**1.9 Factors influencing the acceptance of contraceptive implants**

Some studies identified the demographic factors influencing the use of contraceptive as age; parity; marital status and marriage type e.g. polygamy has been associated with lower levels of contraceptive use. A study from Northeast Nigeria reported that women in polygamous unions are less likely to use contraceptives compared with women in monogamous unions. Polygamy, when coupled with youthful age at marriage and with a wide differences in age between spouses, may inhibit husbandwife interactions and perpetuate male dominance within the marriage. This was in line with the study carried out in Ethiopia that showed that woman's age, number of children alive, couple's intention for more children and discussions about contraceptive use among the couple were significantly associated with demand for modern contraceptives among women. Also, it was agreed that religion, education status and age at marriage were significantly associated with contraceptive usage. Furthermore, in a study, it was discovered that age does not affect contraceptive implants use; educational status is significant to the usage of contraceptive implants; there is an association between the age at first birth and the use of contraceptive implants, which indicates that age at first birth influences the use of contraceptive implants;

and the number of liveborn children has a significant impact or influence on the use of implants. A study also indicates that any categories of women of childbearing age could use or utilise contraceptive implants [10, 13–15].

It has been stressed that age of women, the level of education of women, the religion of women, marital status of women, health care visits during antenatal care and childbirth were significantly associated with the use of any contraceptive method [16].

It had been discovered that socio-demographic factors may be alleviated by biological and behavioural factors, such as sexual activity, fecundity and desire for children. African societies as pro-natalist, believe that children are a gift from God and as such are social and economic investments; this has undesirable influence on the use of contraceptives. Studies have found that an inverse relationship exists between the number of living children and use of modern contraceptives. Evidence from variety of nations has pointed towards the partner's disapproval and his desire for more children as key factors for non-use of contraception [13].

Furthermore, it has been stressed that there has been found a strong relationship between women's education, especially completed primary education and entry into secondary level, and fertility reduction. Several studies have reported that women's education has a strong positive impact on contraceptive use). In Nigeria, education has been found to increase contraceptive use. Nigerian women with tertiary level education are one-and-a-half times more likely to have ever used contraception than women with secondary education. Partner's level of education is equally important, because it may operate through many of an equivalent pathways (childbearing preferences) because the woman's own education, as long as education levels of husbands and wives are positively correlated. Results from some studies conducted showed that older female adolescents were quite three (3) times likely to practice contraceptive use than younger female adolescents. The findings also revealed that the level of education, working status, knowledge of ovulatory cycle, visit of the health facility and marital status were the determinants for contraceptive use among female adolescents [13, 17].

The extent of education may be a predictor of socio-economic status, which correlates with contraceptive use. It showed that women of lower socio-economic status have lower uptake rates of contraceptives. Also, exposure to mass media has strong effects on attitudes towards family planning through ideation. However, a study identified the following as reasons for rejecting contraceptive implants among women of childbearing age: fear of side effects; lack of interest; husband's refusal; lack of information; religion influence; contraceptive failure; lack of regular sex; and it diminishes sexual pleasure [10, 13].

#### **1.10 Attitude and practice of women of childbearing age to contraceptive usage**

It has been discovered in some studies that some women were afraid of the side effects of contraceptives; some want to conceive; familial pressure; lack of knowledge, are the reasons some women of childbearing age do not accept contraceptives. Also, a research showed that the fear of side effects is the main reason for low contraceptive prevalence among young female students. However, the results of a study carried out indicated that the main reasons for switching to implant contraceptive among women of childbearing age were: convenience, contraceptive failure and experienced side effects with other contraceptive methods.
