Intention to use contraceptives among married and cohabiting women in sub-Saharan Africa: a multilevel analysis of cross-sectional data

Abstract

ObjectiveTo examine the factors associated with intention to use contraceptives among married and cohabiting women in sub-Saharan Africa (SSA).DesignData for the study were extracted from the most recent Demographic and Health Surveys of 29 countries in SSA conducted from 2010 to 2020. We included a total of 180 682 women who were married or cohabiting. Multilevel regression analysis was carried out and the results were presented as adjusted odds ratio (AOR), with 95% confidence interval (CI).Setting29 countries in SSA.ParticipantsWomen aged 15–49 years in sexual unions.Outcome measureIntention to use contraceptives.ResultsThe pooled prevalence of intention to use contraceptives among married and cohabiting women in the 29 countries was 41.46%. The prevalence ranged from 18.28% in Comoros to 71.39% in Rwanda. Intention to use contraceptives was lower among women aged 45–49 (AOR=0.06, 95% CI= 0.05 to 0.07), those with no education (AOR=0.60, 95% CI= 0.58 to 0.61), and primary education (AOR=0.90, 95% CI 0.88 to 0.93), married women (AOR=0.81, 95% CI= 0.79 to 0.84), those of the poorest wealth quintile (AOR=0.78, 95% CI= 0.75 to 0.82), and women who were not exposed to mass media (AOR=0.87, 95% CI= 0.86 to 0.90). Women with four or more births (AOR=2.09, 95% CI= 1.99 to 2.19) had greater likelihood of contraceptive use intention compared to those with no birth. Women in rural settings were found to have greater likelihood of intention to use contraceptives compared to those in urban settings (AOR=1.10, 95% CI= 1.07 to 1.14).ConclusionThere is a low prevalence of contraceptive use intention among married and cohabiting women in SSA with differences between countries. It is imperative for policymakers to consider these factors when developing and executing contraceptive programmes or policies to enhance contraceptive intents and use among married and cohabiting women. To resolve discrepancies and increase contraceptive intention among women, policymakers and other key stakeholders should expand public health education programmes.

Effects of continuum of care for maternal health service utilisation on intention to use family planning among pastoralist women of Ethiopia: a robust regression analysis and propensity score matching modelling

“…A multilevel analysis from SSA revealed that women with no education and primary education were associated with a decreased intention to use FP 39. This was in line with the finding of our study.…”

“…Our study revealed that married pastoralist women who possess electronic devices had an increased intention to use FP. This was supported by the finding from a multilevel analysis from SSA 39. The effect could be explained by the fact that most media programmes broadcast the promotion of family planning repeatedly, which may influence mothers to develop comprehensive knowledge and positive attitude towards FP that positively influence their intention to use FP.…”

“…A study done in Iran found a mean score of 4.67 (±0.87) after measuring the intention to use FP using two items 26. Other studies done elsewhere try to measure the intention to use FP with a proportion and found a result that ranges from 18.2% to 84.3% 33–39. Quantification of intention to use FP with a single item is challenging to find a precise estimate.…”

Proximal factors influencing the likelihood of married and cohabiting women in Sierra Leone to use contraceptives. A cross-sectional study

“…Women who intended to use contraceptives were considered to “Intend to use”, coded as 1, while those who did not intend to use contraceptives were considered “Do not intend to use”, coded as 0. Previous studies [ 4 – 6 ] that utilised the DHS datasets employed the same coding scheme.…”

“…Previous studies [ 4 – 14 ] have found that the determinants of contraceptive practice are multifaceted and encompass various factors such as awareness of contraceptive methods, socio-demographic variables (including age, education, religion, income level, marital status, employment), parity, number of living children, access to reproductive health information, frequency of antenatal visits, history of terminated pregnancies, prior HIV testing, place of residence (rural or urban), literacy, sexual activity, communication and approval from partner.…”