Contraceptive practices among nomadic Fulani women in Bade Local Government Area, Yobe State, Nigeria: a cross-sectional study evaluating barriers and predictors

Introduction: maternal mortality is high in low and middle-income countries due to limited access to maternal health services, including contraception. In Yobe State, modern contraceptive awareness and use are low among married women, particularly nomadic Fulani women. This study investigated barriers and predictors of contraception among these women. Methods: this cross-sectional mixed-methods study, conducted in June 2022, sampled 542 women using multistage and purposive techniques. Data were gathered via questionnaires, focus group discussions, and interviews. Descriptive statistics included means and standard deviations for continuous variables and frequencies for categorical variables. Chi-square tests assessed associations between sociodemographic (independent) and contraceptive use/unmet need (dependent) variables. Variables with p≤0.05 or p≤0.2 in bivariate analysis were included in a binary logistic regression to identify predictors of contraceptive use. Qualitative data, structured with hierarchical headings, were coded in NVivo, analyzed using data mining, and triangulated with quantitative results. Results: the study surveyed 542 nomadic Fulani women, with a mean age of 30.6 years (SD ± 8.31). Contraceptive unmet need was high (355 women, 76.5%), as was demand (390 women, 79.1%), but only 64 women (11.8%) used contraception. Antenatal care attendance was the sole significant predictor of ever-use (aOR = 5.5, 95% CI: 2.56-11.91, P<0.001). Qualitative findings identified cultural beliefs, knowledge gaps, cost, and transportation as key barriers. Conclusion: low contraceptive use persists despite high need. Addressing cultural beliefs, knowledge gaps, and barriers to access through targeted education, training of healthcare workers, loan programs, and mobile healthcare services is recommended.