Bayesian Spatio-Temporal Modelling of Reported Terminated Pregnancy Across Nigerian States (2013-2024)

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Abstract

The long- standing disconnection of abortion legislation in Nigeria with the estimated incidence of 1.8 million terminations a year has contributed to systematic gaps in reliable abortion data for health policy. Any subnational monitoring under conditions of legal restraint tends to remain hidden beneath under-reporting and spatial instability such that policy makers are not left with a clear picture of where and why these decisions are being made. To address this ambiguity, this paper traces the path of state-level evolution of reproductive choices within the 2013, 2018 and 2024 NDHS. We detected the latent socio-demographic causes of terminated pregnancy using a Bayesian spatio-temporal framework, such as wealth, education, literacy, and contraceptive prevalence. The rates were highly spatio-temporally intense and polarized in the region, with probabilistic evidence to justify state-specific reproductive health interventions between 2013 and 2024. Southern and coastal states (e.g., Lagos, Bayelsa) demonstrated sustained increases in prevalence in line with a high fertility transition, termination is more reproductive agency, access to services and reporting. Conversely, the unmet contraceptive need and structural vulnerability were the major causes of increased rates in the northern states (e.g., Yobe, Kano). Patterns of determinants also changed with time: in previous surveys, household wealth turned out to be a protective factor, as of 2024, education and literacy had become the strongest predictors. Such findings affirm a dual reproductive regime in Nigeria—choice based in the South and vulnerability based in the North necessitating a shift from homogenous national approaches to state-specific reproductive health policies.

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