Individual, household, and community-level predictors of modern contraceptive use among married women in Cameroon : a multilevel analysis

Background: Unintended pregnancy remains a major public health and socio-economic problem in sub-Saharan African countries, including Cameroon. Modern contraceptive use can avert unintended pregnancy and its related problems. In Cameroon, the prevalence of modern contraceptive use is low. Therefore, this study investigated the individual/household and community-level predictors for modern contraceptive use among married women in Cameroon. 

Methods: Data for this study were derived from the nationally representative 2018-2019 Cameroon Demographic and Health Survey. Analysis was done on 6080 married women in the reproductive age group (15-49 y) using Stata version 14 software. Pearson χ2 test and multilevel logistic regression analysis were conducted to examine the individual/household and community-level predictors of modern contraceptive use. Descriptive results were presented using frequencies and bar charts. Inferential results were presented using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). 

Results: The results show only 18.3% (95% CI 16.8 to 19.8) of married women in Cameroon use modern contraceptives. Women's age (45-49 y; aOR 0.22 [95% CI 0.12 to 0.39]), education level (secondary education; aOR 2.93 [95% CI 1.90 to 4.50]), occupation (skilled manual; aOR 1.46 [95% CI 1.01 to 2.11]), religion (Muslim; aOR 0.63 [95% CI 0.47 to 0.84]), wealth quintile (richest; aOR 2.22 [95% CI 1.35 to 3.64]) and parity (≥5; aOR 3.59 [95% CI 2.61 to 4.94]) were significant individual/household-level predictors. Region (East; aOR 3.63 [95% CI 1.97 to 6.68]) was identified as a community-level predictor. 

Conclusions: Modern contraceptive use among married women in Cameroon is low. Women's education and employment opportunities should be prioritized, as well as interventions for married women, ensuring equity in the utilization of modern contraceptives across regions.