Family structure factors influencing modern contraceptive use in Cameroon based on analysis of 2018-2019 demographic and health survey data

Abstract

Maternal mortality remains a significant global concern, particularly in sub-Saharan Africa, underscored by its inclusion in Sustainable Development Goal 3.1. Cameroon faces substantial challenges, with a maternal mortality rate of 438 per 100,000 live births as of 2023. Family planning is a crucial strategy for mitigating maternal and infant mortality. This study explored the association between husbands' sociodemographic factors, household socioeconomic characteristics, and modern contraceptive use in Cameroon, contributing to a deeper understanding of contraceptive use. This cross-sectional study utilized data from the 2018-2019 Demographic and Health Surveys to examine modern contraceptive use among married or live-in partners women of reproductive age in Cameroon. The study excluded pregnant women, nonunion women, and individuals identified as sisters, granddaughters, mothers of household heads, or visitors. A quantitative analysis employing multiple logistic regression was conducted to assess the likelihood of modern contraceptive use. The study identified an 18.8% prevalence of modern contraceptive use among Cameroonian women of reproductive age. Sociodemographic and socioeconomic factors significantly influenced contraceptive use. A higher likelihood of modern contraceptive use was associated with husbands' occupation (AOR: 4.53, 95% CI (2.55-8.04)), desire for fewer children (AOR: 1.57, 95% CI (1.28-1.93)), educational level (AOR: 2.36, 95% CI (1.80-3.12); AOR: 2.44, 95% CI (1.84-3.24); AOR: 3.9, 95% CI (2.78-5.47); AOR: 1.06, 95% CI (0.65-1.74)), household size (AOR: 1.25, 95% CI (1.06-1.49)), and wealth index (AOR: 2, 95% CI (1.60-2.50); AOR: 1.83, 95% CI (1.46-2.30); AOR: 2.21 95% CI (1.72-2.85); and AOR: 1.90, 95% CI (1.44-2.51)). Conversely, factors such as husbands living elsewhere (AOR 0.75, 95% CI (0.60-0.95)), women's unawareness of their husbands' desired number of children (AOR: 0.76, 95% CI (0.66-0.88)), living in households headed by older individuals (AOR: 0.64, 95% CI (0.50-0.83) and AOR: 0.50, 95% CI (0.36-0.68)), and having more than one ideal number of male children (AOR: 0.83, 95% CI (0.72-0.94) and AOR: 0.55, 95% CI (0.47-0.65)) were associated with a decreased likelihood of modern contraceptive use. These findings emphasize the complexity of family planning decisions and the need to consider diverse sociodemographic and socioeconomic factors in reproductive health initiatives. Key policy recommendations include comprehensive family planning education, gender equity promotion, engagement of elderly household heads, and cultural sensitivity in program implementation.