Pooled prevalence of modern contraceptive utilization and its associated factors among reproductive age women in East Africa: derived from demographic and health surveys.

UNLABELLED: One of the most significant global public health concerns for women of reproductive age is the unmet need for modern contraceptives. The goal of increasing the use of modern contraceptives is to lower mother and child mortality and morbidity. Since East African nations are part of sub-Saharan Africa, a region primarily composed of low-income countries, they face significant challenges in accessing modern contraceptives due to limited healthcare infrastructure, economic constraints, and socio-cultural barriers. The objective of this study was to investigate the prevalence and factors associated with modern contraception utilization among reproductive-age East African women.

METHODS: The data was taken from the individual records (IR) of the ten East African countries' Demographic and Health Surveys. The study included 112,810 women of reproductive age. The primary outcome was modern contraceptive utilization, defined as a binary variable (yes = use of modern methods; no = use of traditional/folkloric or no methods). Key predictors included age, place of residence, marital status, sex of household head, wealth index, exposure to media (newspaper, radio, television), pregnancy termination history, and number of living children. Bivariate analysis was utilized to select the variables for multivariable analysis. At last, 95% CIs for the odds ratio and percentage were presented.

RESULTS: Among women of reproductive age, 33.81% of them used modern contraceptives, with a 95% CI of [33.53-34.09]. Individuals aged 20-24, 25-29, 30-34, and 35-39 demonstrate the following statistically adjusted odds ratios (AOR) and confidence intervals (CI): AOR = 1.68, 95% CI (1.68, 1.79); P = 0.0001; AOR = 1.56, 95% CI (1.46, 2.65); P = 0.0001; AOR = 1.43, 95% CI (1.33, 1.54); P = 0.0001; and AOR = 1.34, 95% CI (1.24, 1.44); P = 0.0001, respectively. urban residence is associated with an AOR of 1.06, 95% CI (0.91, 0.97); P = 0.001; being married [AOR: 1.20, 95% CI (1.13, 1.28); P = 0.0001]; belonging to the highest wealth quantile [AOR: 1.34, 95% CI (1.27, 1.43); P = 0.0001]; reading magazines at least once a week [AOR: 1.07 (1.00, 1.14); P = 0.032]; listening to the radio almost daily [AOR: 1.91 (1.69, 2.17); P = 0.0001]; watching television daily [AOR: 1.62 (1.45, 1.82); P = 0.0001]; and having 3-4 children [AOR: 11.68, 95% CI (10.78, 12.66); P = 0.0001] were found positively associated with modern contraceptive utilization. Conversely, having a history of pregnancy termination [AOR: 0.83 (0.80, 0.87); P = 0.0001] and belonging to a household headed by a woman [AOR: 0.95 (0.92, 0.99); P = 0.037] were found to be inversely associated with modern contraceptive utilization.

CONCLUSION AND RECOMMENDATION: This study identified key factors influencing modern contraceptive use among women in East Africa. Higher utilization was associated with being aged 20-39, urban residence, being married, higher wealth status, media exposure, and having more children. In contrast, lower use was observed among women living in female-headed households and those with a history of pregnancy termination. Despite these influencing factors, modern contraceptive use in East Africa remains below the 2030 Sustainable Development Goal (SDG) target. Therefore, to improve uptake among women of reproductive age, healthcare providers and policymakers should design and implement targeted interventions focusing on adolescents, rural residents, women with a history of pregnancy termination, and socioeconomically disadvantaged groups to enhance contraceptive use and reproductive health outcomes in the region.