Predictors of modern contraceptive use among reproductive-aged women (15-49 years) in Mozambique: Evidence from Mozambique Demographic and Health Survey.

Abstract

Background: Modern contraceptive use remains low in many sub-Saharan African countries, including Mozambique, limiting progress towards sexual and reproductive health and Sustainable Development Goals (SDGs). Understanding the prevalence, determinants, and inequalities in modern contraceptive use based on Mozambique-wide national survey is critical to informing effective family planning interventions. Method: We analyzed the most recent data from the Mozambique Demographic and Health Survey (DHS), 2022-2023, focusing on a total of 11,783 reproductive-aged women (15-49 years). The outcome variable was current use of modern contraceptives. Several individual, household-related and community determinants of modern contraceptives were examined employing multivariable logistic regression. Adjusted odds ratio with corresponding confidence intervals and p-values were reported. Erreygers Concentration Index (ECI) and concentration curves were used to assess wealth- and empowerment-related inequalities. All analyses were conducted on weighted data. Result: Overall, 27.6% of women reported current use of modern contraceptive methods. Younger age, higher education, being employed, higher parity, greater wealth, and a partner with higher education were positively associated with modern contraceptive use. Significant wealth-related (ECI = 0.32, p < 0.001) and women's empowerment-related (ECI = 0.26, p < 0.001) inequalities were observed, indicating that wealthier and more empowered women had higher use of modern contraceptive methods. Conclusion: Modern contraceptive use in Mozambique is suboptimal and influenced by a combination of individual, household, and contextual factors, with marked socioeconomic and empowerment-related disparities. Policy interventions should focus on improving access to and encouraging use of contraceptives for economically disadvantaged and women with low-empowerment, promoting women's autonomy, enhancing male involvement, and leveraging media and community-based programs to increase awareness and uptake. Equity-focused strategies are essential to achieving national and global family planning targets.