Multinomial multilevel analysis of factors affecting the use of modern contraceptives in sub-Saharan Africa: evidence from 2015 to 2023 Demographic Health Survey

Abstract The use of modern contraceptives both, short-acting and long-acting in most African countries has been low. This study aimed to determine factors affecting the use of modern contraceptive methods among women of reproductive age in 23 sub-Saharan Africa countries. The most recent 2015–2023 DHS data set of 23 SSA countries was used. A total of 230,387 women who completed the survey were included in the study. In the multivariable analysis variables with p-value less than ≤ 0.05 were considered to be factors associated with the use of both short-acting and long-acting modern contraceptive methods. The overall prevalence of use of both short-acting and long-acting contraceptive methods was 28.4%. The prevalence of short-acting contraceptive use was 18.7% and prevalence of use of long-acting contraceptive method was 9.6%. from individual level variables; parity, maternal educational status, partners educational status, maternal age, media exposure, wealth index, work status, age at first cohabitation, and head of household head were factors associated with both short-acting and long-acting contraceptive method. And from community level variables community level media exposure and country of region were associated with use of both short-acting and long-acting contraceptive methods. While current breast-feeding status, community level education and community level wealth status were associated with only the use of long-acting contraceptive methods. Therefore, reproductive health and family planning initiatives in SSA should target high risk groups in order to increase utilization of modern contraceptive methods.