Factors associated with modern contraceptive use among women of reproductive age in the West Nile Region, Uganda

Abstract

Modern contraceptive use remains a critical determinant of reproductive health outcomes, yet uptake in Uganda continues to vary widely across regions. This study examined the socio-demographic and economic determinants of modern contraceptive use among women aged 15-49 years in the West Nile region, Uganda, using secondary data from the Uganda Demographic and Health Survey (UDHS). A cross-sectional design was adopted, drawing on a weighted sample of 1,247 women, reduced to 1,163 in the multivariable analysis after excluding cases with missing covariate data. Data were analyzed at the univariate, bivariate, and multivariable levels, with binary logistic regression used to identify independent predictors of contraceptive use, expressed as odds ratios with 95% confidence intervals.Findings showed that only 14.6% of women were currently using a modern contraceptive method, pointing to a substantial unmet need for family planning in the region. At the bivariate level, age, marital status, age at first sexual intercourse, current employment status, and number of children both ever born and living were significantly associated with contraceptive use, while education, wealth, residence, religion, and ideal family size were not. After adjusting for confounders in the multivariable model, total children ever born emerged as the strongest predictor, with women who had 10 or more children 35 times more likely to use contraception than those with none. Secondary education (OR = 2.76), the middle and fourth wealth quintiles (OR = 2.01 and 1.96, respectively), older age (45-49 years, OR = 0.22), and Muslim religious affiliation (OR = 0.52) were also significant independent predictors, while residence and stated ideal family size lost significance once other factors were controlled for.The study concludes that contraceptive use among women in West Nile is shaped primarily by their actual reproductive history, educational attainment, economic status, and religious background rather than by geographic location or expressed fertility preferences alone. It recommends strengthening girls’ access to and retention in education, expanding community-based family planning and reproductive health education particularly for women with little or no schooling and designing targeted, multi-pronged interventions that account for parity, wealth, and religious diversity in order to close the region’s family planning gap.