Factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa: evidence from cross-sectional surveys of 29 countries

Bright Opoku Ahinkorah; Eugene Budu; Richard Gyan Aboagye; Ebenezer Agbaglo; Francis Arthur-Holmes; Collins Adu; Anita Gracious Archer; Yaa Boahemaa Gyasi Aderoju; Abdul-Aziz Seidu

doi:10.1186/s40834-021-00165-6

Factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa: evidence from cross-sectional surveys of 29 countries

Contracept Reprod Med. 2021 Aug 1;6(1):22. doi: 10.1186/s40834-021-00165-6.

Authors

Bright Opoku Ahinkorah¹, Eugene Budu², Richard Gyan Aboagye³, Ebenezer Agbaglo⁴, Francis Arthur-Holmes⁵, Collins Adu⁶, Anita Gracious Archer⁷, Yaa Boahemaa Gyasi Aderoju⁸, Abdul-Aziz Seidu^{9

10}

Affiliations

¹ School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
² Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
³ School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
⁴ Department of English, University of Cape Coast, Cape Coast, Ghana.
⁵ Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong.
⁶ Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁷ School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
⁸ Department of Adult Health Nursing, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana.
⁹ Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. abdul-aziz.seidu@stu.ucc.edu.gh.
¹⁰ College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, Australia. abdul-aziz.seidu@stu.ucc.edu.gh.

Abstract

Background: In sub-Saharan Africa, the majority of women of reproductive age who want to avoid pregnancy do not use any method of contraception. This study sought to determine the factors associated with modern contraceptive use among women with no fertility intention in sub-Saharan Africa.

Methods: This study used data from the Demographic and Health Surveys of 29 countries in sub-Saharan Africa. A total of 87,554 women aged 15-49 with no fertility intention and who had completed information on all the variables of interest were considered in this study. Using a multilevel logistic regression analysis, four models were used to examine the individual and contextual factors associated with modern contraceptive use. The results were presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs). Statistical significance was set at p< 0.05.

Results: The prevalence of modern contraceptive use was 29.6%. With the individual-level factors, women aged 45-49 had lower odds of using modern contraceptives (aOR = 0.33, 95% CI = 0.28, 0.39). Women who had their first sex at age 15-19 (aOR = 1.12, 95% CI = 1.07, 1.17), those with higher education (aOR = 1.93, 95% CI = 1.75, 2.13), and women who were exposed to newspaper (aOR = 1.15, 95% CI = 1.10, 1.20) and radio (aOR = 1.21, 95% CI = 1.17, 1.26) had higher odds of modern contraceptive use. In terms of the contextual factors, women living in urban areas (aOR = 1.06, 95% CI = 1.02, 1.11), women in the richest wealth quintile (aOR = 1.55, 95% CI = 1.43, 1.67), and those in communities with medium literacy level (aOR = 1.11, 95% CI = 1.06, 1.16) and medium community socio-economic status (aOR = 1.17, 95% CI = 1.10, 1.23) had higher odds of modern contraceptive use. Across the geographic regions in sub-Saharan Africa, women in Southern Africa had higher odds of modern contraceptive use (aOR = 5.29, 95% CI = 4.86, 5.76).

Conclusion: There is a relatively low prevalence of modern contraceptive use among women with no fertility intention in sub-Saharan Africa, with cross-country variations. Women's age, age at first sex, level of education, mass media exposure, place of residence, community literacy level and community socio-economic status were found to be associated with modern contraceptive use. It is, therefore, important for policy makers to consider these factors when designing and implementing programmes or policies to increase contraceptive use among women who have no intention to give birth. Also, policymakers and other key stakeholders should intensify mass education programmes to address disparities in modern contraceptive use among women.

Keywords: Fertility intention, modern contraceptives, sub-Saharan Africa; Women; Women’s health.