Evaluating contraceptive preferences and barriers in Sierra Leone: Analysis of 2020 Sierra Leone District Health Information System 2 (DHIS2) data

Background Access to and use of modern contraceptive methods are essential components of reproductive health and are critical for reducing maternal mortality, preventing unintended pregnancies, and promoting gender equality. This study aimed to evaluate contraceptive preferences, patterns, and barriers to family planning in Koinadugu District, Sierra Leone, in 2020. Methods This study utilized a retrospective, descriptive cross-sectional approach and extracted data from the District Health Information System 2 (DHIS2). The data collection process involved extracting variables related to contraceptive type, demographic information, and temporal patterns of service use. To ensure data accuracy, the research team worked in conjunction with the Koinadugu District Health Management Team, implementing validation procedures, such as eliminating duplicates, cross-checking information, and following standardized protocols. After the dataset was cleaned, the researchers conducted descriptive and temporal trend analyses via Microsoft Excel. Results This study identified 10,795 family planning users in 2020, 42% of whom were aged 25 and above, 31% of whom were between 20 and 24 years, and 27% of whom were in the 10–19 age group. The contraceptive methods showed a preference for male condoms (62%), with oral contraceptives (16%), injectables (10%), and implants (7%). Regional disparities were notable, as Diang chiefdom reported the highest uptake at 34%, in contrast to Thamiso (1.7%). Usage peaks in December, potentially owing to seasonal or cultural factors. Societal disapproval and stereotypes have emerged as significant barriers, particularly affecting women's access to family planning services. Conclusion An analysis of family planning services in Koinadugu District revealed disparities based on age and location, with male condoms as the primary contraceptive method. Although utilization experiences seasonal fluctuations, societal stigma and misconceptions pose substantial obstacles, particularly for females. Addressing these challenges could enhance equitable long-term contraceptive adoption across districts.