Influence of the Service Delivery Environment on Family Planning Outcomes in Nigeria

Using linked data from a 2009 health facility and household survey and multilevel logit models, this paper examined the association of the service delivery environment with contraceptive outcomes in Nigeria. The findings showed significant positive associations of the number of modern contraceptive methods provided and quality assurance systems used by health facilities in the Local Government Area (LGA) with the odds of knowing three or more modern methods. These odds were significantly higher among rural than urban residents. The LGA indices of provider training in FP and provider-client interaction had significant positive associations, while a perceived need for more staff in FP health facilities had a significant negative association with the odds of current use of a modern method. The positive association between the index of FP provider-client interaction and current use of a modern method was significantly stronger among women than men and in semi-urban than urban areas.