Perspectives among postpartum women, men, and healthcare providers on barriers to family planning services in rural Nigeria.

Low uptake of family planning (FP) particularly during the postpartum period contributes to unintended pregnancies, thus increasing the risk of maternal morbidity and mortality globally. This cross-sectional mixed-methods study explored barriers to FP in rural southwest Nigeria using surveys from 388 men and women and interviews with 14 midwives across three states (June-July 2022). Eligible participants included postpartum women, men, and midwives. Quantitative data were analyzed using SPSS, and qualitative data using Braun and Clarke's thematic analysis in Atlas.ti. The results show that although 62.6% of respondents had good knowledge of FP, only 35.5% reported current use. However, positive attitude (OR=1.689, p<0.05), tertiary education (OR=2.331, p<0.05), and having multiple partners (OR=1.793, p<0.05) were significant predictors. Thematic analysis of provider interviews revealed user-related, provider-related, and health system barriers. The study highlights the need for targeted FP education and structural interventions to improve uptake and overcome both individual and systemic challenges in rural communities.