Determinants of modern contraceptive use among married women of reproductive age in a municipality of Nepal: A cross-sectional study

Abstract

Background: The use of modern contraceptives plays a crucial role in reducing unintended pregnancies and improving maternal and child health outcomes. The level of contraceptive use is strongly linked to the total fertility rate (TFR) and population growth rate. This study aimed to assess the utilization of modern contraceptive methods and associated factors among married women of reproductive age (MWRA) in Birendranagar Municipality, Surkhet district.

Material and Methods: A community-based cross-sectional study was conducted from April 28, 2023 to October 31, 2023. Eight wards were selected by simple random sampling from the 16 wards of Birendranagar Municipality. The total MWRA population (25,738) in the selected wards was identified, and sample allocation was done using probability proportional to size (PPS). Within each ward, households were selected by systematic random sampling. A sample size of 494 was calculated using the Cochrane single proportion formula. The validated NDHS 2022 questionnaire was used for data collection through face-to-face interviews. Cronbach's alpha was used to assess reliability. Data were analyzed using SPSS version 11.5. Descriptive statistics, Chi-square test, and binary logistic regression were performed at a 95% confidence interval (CI).

Result: The mean (± SD) age of participants was 32.97 ± 7.791 years. All respondents (100%) had previously used a family planning method, and 70.6% were currently using modern contraceptives. The most frequently used method was the male condom (29.2%). Total unmet need for modern contraceptives was 22.8%. Multivariate analysis showed that Janjati ethnicity (AOR=4.0, 95% CI: 1.3–12.1), husband's occupation as farmer/daily wage worker (AOR=8.4, 95% CI: 3.7–19.1) or engaged with work (AOR=8.3, 95% CI: 4.5–15.2), and information about side effects provided at the healthcare facility (AOR=1.9, 95% CI: 1.2–3.3) were significantly associated with modern contraceptive use.

Conclusion: Modern contraceptive use was 70.6% among married women of reproductive age in Birendranagar Municipality, higher than the national estimate (43%), while unmet need remained at 22.8% which is almost similar to the national data (21%) [1]. These findings highlight the need to improve counselling quality and implement targeted interventions to reduce unmet need and promote informed contraceptive use.