Exploring Structural Barriers to Family Planning Uptake Among Rural Women in Sokoto State: A Qualitative Inquiry

Background: Despite national policy commitments to expanding contraceptive access, family planning uptake in rural North West Nigeria remains critically low. This qualitative study explores the structural barriers to family planning service uptake among rural women in Sokoto State from provider and community perspectives. Methods: A phenomenological qualitative design was employed. Purposive sampling recruited 30 rural women, 12 community health workers, and eight facility managers for in-depth interviews and focus group discussions. Data were audio-recorded, transcribed, and analysed using interpretive thematic analysis with NVivo version 12. Results: Three major structural barrier themes emerged: geographic inaccessibility of service delivery points, commodity stockouts particularly for long-acting reversible contraceptives, and absence of female healthcare providers limiting uptake among Muslim women. Spousal permission requirements and social surveillance in small communities reinforced systemic barriers. Conclusion: Structural barriers to family planning in rural Sokoto State operate across multiple system levels and require multi-sector solutions. Family medicine departments should lead the co-design of community-integrated family planning delivery models that address geographic, commodity, and gender-sensitive access challenges. Keywords: family planning, rural women, structural barriers, Sokoto State, qualitative