planning between women and men.
Ethical clearance was obtained from the Health Research
Ethical Committee of Adamawa State Ministry of Health. Verbal
informed consent was obtained from all study participants, and
they were assured of voluntary withdrawal from the study at any
point. Each study participant was given 300 naira as compensation
for his or her time.
A total of 197 eligible people were approached. Among them,
95 married women and 96 married men were interviewed,
yielding a response rate of 96.9%. One woman was later revealed
to be ineligible due to her age, and five households refused to
participate in the study
Differences between women and men
Table 1 shows differences in sociodemographic characteristics
between men and women. The average age among women was
29.41 years old, and the women were 11 years younger than the
men. Women were much less educated than men; the proportion
of women who had completed secondary education or more was
37.1 percentage points less than the proportion of men who had
done the same. We also asked for the ages and education levels
of interviewees’ spouses. Women were 13 to 14 years younger
than their husbands, and women were much less educated than
their husbands; 34.7% of women had received at least secondary
education, while 68.4% of women’s spouses had secondary
education. The majority of respondents, over 85%, were Muslim,
regardless of gender. Women were 12.7 percentage points less
likely to have paid work than men.
Table 2 presents the differences in fertility preferences
by gender. The average number of children women wanted in
the future is significantly less than the number of children men
wanted. While women on average would like to have 3.6 more
children in the future and 0.67 children in the next 2 years, they
wanted 3.07 fewer children in the future than men did, and they
wanted 1.6 fewer children in the next 2 years than men.
Perceptions about their spouse’s fertility preferences, on the
other hand, were not significantly different between women and
men. Statistically, the same proportion of women and men thought
that their spouse wanted the same number of children as they did,
and the same proportion of women and men thought that their
spouse wanted more children than they did. The proportion of
women who were very happy with their husbands in terms of the
number of children they had is the same as the proportion of men
felt the same way regarding their wives.
Among women, 15.5% of them thought that having many
children was good, and around the same proportion of women
(14.7%) thought that their husband thought the same, and
18.9% of women thought that people in their community
thought that having many children was good. These percentages
were statistically the same as the percentages among men. The
perception about birth spacing is similar among women and men
from their own perspective, their spouse’s perspective, and the
Table 3 presents family planning use. The use of family
planning self-reported by women and reported by men about
their wives was statistically the same. Only 7.4% of women were
currently using family planning, while 17.2% of them had ever
used modern family planning. Among ever-users out of the female
interviewees, 56.3% had used injectables, 37.5% had used oral
pills, and the remaining 6.3% had used implants. Among male
respondents’ wives, 5.2% were currently using family planning,
and 13.5% had ever used family planning. Among ever-users out
of male interviewee’s wives, 53.8% had used oral pills, followed by
Table 4 presents the knowledge, perceptions, and intention
of family planning use. The knowledge level of each method of
family planning was statistically the same between women and
men. Among eight different methods of family planning (family
planning, female sterilization, male sterilization, IUD, injectables,
implants, oral pills, and condoms), women knew about slightly
over half (4.55, or 56.8%) of them. While the lowest proportion
of women knew about male sterilization (16.8%), 76.8% of
women knew about injectables. Women had correct knowledge
about 56.5% of family planning methods. There was no statistical
difference in knowledge of family planning between women and
There was no difference in most of the perceptions about
family planning, both negative and positive. Among women, 9.5%,
5.3%, and 4.2% of them respectively thought that infertility would
be caused by injectables, IUDs, and implants. A small proportion
of women (3.2%) thought that implants were inserted into the
vagina, which is false information. Over 15% (17.9%) of women
thought that family planning was evil, while 12.6% and 11.6%
of women respectively thought that family planning was good
for women and for babies who are to be born. About one-third
(30.5%) and one-fifth (18.9%) of women respectively thought
that family planning was dangerous for women and for husbands.
These perceptions were statistically the same among women and
The exception is on the cancer risk caused by oral pills. While
9.5% of women thought that oral pills caused cancer, 20.8% of
men thought so. The difference is statistically significant (11.4
percentage points). Finally, the intention of family planning use in
the future is also statistically identical between women and men.
For men, we asked their intention to recommend family planning
use to their spouses. On average, 74.7% of women and 82.3% of
men had the intention to recommend it to their spouses.
This study compared differences in preference for and
understanding of fertility and family planning between married
women and men. Although women and men were not always
paired in our sample, we consider that the characteristics of the
interviewed men reflect the similar characteristics of interviewed
women’s husbands due to the same selection criteria we used for
interviewed women and men’s spouses.
We found a large gap in sociodemographic characteristics
between women and men, which might lead to unbalanced
decision power regarding family planning use. Women were
much younger and much less educated than their husbands.
Women were also much less likely to have paid work than men.
In this setting, demand for family planning among women can be
hindered by the unbalanced power in decision-making when men
have different perceptions from women [9-12]. Our study also
revealed that men want significantly more children than women
do. This difference in fertility preference is another risk factor for
the low uptake of family planning among women.
Contrary to this concern, however, we found that most women
(82.1%) were very happy with their spouses in terms of fertility
preferences. Women did not perceive differently from men in terms
of the number of children they thought their spouses wanted to
have. We also did not observe any significant differences in terms
of perceptions on birth spacing between women and men. Thus,
although there is a gap in fertility preferences between women
and men, wives and husbands seem to have good understandings
of each other and similar understandings of the important
Our study also implies that men have deeper knowledge and a
potentially more favorable view on family planning than women.
First, the knowledge level of family planning methods was higher,
although insignificantly so, among men than among women.
Second, we observed that men were also more likely, although
insignificantly so, to acknowledge that family planning is good and
less likely to think that it is evil. We also found that the intention to
use family planning in the future was qualitatively higher among
men (their intention to recommend that their wives use family
planning) than among women (their own intention to use family
planning), although the difference was insignificant. It is also
important to note that that the intention of future use was high for
both women and men: 74.7% and 82.3%, respectively.
Third, although men were also more likely to have concerns
about side effects of family planning such as infertility and cancer
than women, this might indicate the higher level of knowledge
on family planning among men. These results are consistent
with some extant studies, which have observed the high level of
knowledge and favorable attitude toward family planning among
men in Africa [13,14], while other studies found that African men
have negative attitudes toward family planning .
Overall, our findings consistently indicate that it is unlikely that
men’s perceptions are barriers to women’s use of family planning,
and there is no significant disagreement in terms of decisionmaking
on family planning use. This finding is not consistent with
the findings of Duze and Mohammed  from northern Nigeria.
However, as Bietsch  pointed out, it is possible that men have
increased their acceptance of family planning in recent years.
We need to be cautious about the interpretation of the results,
however, especially the satisfaction with spouses in terms of
fertility preferences. It is possible that wives and husbands might
not have been discussing family planning use as an option as well
as their fertility choices, given the extremely low rate of family
planning use. Tumlinson et al.  observed that in Kenya, while
23-30% of men and women never discussed family planning with
their partners, about 70% of those who never discussed family
planning perceived that their partners and they were in agreement
in terms of fertility desires.
Our study has several limitations. First, the sample was not
randomly selected; thus, it might not be representative. Although
we made sure that we approached all the households, this method
could still cause some bias. Thus, we do not claim the external
validity of the study. Second, it is challenging to evaluate the
comparison between women’s intention to use family planning
and men’s intention to recommend that their wives use family
planning. It might be easier for men to recommend use to their
wives than for women to actually use family planning [16-19].
This paper evaluates the differences in fertility preferences and
knowledge and preferences regarding family planning between
married women and men in northern Nigeria, where family
planning utilization is extremely low. We found that the married
women had a preference for significantly fewer children than men.
However, this difference in fertility preferences did not seem to
cause dissatisfaction with their spouses in terms of fertility from
both women’s and men’s perspectives. We additionally found that
the level of understanding about family planning methods was
statistically the same between women and men, and that the
intention to use family planning was also the same. Furthermore,
we found that, qualitatively, men viewed women’s use of family
planning more favorably than women themselves did. These
results indicate that, contrary to the findings from existing papers,
men’s opposition to women’s use of family planning is unlikely
to be a major barrier to the demand for family planning among
women in northern Nigeria.
a) We are grateful to Abdullahi Belel and the Adamawa State
Primary Health Care Development Agency for their cooperation
and support throughout the project implementation. We give
special thanks to Benjamin Fintan and the field team who devoted
themselves to the project.