Family Health and Wealth Study Funded By: The Bill and Melinda Gates Institute, Johns Hopkins University, USA.

The family health and wealth study is a multi-center and multi-country longitudinal study that aims to examine individual-and-family level health and economic consequences of family size on wide ranges of reproductive health issues with special emphasis on family planning. As a follow-up to the sampling of 502 households in the first phase of the study in year 2010, a 2-week training was conducted for 30 Research Assistants, 2 field workers and 3 supervisors in Ibadan between September and October, 2011. Following this, the field work was commenced from October to December 2011. Of the 502 households sampled in the first round, 307 were successfully followed up. A very high migration rate was observed among the households. An additional 550 households were then selected from a sampling frame of 1100 from appropriately selected and randomized enumeration areas in the same local government area but different from the enumeration area of phase I. Over 500 of these have been surveyed at the moment. Data entry and analysis for has been completed with preliminary analysis done.

Conference Presentations

Spousal Separation and Modern Contraception use in a Peri-urban Society: Findings from the Family Health and Wealth Study (FHWS)

Imran Morhason-Bello¹, Tolulope Mumuni², Rukiyat Abdus-salam ³, Michael Okunlola¹, Oladosu Ojengbede^{1, 2}

1. Department of Obstetrics and Gynaecology, University of Ibadan
2. Center for Population and Reproductive Health, College of Medicine, University of Ibadan
3. Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan

Objectives: To assess the association of spousal separation on modern contraceptive (MC) use among women in a peri-urban community in Nigeria.

Method: The FHWS is an open-cohort study among 497 randomly selected couples from households in Moniya, Akinyele Local Government Area conducted in 2010.  Eligible couples were enrolled following delineation and listing of all houses within the selected site. Spousal separation was defined as couples not leaving together all the time. In this analysis the primary outcome was assessed using the question on type of contraceptive used by the women. Bivariate and multivariate analyses were used to determine factors associated with modern contraceptive use at 95% confidence level.

Results: The reported duration of spousal separation was 1-4 weeks by 167 (33.6%) women. Modern contraception use among women reporting spousal separation was 31.1 % against 37.6% among those leaving with their spouse. Women with highest household wealth quintile had a higher proportion reporting MC use (45.9%) compared to women who had lower/middle (33.3%), higher (21.9%) and lowest (20.0%) wealth quintiles. Women in polygamous unions (32.0%) and those married for 10 years and more (38.7%) had a higher proportion reporting MC use compared to women in monogamous unions (28.6%) and those married for less than 10 years (26.7%). These were not statistically significant

Conclusions: This study did not establish an association between spousal separation and MC use. This is not in tandem with previous research findings.

Relationship Quality Assessment by Women and Modern Contraceptive use in a Peri-Urban Setting in Nigeria: Findings from the Family Health and Wealth Survey (FHWS)

Michael Okunlola¹, Imran Morhason-Bello¹, Tolulope Mumuni ², Rukiyat  Abdus-salam ³, Oladosu Ojengbede^1,2

1. Department of Obstetrics and Gynaecology, University of Ibadan
2. Center for Population and Reproductive Health, College of Medicine, University of Ibadan
3. Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan

Objectives: This study assessed the association between key construct of marital relationship quality scale (RQS) and uptake of modern contraception (MC) by married women in Nigeria.

Method: The FHWS was an open-cohort study conducted in 2010 among 497 randomly selected couples from households in Moniya, Akinyele Local Government Area, Nigeria The 5 RQS scales used were  commitment, trust, constructive and destructive communication and relationship satisfaction.  Descriptive, bivariate and multivariable analyses were performed to determine associated factors for MC uptake at 95% confidence level.

Results: 35% of the women reported MC use. Higher commitment scores was associated with MC use (39.8+5.2) compared to non use ((38.6+6.1), (p=0.032). Women married for 5-9 years (OR=2.46, 95%CI= 1.46-4.14) and 10 years and above (OR=2.46, 95%CI= 1.45-4.17) were twice more likely to use a modern contraceptive method to those married for less than 5 years.  Women with the lowest wealth quintile were twice less likely to use MC compared to the highest wealth quintile (OR=0.50, 95%CI=0.26-0.93).

Conclusions:  Some RQS measures appear to influence MC uptake among Nigerian family. More research is required to further understand this concept which may be beneficial in the development of family planning programmes.

Gender fertility preference by men: A disincentive for Modern Contraceptive uptake among couples in Nigeria?

Tolulope Mumuni¹, Oladosu Ojengbede^1,2, Imran Morhason-Bello ², Rukiyat  Abdussalam ³, Michael Okunlola ²

1. Center for Population and Reproductive Health, College of Medicine, University of Ibadan
2. Department of Obstetrics and Gynaecology, University of Ibadan
3. Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan

Objectives: The study aimed to determine the association between male fertility preferences, male involvement in family planning and modern contraceptive use

Method: The Family Health and Wealth Study (FHWS) is an open-cohort study among 497 randomly selected couples from households in Moniya, Akinyele Local Government Area conducted in 2010.  Eligible couples were enrolled following delineation and listing of all houses within the selected site. In this analysis the primary outcome modern contraceptive (MC) use was assessed using the question on type of contraceptive used by the men. Bivariate and multivariate analyses were used to determine factors associated with MC use at 95% confidence level.

Results: MC use and desire for more children was 28.4% and 72.4% among the men. MC use was higher among men who did not desire more children (38.7%) compared to those who desired more (27.7%) and those who were not sure (34.6%), (p=0.013). Discussion of number of children with wives (p<0.001), desire for same number of children as wives (p=0.003), ability to afford another child (p=0.015) and joint decision making on family health (p=0.039) were significantly associated with MC use. MC use was higher among men who desired only male children (30.0%) compared to those who desired either male/female children (24.6%), (p=0.695).

Conclusions: Men who do not prefer to have more children and those who desired only male children are more likely to use MC. The findings further buttress the role of men in family planning.