Socio-Economic Determinants of Contraceptive Use among Married Women in the Addis Urban Health and Demographic Surveillance System (Addis-HDSS) in Ethiopia

Abstract

BACKGROUND: Contraceptives are essential for protecting women’s sexual and reproductive health, as well as for reducing maternal and infant morbidity and mortality. This study aimed to identify socioeconomic factors associated with contraceptive use among married women of childbearing age in Ethiopia.

METHODS: We analysed cross-sectional data from 15,499 married women aged 18-49 years, collected as part of the Urban Health and Demographic Surveillance System (HDSS) in Addis Ababa. Trained interviewers conducted face-to-face interviews using structured, pre-tested questionnaires. Bivariable and multivariable logistic regression models were used to calculate adjusted odds ratios (AOR) with 95% confidence intervals (CIs) to assess associations between socioeconomic factors and contraceptive use.

RESULTS: The overall prevalence of contraceptive use among married women was 53.5% (95% CI: 52.7-54.4%). Women with larger family sizes (>6) (AOR: 2.1; 95% CI: 1.5-2.8), excellent self-reported health (AOR: 1.6; 95% CI: 1.3-1.9), and those in households with adequate income to meet basic needs (AOR: 1.29; 95% CI: 1.11-1.48) were more likely to use contraceptives. Women over 40 years old (AOR: 0.21; 95% CI: 0.18-0.25) and those living in female-headed households (AOR: 0.68; 95% CI: 0.61-0.76) had lower odds of using contraception.

CONCLUSION: About half of urban married women of reproductive age reported using contraceptives. Factors associated with higher contraceptive use included better self-reported health and larger family sizes. Further research is needed to understand the complex dynamics of contraceptive use in low-income urban settings.