Background Non-use of modern contraceptives among married or in-union women aged 15 to 49 years is a demographic and public health challenge. Studies on the predictors of contraceptive use among women in Sierra Leone are few, more than two decades old, and not nationally representative. This study aims to fill this gap by estimating the prevalence and the predictors of the current use of modern contraceptives among married or in-union women in Sierra Leone. Methods This is a population-based study that used the 2013 Sierra Leone Demographic and Health Survey (SDHS) dataset. We performed complex samples logistic regression with 9,111 reproductive-age women. The analysis was done using the IBM SPSS Statistics version 21, and statistical significance was pegged at p�0.01 and p�0.05. The outcome of interest is the current use of modern contraceptives among reproductive-age married or in-union women in Sierra Leone, measured as 'Yes' (currently using a modern method) and 'No' (using a folkloric method, traditional method, and no method). Results About 18.1% of reproductive-age women were currently using a modern contraceptive. The study found the following sociodemographic factors as positive correlates: being within the age group of 20-24 years [

Background: Variations in the effect of predictors of Sierra Leone women’s use of modern contraceptive from one community to another is unknown. The identified gap was addressed using multilevel logistic regression models.Methods: Pooled 2008 and 2013 Sierra Leone Demographic and Health Surveys datasets were used. Single level logistic regression analyses were conducted on 24,032 women, and multilevel logistic regression models were performed on 23,329 women. Statistical significance was pegged at p≤0.01 and p≤0.05.Results: About 22.1% of the reproductive age women ever used a modern contraceptive. The best-fitted model indicated that the effects of individual, household, and geo-residential level factors on the use of modern contraceptives among Sierra Leone Women vary from one community to another. The woman’s age, marital status, educational qualification, listening to the radio, recent sexual activity, household wealth, place of residence, and region of residence were the statistically significant predictors of modern contraceptive use among reproductive-age Sierra Leone women.Conclusion: The study provided in-depth insight into the significant factors that account for the variability in women use of contraceptives in Sierra Leone. The study underscored the need for community-based intervention programs to address the low use of modern contraceptives among Sierra Leone women.