Parallel 3 - Abstract presentations (Oral-025 - Oral-027)

Women and girls living below poverty benchmarks have high fertility rates, unmet need, live in communities with limited accessibility to contraceptive, and are less likely to afford the cost of transport as well as the cost contraceptive services. To bridge the multidimensional disparities in access and utilization of contraception, Marie stopes deployed 23 Marie Stopes mobile Outreach across the six geo-political zones including the FCT to provide quality contraceptive services free of charge to the client. Our study aimed to assess the utilization of contraception among women and girls living in multidimensional poverty among other consideration. 
Method: The study was cross sectional involved 277 randomly selected clients in Outreach sites. Following informed consent, a pretested-interviewer-administered questionnaire was used elicit information about the service taken, travel time, and access to alternative providers. The global multidimensional-poverty-index (MPI) was used to assess the living condition of the clients.
Results: 36% of the 277 clients live in severe MPI, while 62% are live in MPI. 74% traveled one- hour to reach an outreach site. 81% did not know alternative provider where they could access same service. The method of choice was mostly LARC. The reason for the choice was mainly the long duration of the method. FP2030-MII was 77%, and net promoter score was 61%.
Conclusion: The Outreach model is a viable approach for reaching vulnerable population living in hard-to reach geographies with contraceptive services. Outreach models should be scaled to ensure no one is left behind.

Background/objective: Nigeria is among countries with the poorest contraceptive prevalence rate globally. Many challenges have been identified as constraints, but little have been studied about early marriage as a barrier to contraception. This study explores early marriage as a predisposing factor to low utilization of contraceptives among married women in Nigeria.
Materials and Method: The sample for this study included ever-married women aged 20-24 years who were successfully interviewed in NDHS, 2018. The survey used a two-stage stratified cluster sampling technique for selection of respondents who were interviewed using structured questionnaire adapted from the DHS Program's standard Demographic and Health Survey (DHS-7) questionnaire. The data was analysed using Statistical Package for Social Sciences (version 20.0)
Result: The study showed that higher proportion of early married compared to adult married women preferred less than 24 months waiting period between births (72.2% vs 15.7%), desired 5 or more children as ideal (83.7% vs 57.5%), birth in first year of marriage (75.2 vs 57.3), in lowest wealth quintile (33.3% vs 12.8%), with no education (59.4% vs 20.3%) and married to spouses who desired more children (65.7% vs 45.5%) and with no education (48.7% vs 14.4%). The multivariate analysis revealed that early brides have higher odd for childbirth in first year of marriage (OR=2.26, CI=1.96-2.61), birth of up to 4 children (OR=38.43; CI=28.09-52.58), ever had a pregnancy terminated (OR=1.21; CI=1.00-1.48) and lower odd of waiting period of two or more years (OR=0.66; CI=0.52-0.83). However, Early marriage was only associated with birth of less than 3 children in the adjusted model (AOR=10.28; CI=2.57-41.13).
Conclusion: Early marriage was found to predispose women to constraints that limit the use of contraceptives. It is therefore pertinent to strengthen legislation that supports increasing age of marriage and promote targeted intervention among married adolescents

Background: One of the many decisions made in the household, which has consequence on family well-being, is the timing and spacing of children. This study explored the association between exposure to various forms of communication strategies and contraceptive behavior between women of reproductive age and their spouses. 
Methods: The study was mixed method in design with sequential exploratory method of data collection. About 228 women who gave birth in the last 2 to 4 years and are residing in Kano for more than 6 months were selected using multistage random sampling technique. 
Results: A total of 228 women of childbearing age were interviewed. Majority of the respondent (39.5%) were in the age group 15 to 25 years. The respondents indicated that the most commonly encountered childbirth spacing media programs in Kano State were "Lafiyar Iyalina" and "Ya Take ne Arewa" (with each having 20.6% of the respondents). Using logistic regression model, only watching "Lafiya Jari" [P=0.001, AOR=0.204, 95% confidence interval (CI)=0.204–0.514] and listening to "Lafiya Babbar Ni'ima" (P=0.018, AOR= 0.291, 95% CI =0.11–0.81) were found to be independent predictors of uptake of childbirth spacing. 
Conclusion: Governments and partners working on childbirth spacing should ensure appropriate information on childbirth spacing is passed to the general public using the different relevant mass media to complement interpersonal communications in health facilities. In addition, all media programs on childbirth spacing should target men as partners in progress in matters related to family planning. Keywords: Childbirth spacing, communication, program, uptake, utilization