Contraceptive Utilization and Its Associated Factors Among Married Women in West African Countries: A Population-Based Survey Using Multinomial Logistic Regression

Abstract

Bewuketu Terefe,1 Mahlet Moges Jembere,2 Engidaw Fentahun Enyew,3,4 Bogale Chekole5 1Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 4Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 5Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Southern Ethiopia, EthiopiaCorrespondence: Bewuketu Terefe, Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Post Office Box: 196, Gondar, Amhara Region, Ethiopia, Tel [phone], Email [email protected]: The international development agenda emphasizes universal access to family planning, as seen in Sustainable Development Goal 3.7. However, the use of modern contraceptive methods remains low in developing countries, specifically in West Africa. This study aimed to assess the current status of contraceptive use in the region, focusing on different methods.Methods: We analyzed Demographic and Health Survey data from 13 West African nations (2012– 2022) involving 117,165 married women. Using binary and multiple multinomial logistic regression, we identified key factors associated with contraceptive use. Adjusted odds ratios with 95% confidence intervals were utilized, and significance was determined at p ≤ 0.2 for binary regression and p < 0.05 for multiple multinomial regression.Results: About 80.86% of women did not use any method, while 16.56% of women used modern methods. Maternal age of 35– 49 years (RRR=0.77, 95% CI, 0.72,0.82), had given first birth after 20 years (RRR=0.80,95% CI, 0.77,0.83), cohabitation after 20 years old (RRR=1.24,95% CI, 1.18,1.29), being employed (RRR=1.38,95% CI, 1.33,1.43), women who have from 3– 5, and more than five living children (RRR=2.06,95% CI,1.97,2.16, and (RRR=2.57, 95% CI, 2.42,2.74), primary(RRR=1.59, 95% CI, 1.52,1.66), secondary/higher education (RRR=2.08, 95% CI, 1.99,2.18), antenatal visit (RRR= 1.38, 95% CI 1.28,1.49), institutional delivery(AOR=1.42, 95% CI, 1.35,1.49), husband working status (RRR=1.39, 95% CI, 1.28,1.51), media exposure(RRR=1.23, 95% CI, 1.19,1.28), visited health facility more than once (RRR=1.09, 95% CI, 1.05,1.13), rural women (RRR=0.89,95% CI,0.85,0.93), female households (RRR=0.79, 95% CI,0.76,0.83), richer (RRR=1.42, 95% CI,1.33,1.51), and richest wealth indexes (RRR=1.69,95% CI,1.58,1.82) were associated.Conclusion: This study revealed a low level of contraceptive use among women in West Africa. Strengthening maternal reproductive health services, such as antenatal care, institutional delivery, and health visits, while also targeting mass media and disadvantaged women, has the potential to significantly increase the adoption of modern contraception techniques.Keywords: contraceptive utilization, family planning, married women, West Africa, multinomial logistic regression

Keywords

• contraceptive utilization
• family planning
• married women
• west africa
• multinomial logistic regression