# Modern contraceptive use in Somalia: a multivariable analysis of prevalence and predictors among women of reproductive age

## TL;DR

Modern contraceptive use is very low in Somalia, with older women and those exposed to health facility education more likely to use them.

## Contribution

Identifies key predictors of modern contraceptive use in Somalia using nationally representative survey data.

## Key findings

- Modern contraceptive use among Somali women of reproductive age was only 1.8%.
- Women aged 26 and older were significantly more likely to use contraception.
- Exposure to family planning education at health facilities doubled the likelihood of contraceptive use.

## Abstract

Despite global advancements in reproductive healthcare, the utilization of modern contraceptives in Somalia remains critically low, marked by significant regional and sociodemographic disparities. This study assessed the prevalence and identified key predictors of modern contraceptive use among Somali women of reproductive age using data from the 2020 Somali Health and Demographic Survey (SHDS).

A nationally representative cross-sectional analysis was conducted on a sample of 2,704 women aged 15–49 years. Descriptive statistics and multivariable logistic regression were employed to identify factors associated with the use of modern contraceptives.

The majority of participants were aged 26 years or older (57.6%), resided in urban areas (85.1%), and belonged to the highest wealth quintile (62.4%). The prevalence of modern contraceptive use among the study participants was exceptionally low at 1.8%. The most commonly reported methods were oral contraceptive pills (0.6%) and implants (0.2%), while the use of intrauterine devices (IUDs) was minimal (0.04%). A significant gap in exposure to family planning information was observed, with only 13.6% of women reported to have received it at health facilities. Key predictors for modern contraceptive use included the age of the women and exposure to family planning education at a health facility. Women aged 26 years and older demonstrated significantly higher odds of using contraception compared to their younger counterparts [adjusted odds ratio (AOR): 10.13; 95% confidence interval (CI): 2.39–42.97]. Furthermore, women who received family planning information from health facilities were twice as likely to use modern contraceptive methods (AOR: 1.99; 95% CI: 1.02–3.88).

The findings underscore an urgent need to enhance both the accessibility and knowledge of modern contraceptives in Somalia. Targeted interventions focusing on health facility-based education and expanding the limited variety of available contraceptive methods are crucial to improving uptake and addressing the reproductive health needs of Somali women.