Trends and Factors associated with use of Modern Contraception Methods in Rwanda: A comparative study using Rwanda Demographic and Health Surveys 2010, 2014/2015, and 2019/2020
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Background
Modern contraception methods remain the most reliable means to control and space births. However, their use remains low for various social and economic reasons, particularly in low- and middle-income countries (LMICs), including Rwanda. This study examined trends and factors associated with the use of modern contraceptive methods among women aged 15 to 49 years in Rwanda from 2010 to 2020, using data from the Demographic and Health Survey (DHS) data.
Methods
This study was a comparative study using cross-sectional surveys weighted data of 3 editions of the Rwanda Demographic and Health Surveys (RDHS); 2010, 2014/2015, and 2019/2020. The study population was composed by women aged 15 to 49 years enrolled in each DHS. The participants were selected using stratified, two-stage sampling. The study used descriptive statistics, bivariate analysis, and logistic regression to analyze the data.
Results
The study found that the proportion of women using modern contraceptive methods increased significantly from 24.8% in 2010 to 27.1% in 2014/2015 and 33.9% in 2019/2020 (p<0.001). In the three editions of Rwanda DHs, variations in factors influencing the use of modern contraception methods were observed. In 2010, higher likelihoods of using modern contraception methods were among women reporting 1 to 3 as ideal number children a couple should have (aOR: 3.6 with 95%CI: 1.2-10.5), in Muslim religion (aOR: 8.2 with 95% CI: 1.0-64.4), married or cohabiting relationship (aOR: 2.2 with 95%CI: 1.6-3.2), and among those living in Northern province (aOR: 2.1 with 95% CI: 1.2-3.5). However, women living in households with 11 or more members, those of the Protestant faith, and those whose husbands make decisions regarding contraception use were less likely to use modern contraceptive methods. Secondly, in 2014/2015, women who received FP information from a health facility were 1.6 (aOR: 1.6 with 95% CI: 1.2-2.1) times more likely to use contraception than those receiving the information from radio. Similar to the 2010 DHS, lower likelihoods were noticed among those living in households with 11 or more members. Lastly, in 2020, higher likelihoods of using modern contraception were among women aged 20 to 44 years (aOR ranging from 2.1 to 2.8) as compared to those aged 15 to 19 and 45 to 49 years old. Moreover, women who decide mainly on their use of contraception were more likely to use it compared to those whose husbands do or jointly decide. Like in 2010, likelihoods were also higher among women reporting 1 to 3 as an ideal of children than one should give birth to, and among married or cohabiting partners (aOR: 1.4 with 95% CI: 1.0-2.0). However, it was unclear why lower likelihoods were among women with increasing education level.
Conclusion
This study found that modern contraception use increased from 24.8% in 2010 to 33.9% in 2019/2020. However, disparities persist, particularly among women from larger households, Protestant backgrounds, and higher education levels. These findings highlight the need for targeted interventions to address barriers to contraceptive use, especially among adolescent girls, young women, and religious groups with lower usage rates.
