BackgroundSexual and reproductive decision-making has emerged as an important health indicator in family reproductive health issues. While there is evidence of male dominance in sexual and reproductive health decisions, the role of socio-demographic factors on women’s decision to use contraception is not well understood.AimThis study aimed at exploring the socio-demographic factors associated with married women’s decision-making to use contraception.SettingThe study was conducted in Mahikeng local municipality in the Modiri Molema District Municipality.MethodsData were generated in Mahikeng from married and cohabiting women, aged 18–49 years, from a survey comprising 568 participants. Data were collected on women’s demographic characteristics and contraceptive behaviour. Descriptive, bivariate and multivariate analyses were used to examine factors related to decision-making on contraceptive use.ResultsThe result revealed that 57% of the participants were currently using contraception and 45% stated jointly-made decision regarding the use of contraception. Decisions on use of contraceptives were associated with education, occupation, religion, duration of union and home language. Other factors associated with decision-making on contraceptive use were perception on husband’s right to sex, use of force for sex and spousal communication about sex.ConclusionEmpowering women to use contraception to meet their fertility desire should aim at improving their socio-economic status and spousal communication. Family planning providers should recognise socio-cultural barriers under which the relationships exist and how women can navigate these contextual factors.

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Husbands continue to be the greatest source of sexually transmitted infections including HIV to their wives. Using a survey of 568 respondents and 33 in-depth interviews, this