Determinants Of Modern Contraceptive (mCP) Use Mong Married Rural Women In 21 African Countries: Multi-Level Modeling (MLM) using recent Demographic and Health Surveys (DHS)

Family planning is a cost-effective and high-yield investment with benefits beyond controlling birth. Previously stunted efforts have been revived following the FP2020 initiative that aimed to provide contraceptives to women in the poorest countries. Since its start, the number of contraceptive users has grown globally yet, progress has been uneven, with women in rural areas and other vulnerable groups often being neglected. Data from 21 Sub-Saharan African countries was compiled to create the dataset for this study. This study focused on rural married women residing in those countries. Variables conceptualized to affect contraceptive use were categorized as individual and community-level variables. Tables and graphs were used for descriptive statistics while two-level multilevel regression was done to find out factors associated with contraceptive use. Prevalence of modern contraceptive use was found to be 34.6% with injectable and implants being the most common. Contraceptive use varied across countries with Southern Africa countries recording higher proportion. Individual factors that affected contraceptive use include age, wealth quintile index, educational level and fertility desires. Community variables that were found to be associated with contraceptive use include mean age of debut (sex, birth and marriage), community wealth quintile index, community domestic violence (DV) score and decision autonomy scores and so on. Modern contraceptive use among married, rural residing women in 21 countries was low compared to other studies. Generally, contraceptives have been effectively utilized in a community where women are typically empowered, have at least primary education, and have higher decision autonomy. Identifying individual and community factors dictating contraceptive use would help governmental and non-governmental organizations to scale up their effort to provide contraceptives for poor and marginalized societies in Sub-Saharan Africa.