INTRODUCTION:
Cognitive accessibility, one of the six dimensions of family planning accessibility according to Choi et al. (1), is the first form of accessibility and guarantees women's human right to information. Drawing on the general framework for access to healthcare proposed by Levesque et al. (2), we formalize the concept as women's ability to access information, understand it, and integrate it into their family planning decisions. In Niger, characterized by significant structural disparities (3, 4), we examine the extent to which literacy inequalities between women and between urban and rural areas translate into differences in cognitive accessibility to family planning.

METHODS:
Using an ascending hierarchical classification, we operationalized cognitive accessibility based on three components: contraceptive knowledge, knowledge of formal sources for obtaining methods, and active exposure to information on family planning. Using binary and multinomial logistic regression models, we then measured its association with literacy according to urban or rural residence.

RESULTS:
Thirty-eight percent of women in rural areas have low cognitive accessibility, compared to 22% in urban areas. A more significant difference is seen in contraceptive knowledge: 33% of women in rural areas have good knowledge of methods, compared to 53% in urban areas. The results of the multinomial logistic regression model indicate that literate women are 3.48 times (95% CI: 1.07-11.4) more likely to have average cognitive accessibility rather than low cognitive accessibility, adjusted for place of residence. The interaction between literacy and place of residence neither confirms nor refutes a significant change in the effect of literacy across places.

CONCLUSIONS:
Our results suggest reducing literacy inequalities as a critical strategy to ensure universal cognitive access to family planning in Niger.