Determinants of contraceptive use among married women in Rwanda: evidence from women’s empowerment-related indicators in the 2019/2020 Demographic and Health Survey
Emile Twagirumukiza, Egide Munyaneza, Valens Bubanje, Revocathe Girimpundu, Briand Mvuyekure, Emile SeberaBackground
Understanding factors influencing contraceptive use among married women is crucial for improving reproductive health outcomes. This study investigated the contribution of women’s empowerment-related indicators and contraceptive utilisation in Rwanda.
Methods
This study analysed data from the 2019/2020 Rwanda Demographic and Health Survey focusing on 7401 married women aged 15–49 years who had given birth within the 5 years before the survey. Women’s empowerment-related indicators included employment in the past 12 months, highest educational attainment, decision-making power and attitudes towards wife-beating. Additionally, sociodemographic factors including age, number of living children, the educational attainment of the husband, region, type of residence and wealth index were used to control for confounding effects. The outcome variable was the current use of any contraceptive method. Logistic regression analyses were conducted using SPSS V.25.0 to determine the association between predictors and the outcome variable.
Results
The proportion of contraceptive use was 64.1%. Bivariate analysis showed significant associations between all sociodemographic characteristics, participation in decision-making, and contraceptive use (trend p<0.001). In the second model of multivariate analysis, women with primary education had higher odds of using contraceptives (adjusted OR (aOR): 1.376, 95% CI 1.178 to 1.608, p<0.001) compared with other educational levels. Employed women showed an increased likelihood of contraceptive use (aOR: 1.272, 95% CI 1.105 to 1.465, p=0.001). High participation in decision-making was strongly associated with contraceptive use (aOR: 1.664, 95% CI 1.311 to 2.111, p<0.001). The number of living children emerged as the strongest predictor, with women having 2–3 children showing the highest odds of contraceptive use (aOR: 175.209, 95% CI 91.268 to 336.353, p<0.001). Age exhibited an inverse relationship, with women aged 45–49 having significantly lower odds (aOR: 0.155, 95% CI 0.118 to 0.204, p<0.001).
Conclusions
Women’s empowerment through education, employment, and active participation in decision-making significantly influences contraceptive use among women in Rwanda. These findings underscore the importance of integrating women’s empowerment initiatives into reproductive health programs, focusing on education access, economic opportunities, and women’s involvement in household and reproductive health decisions to enhance reproductive health outcomes in Rwanda.