Abstract
BACKGROUND: Non-use of modern contraceptives among married or in-union women aged 15 to 49 years is a demographic and public health challenge. Studies on the predictors of contraceptive use among women in Sierra Leone are few, more than two decades old, and not nationally representative. This study aims to fill this gap by estimating the prevalence and the predictors of the current use of modern contraceptives among married or in-union women in Sierra Leone. METHODS: This is a population-based study that used the 2013 Sierra Leone Demographic and Health Survey (SDHS) dataset. We performed complex samples logistic regression with 9,111 reproductive-age women. The analysis was done using the IBM SPSS Statistics version 21, and statistical significance was pegged at p≤0.01 and p≤0.05. The outcome of interest is the current use of modern contraceptives among reproductive-age married or in-union women in Sierra Leone, measured as 'Yes' (currently using a modern method) and 'No' (using a folkloric method, traditional method, and no method). RESULTS: About 18.1% of reproductive-age women were currently using a modern contraceptive. The study found the following sociodemographic factors as positive correlates: being within the age group of 20-24 years [AOR = 1.52, CI: 1.05, 2.19], 25-29 years [AOR = 1.57, CI: 1.10, 2.19], 30-34 years [AOR = 2.31, CI: 1.59, 3.36], 35-39 years [AOR = 1.89, CI: 1.33, 2.70], 40-44 years [AOR = 1.68, CI: 1.12, 2.52], obtaining either a primary [AOR = 1.40, CI: 1.14, 1.71] or secondary level education [AOR = 1.34, CI: 1.02, 1.74], belonging to the category of women that condemned wife beating under only one condition [AOR = 1.37, CI: 1.03, 1.78], under two conditions [AOR = 1.45, CI: 1.08, 1.93], under three conditions [AOR = 1.73, CI: 1.28, 2.35], under four conditions [AOR = 1.91, CI: 1.34, 2.72], and under five conditions [AOR = 1.41, CI: 1.07, 1.85], having the ability to refuse sex [AOR = 1.46, CI: 1.23, 1.76], ever heard family planning on the radio [AOR = 1.30, CI: 1.08, 1.58], being sexually active four weeks prior to the survey [AOR = 3.90, CI: 3.14, 4.84], ever taken an HIV test [AOR = 1.67, CI: 1.39, 2.02], ever visited a health facility in the last 12 months [AOR = 1.73, CI: 1.44, 2.09], dwelling in a richer household [AOR = 1.32, CI: 1.01, 1.72], and dwelling in an urban area [AOR = 1.44, CI: 1.14, 1.81]. Exposure to family planning through print media (newspaper/magazine) was negatively associated with current use of modern contraceptive [AOR = 0.60, CI: 0.37, 0.96]. CONCLUSION: The study provided in-depth insight into the sociodemographic predictors of the current use of modern contraceptives among married or in-union women in Sierra Leone. The study underscored the need to promote the protective factors of the current use of modern contraceptives and address the risk factors of the low prevalence of modern contraceptive use through policies, programs, and interventions in Sierra Leone.