Armed conflict, insecurity, and attitudes toward women's and girls' reproductive autonomy in Nigeria

Signe Svallfors; Karin Båge; Anna Mia Ekström; Kelly Elimian; Ezra Gayawan; Helena Litorp; Anna Kågesten

doi:10.1016/j.socscimed.2024.116777

Armed conflict, insecurity, and attitudes toward women's and girls' reproductive autonomy in Nigeria

Soc Sci Med. 2024 Mar 27:348:116777. doi: 10.1016/j.socscimed.2024.116777. Online ahead of print.

Authors

Signe Svallfors¹, Karin Båge², Anna Mia Ekström³, Kelly Elimian⁴, Ezra Gayawan⁵, Helena Litorp⁶, Anna Kågesten⁷

Affiliations

¹ Department of Sociology, Stanford University, USA; Department of Global Public Health, Karolinska Institutet, Sweden. Electronic address: svallfors@stanford.edu.
² Department of Global Public Health, Karolinska Institutet, Sweden. Electronic address: karin.bage@ki.se.
³ Department of Global Public Health, Karolinska Institutet, Sweden; Department of Infectious Diseases, Venhälsan, South General Hospital Stockholm, Sweden. Electronic address: anna.mia.ekstrom@ki.se.
⁴ Department of Global Public Health, Karolinska Institutet, Sweden. Electronic address: kelly.elimian@ki.se.
⁵ Department of Statistics, Federal University of Technology, Akure, Nigeria. Electronic address: egayawan@futa.edu.ng.
⁶ Department of Global Public Health, Karolinska Institutet, Sweden; Department of Women's and Children's Health, Uppsala University, Sweden. Electronic address: helena.litorp@ki.se.
⁷ Department of Global Public Health, Karolinska Institutet, Sweden. Electronic address: anna.kagesten@ki.se.

PMID: 38569280
DOI: 10.1016/j.socscimed.2024.116777

Abstract

Background: Armed conflict and insecurity have been linked to deteriorations in reproductive health and rights globally. In Nigeria, armed violence has taken a significant toll on women's and girls' health and safety. However, knowledge is limited about how conflict shapes attitudes surrounding their ability to make autonomous decisions on relationships and childbearing. Drawing on a socioecological framework and terror management theory, we aimed to investigate the association between conflict, insecurity, and attitudes toward women's and girls' reproductive autonomy in Nigeria.

Methods: We conducted a cross-sectional study using data from two sources: the World Values Survey (WVS) and the Uppsala Conflict Data Program-Georeferenced Event Dataset (UCDP-GED). Nationally representative data on attitudes of 559 men and 534 women was collected by WVS in 2017-2018. Linear probability models estimated the association between attitudes toward five dimensions of women and girl's reproductive autonomy (contraception, safe abortion, marital decision-making, delayed childbearing, early marriage), respondents' perceptions of neighborhood insecurity using WVS data, and geospatial measures of conflict exposure drawn from UCDP-GED.

Results: Exposure to armed conflict and perceived neighborhood insecurity were associated with more supportive attitudes toward access to safe abortion among both men and women. Among women, conflict exposure was associated with higher support for contraception and the perception that early marriage can provide girls with security. Conflict-affected men were more likely to support a delay in girls' childbearing.

Conclusion: Our findings suggest that conflict and insecurity pose a threat to, but also facilitate opportunities for, women's and girls' reproductive autonomy. Contraception, abortion, early marriage, and postponement or childbearing may be perceived as risk-aversion strategies in response to mortality threats, livelihood losses, and conflict-driven sexual violence. Our findings foreshadow changes in fertility and relationship patterns in conflict-affected Nigeria and highlight the need for health programming to ensure access to contraception and safe abortion services.