Achieving SDG-related sexual and reproductive health targets in Tanzania:Socioeconomic and area-based inequalities in modern contraceptive use among adolescent girls and young women

Background Contraceptive use is fundamental to achieving Sustainable Development Goal 3.7. Given the low prevalence of modern contraceptive use, understanding socioeconomic and area-based inequality in the use of modern contraceptives is essential to address disparities among adolescent girls and young women (AGYW) in Tanzania. Therefore, this study examined the socioeconomic and area-based inequalities in modern contraceptive use among AGYW in Tanzania. Methods This study employed a cross-sectional analysis of the 2022 Tanzania Demographic and Health Survey (TDHS) data. A weighted sample of 3,724 sexually active AGYW was included in the study. We used the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software for data analysis. Modern contraceptive use was disaggregated using five equity stratifiers (age, economic status, education, residence, and geographical zones). Data were analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R), and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI). Results Our findings revealed significant socio-economic, educational, geographic, and age-related disparities in modern contraceptive use. Women in wealth quintile (PAF: 11.08% [95% UI: 10.98–11.18], D: 13.43 [95% CI: 13.37–13.49], educated (PAR: 3.22 [95% UI: 2.35–4.09], R: 1.87 [95% UI: 1.86–1.87]), those in rural areas (PAF: 14.83% [95% CI: 14.76–14.90], R: 1.24 [95% UI: 1.24–1.24]), older age group (PAF:16.46% (95% CI: 16.43–16.50], PAR: 4.93 [95% CI: 3.93–5.93], R: 1.73 (95% CI: 1.73–1.73]) had a higher chance of modern contraceptives use than their counterparts. Conclusion This study provides compelling evidence of persistent inequalities in modern contraceptive use among AGYW in Tanzania, shaped by socioeconomic status, educational attainment, age, and geographic residence. A multi-dimensional and equity-focused reproductive health policy and programs, emphasizing empowerment through education, youth-friendly services, financial accessibility, and culturally sensitive community engagement, would be essential in addressing inequalities among AGYW in Tanzania.