Regional disparities and sociodemographic determinants of intention to use contraceptives among Somali women: a cross-sectional analysis of the 2020 SDHS.

Background: Contraceptive use is vital to improve maternal and child health, promote economic stability, and empower women. Despite global progress in family planning, Somalia faces unique challenges due to cultural, economic, and infrastructural barriers, resulting in low contraceptive use. This study investigated the prevalence and determinants of the intention to use contraceptives among women of reproductive age in Somali.

Methods: Using data from the 2020 Somali Demographic and Health Survey (SDHS), this study analyzed a sample of 7,967 women aged 15-49. Contraceptive intention was categorized as "intent to use" versus "no intent to use." The SDHS questionnaire assesses intention to use contraceptives in the next 12 months, which aligns with standard DHS definitions. Bivariate and multivariable logistic regression analyses were conducted to assess the association between contraceptive intention and sociodemographic factors. Choropleth maps and bar charts illustrate regional disparities.

Results: Overall, only 7.6% of the women intended to use contraception, with substantial regional variation. Woqooyi Galbeed reported the highest prevalence of contraceptive intention at 18.4%, while Gedo had the lowest at 1.1%. Significant predictors of contraceptive intention included higher education (AOR: 2.34, 95% CI: 1.21-4.56), secondary education (AOR: 1.91, 95% CI: 1.12-3.26). Women residing in nomadic communities had significantly lower odds of intending to use contraception (AOR: 0.40, 95% CI: 0.23-0.68). Since nomadic residence often implies reduced healthcare access, this finding suggests logistical and cultural barriers to contraceptive intentions. Cultural and geographic factors significantly influence contraceptive intentions.

Conclusion: Regional, educational, and socioeconomic variations affect contraceptive intentions in Somalia. Addressing these disparities through targeted educational and healthcare access interventions could improve family planning and utilization, ultimately enhancing maternal and child health outcomes.