This study investigated urban-rural differences in the prevalence of unmet need for family planning among women of reproductive age in Kano State, Nigeria, and identified factors contributing to these disparities. Rural-urban disparities in unmet need for family planning outcomes and women's characteristics were assessed. Univariate multilevel mixed-effect logistic regression models were employed to quantify the association between rural/urban residences and each unmet need for family planning and related outcomes. In urban areas, factors associated with unmet need for family planning included husband/partner (OR: 0.25, 95% CI 0.07 to 0.88, p=0.031) and joint decision-making about medical treatment (OR: 0.27, 95% CI 0.09 to 0.80, p=0.018). In rural areas, middle wealth categories (OR: 1.92, 95% CI 1.07 to 3.47, p=0.029), women with 3-4 (OR: 5.41, 95% CI 1.07 to 27.1, p=0.040) and ≥5 birth events (OR: 8.44, 95% CI 1.74 to 40.82, p=0.008) and those who work but are not paid in cash (OR: 0.46, 95% CI 0.21 to 0.99, p=0.049) were associated with unmet need for family planning. Tailored interventions considering socioeconomic, cultural and geographical factors are essential to reduce barriers to family planning services and promote informed decision-making among women in Kano State.
Keywords: comparative; disparities; family planning; rural; unmet need; urban.
© The Author(s) 2025. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.