Multilevel mixed effects analysis of individual and community level factors associated with modern contraceptive use among married women in Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Public Health
Abstract
In spite of the universal right for women to decide freely for themselves when, and how many
children they want to have in life, married women in Uganda are less likely to use modern contraceptives as
compared to other marital categories. This study examines the individual and community factors associated with
modern contraceptive use among married women in Uganda.
Methods: The study used data from the 2016 Uganda Demographic and Health Survey which comprised of 8671
married women aged 15–49 years who were fecund and non-pregnant at the time of the survey. Analysis was
done using a multilevel mixed-effects logistic regression model.
Results: Findings showed that married women who were; Muslims (AOR = 0.78, CI = 0.66–0.91), had more than five
children (AOR = 0.76, CI = 0.61–0.98), staying in communities with high poverty (AOR = 0.78, CI = 0.65–0.93), with
older age at first birth (AOR = 0.94, CI = 0.92–0.96) as well as having spousal age difference of more than 9 years
(AOR = 0.86, CI = 0.76–0.98) were associated with low modern contraceptive use. Women living in communities
with higher age at first marriage (AOR = 0.93, CI = 0.88–0.98) or higher sexual debut (AOR = 0.91, CI = 0.85–0.98)
were also associated with reduced odds of modern contraception. In addition, older women (AOR = 1.03, CI = 1.01–
1.04), having secondary/higher education (AOR = 1.93, CI = 1.58–2.37), living in a rich household (AOR = 1.32, CI =
1.14–1.53), short distance to health facility (AOR = 1.18, CI = 1.06–1.31), high community education (AOR = 1.38, CI =
1.17–1.62), high community exposure to family planning messages (AOR = 1.24, CI = 1.08–1.42), and communities
with high proportion of women working (AOR = 1.22, CI = 1.06–1.39) were more likely to use modern
contraceptives. Conclusion: The study revealed that both individual and community factors were important in explaining the
factors associated with modern contraceptive use among married women in Uganda. Therefore, there is need to
invest in community based programs like: family planning outreach services, mass media campaigns and
community mobilization activities to help in dissemination of family planning information, increase awareness and
promotion in use of modern contraceptives. Also, expansion of higher education and the need to make family
planning services available and accessible to areas with limited physical access to health facilities will lead to
sustained increase in uptake of modern contraceptives.
Description
Keywords
Modern contraceptives, Community, Married women, Uganda
Citation
Wasswa, R., Kabagenyi, A., & Ariho, P. (2021). Multilevel mixed effects analysis of individual and community level factors associated with modern contraceptive use among married women in Uganda. BMC Public Health, 21(1), 1-13. https://doi.org/10.1186/s12889-021-11069-0