Understanding contraception-use intentions among women of reproductive age not currently using contraceptives in sub-Saharan Africa: key insights from Demographic and Health Surveys.

Background: This study assesses the prevalence of contraception-use intentions and evaluates the associated factors among non-users in sub-Saharan Africa (SSA).

Methods: Data from 2014-2023 Demographic and Health Surveys of 30 countries in SSA consisting of 332 986 women aged 15-49 y not already using contraception were used.

Results: The overall prevalence was 41.18% (95% CI 41.01 to 41.34%). Zimbabwe had the highest prevalence (72.34%; 95% CI 71.11 to 73.57%), whereas Ethiopia had the lowest (15.96%; 95% CI 15.40 to 16.51%). Women aged 25-49 y had lower odds of intending to use contraception compared with those aged 15-19 y, and this was striking among those aged 45-49 y (adjusted OR [AOR]=0.06, 95% CI 0.06 to 0.07). Those with a higher level of education displayed a greater likelihood of intending to use contraception (AOR=1.93, 95% CI 1.82 to 2.05) compared with those with no education. The odds increased with the number of children born, particularly for those with ≥4 children (AOR=1.59, 95% CI 1.52 to 1.67) compared with those with no children.

Conclusions: Promoting the use of contraception requires tailored, multi-pronged interventions that account for the diverse sociodemographic, fertility and informational needs of women in this population.