{
  "abstract": "Couple agreement on contraception is widely treated as a marker of programme success, yet whether such agreement has kept pace with rising contraceptive use in sub-Saharan Africa is largely unknown. We analysed three rounds of the Nigeria Demographic and Health Survey Couples’ Recode (2013, 2018, 2024; 23,547 couples) using design-weighted descriptive, trend, and multivariable logistic analyses. We defined practice concordance from partners’ independently reported current method status and decomposed it into five mutually exclusive categories. A qualitative study of 42 Ogun State couples illustrated the mechanism behind the pattern. National practice concordance fell from 81.6% to 73.5% (and from 70.0% to 46.4% in Ogun State) even as women's modern use (9.7% to 16.1%), spousal communication (33.0% to 42.1%), and Unmet need (16.1% to 21.3%) rose. Concordance was overwhelmingly shared non-use (69.5% in 2024); genuine mutual active use remained near 4%; and wife-only discordance nearly doubled (7.5% to 14.0%), which supplied most of the offsetting rise in discordance as shared non-use contracted. An inverse socioeconomic gradient and a north-south gradient persisted after adjustment, and spousal communication was negatively associated with concordance (odds ratio 0.83, 95% CI 0.76–0.91). Rising, increasingly female-led contraceptive practice is associated at the population level with falling couple concordance, a pattern consistent with an incomplete gender transition rather than programme failure.",
  "abstract_shown": true,
  "affiliations": [
    "Research and Development Department, Fescosof Data Solutions, Ogun State, Nigeria."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Olaniyi Felix Sanni",
      "orcid": "0000-0001-7761-3604"
    },
    {
      "affs": [
        0
      ],
      "name": "Abike Elizabeth Sanni"
    },
    {
      "affs": [
        0
      ],
      "name": "Collins Isioma Onyeagwaibe"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f4vgyy4bmzj4s.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pgph.0007450",
  "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007450",
  "id": "f4vgyy4bmzj4s",
  "issns": [
    "2767-3375"
  ],
  "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007450",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Africa"
    ],
    [
      "heading",
      "Bioengineering"
    ],
    [
      "heading",
      "Biology and Life Sciences"
    ],
    [
      "heading",
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    [
      "heading",
      "Cognition"
    ],
    [
      "heading",
      "Cognitive Psychology"
    ],
    [
      "heading",
      "Cognitive Science"
    ],
    [
      "heading",
      "Communications"
    ],
    [
      "heading",
      "Contraception"
    ],
    [
      "heading",
      "Contraceptives"
    ],
    [
      "heading",
      "Decision Making"
    ],
    [
      "heading",
      "Drugs"
    ],
    [
      "heading",
      "Engineering and Technology"
    ],
    [
      "heading",
      "Female Contraception"
    ],
    [
      "heading",
      "Geographical Locations"
    ],
    [
      "heading",
      "Male Contraception"
    ],
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      "heading",
      "Medical Devices and Equipment"
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      "heading",
      "Medicine and Health Sciences"
    ],
    [
      "heading",
      "Neuroscience"
    ],
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      "heading",
      "Nigeria"
    ],
    [
      "heading",
      "Obstetrics and Gynecology"
    ],
    [
      "heading",
      "People and Places"
    ],
    [
      "heading",
      "Pharmacology"
    ],
    [
      "heading",
      "Psychology"
    ],
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      "Qualitative Studies"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "heading",
      "Research Design"
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      "heading",
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    [
      "heading",
      "Women's Health"
    ],
    [
      "plos",
      "/Biology and life sciences/Bioengineering/Biotechnology/Medical devices and equipment/Contraceptives"
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      "/Medicine and health sciences/Pharmacology/Drugs/Contraceptives"
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      "/Medicine and health sciences/Women's health/Obstetrics and gynecology/Contraception/Female contraception"
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    [
      "plos",
      "/Medicine and health sciences/Women's health/Obstetrics and gynecology/Contraception/Male contraception"
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      "/People and places/Geographical locations/Africa/Nigeria"
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  "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0007450&type=printable",
  "pmcid": "PMC13722185",
  "pmid": "42961882",
  "published": "2026-10-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/f4vgyy4bmzj4s.ris",
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    {
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:neuroscience",
      "subfield": "neuroscience"
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    {
      "field": "biology",
      "origin": "plos:biotechnology",
      "subfield": "systems-synthetic"
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      "field": "medicine",
      "origin": "heading:Pharmacology",
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    {
      "field": "medicine",
      "origin": "plos:obstetrics and gynecology",
      "subfield": "reproductive-child"
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  ],
  "title": "Rising contraceptive use, falling couple concordance: A mixed-methods analysis of the concordance paradox in Nigeria",
  "title_text": "Rising contraceptive use, falling couple concordance: A mixed-methods analysis of the concordance paradox in Nigeria",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:44Z",
  "url": "https://research.draconitic.com/paper/f4vgyy4bmzj4s",
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}