Understanding knowledge, attitude and practice gap in family planning utilisation among married women in Nigeria

Family planning (FP) is a reliable and efficient method that provides good reproductive health and general well-being, thereby preventing infant and maternal deaths. A major contention to FP utilisation in Sub-Saharan Africa (SSA) is that knowledge and availability are not commensurate with the usage. Hence, understanding the FP Knowledge, Attitude and Practice Gap (FP KAP-Gap) is key to improving utilisation and reducing maternal and infant mortality. The study used cross-sectional data collected in year 2022 among 2646 married women of reproductive age through interviews. Univariate, bivariate, and multivariate logistic regression models were used in modelling FP KAP-Gap among the women. The study revealed that more than half (50.3%) of the women identified radio as their source of FP information. Pill (67.6%) and condom (66.0%) were the most popular methods among them. However, the most used methods were condoms and implants. The KAP-Gap increased as the women grew older. Also, increased education, years of marriage, number of male children, number of living children (AOR = 1.957; CI 1.376–2.784), and spousal approval (AOR = 2.709; CI 2.050–3.581) cause KAP-Gap to increase among married women. The knowledge of FP is not commensurate with its utilisation as expected because this present study revealed that different sociocultural cum demographic factors created the KAP-Gap. Therefore, to effectively reduce the KAP-Gap among women, policies and interventions must move from mere increased awareness to community-driven programmes that promote gender-equitable decision making, expand universal access to reproductive health services, and strengthen education and economic empowerment.