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BACKGROUND: Contraceptive use in Nigeria has been consistently low despite its many benefits and several efforts by government and development partners to increase its uptake. According to the Nigeria Demographic and Health Survey, the use of any modern method staggeringly increased from 4 to 12% over 28 years (1990–2018). Studies have identified factors at the individual, household, and societal levels that affect contraceptive use. While studies have also shown that decisions such as contraceptive behavior and acquisition of family skills may vary according to the individual or societal factors, there is a dearth of knowledge on how household structure and composition influence contraceptive use in Nigeria. This article seeks to contribute to the body of knowledge by exploring contraceptive use within the household context. METHOD: We used data from the 2018 Nigeria Demographic and Health Survey to examine the relationship between household structure and contraceptive use. We excluded pregnant and non-married women at the time of the survey from the sample and used multinomial regression analysis to examine the likelihood of using traditional or modern methods of contraception. RESULTS: Results show that having a large household size, and the presence of multiple wives in the household significantly reduces the likelihood of using any method of contraceptive. The result further shows a significant association between household wealth index and contraceptive use as the use of any method increases with household wealth index, with those from richest households being twice as likely as their counterparts in the poorest households to use traditional methods (OR:2.02, p < 0.05). Also, women living in households headed by older men (25 and above), households with under 5 children, and those living in rural areas have significantly reduced likelihood of using any method. CONCLUSION: This study highlights the dynamics of contraceptive use among married women considering household composition. While our study serves ...

Nigeria has the highest population of unimmunized children in the world and is one of few countries with less than half the population covered with essential health services. Low coverage of services poses a threat to the health and well-being of Nigerian children, but this threat becomes even more pronounced against a backdrop of the 'health financing transition', including the transition from support from the Gavi Alliance, the main source of financing for the country's immunization program. The Nigeria Immunization Financing Assessment shows how the factors at multiple levels of government and the health system interact to affect four dimensions of health and immunization financing: adequacy; sustainability; efficiency; and predictability. The findings informed the design of the Nigeria Strategy for Immunization and PHC System Strengthening (NSIPSS), which will be used to guide the country as it transitions from Gavi support. This paper emphasizes the need to implement the NSIPSS in close coordination with the current reforms underway in the health sector. Currently, the government of Nigeria is piloting reforms at federal, state, and local levels to fast track implementation of the National Health Act, which aims to bring additional and 'smarter' domestic resources for health to the facility level. Also needed are systematic linking of health plans to budgets, more efficient allocation of resources, coordinated advocacy, exploration of demand-side barriers to service delivery, capacity building, and strengthened accountability mechanisms that ensure investments in health lead to improved health outcomes. A transition planning process that is grounded, backed by evidence, monitored and adapted regularly, and backed by the highest level of the government of Nigeria will be critical for changing the trajectory for the children of Nigeria.