Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia.

Objective Zambia is among the world's top 10 countries with higher fertility rate (5.5 births/woman); unmet family planning need for births spacing (14%) and limiting births (7%). Women in rural Zambia (24%) are reported to have unmet need for family planning than those in urban areas (17%). This study was conducted to ascertain factors associated with modern contraceptive use among rural Zambian women. Design Cross-sectional study. Setting Rural Zambia. Participants Secondary data of 4903 married or cohabiting rural women (15-49 years) after filtering out the pregnant, urban based and unmarried women from 2013 to 2014 Zambian Demographic and Health Survey (ZDHS) were analysed using SPSS V.22. Multiple logistic regression, Pearson's chi(2) and descriptive statistics were performed to examine factors associated with modern contraceptive use. Results Factors that were positively associated with contraceptive use were respondent's education (secondary adjusted ORs (AOR = 1.61, p <= 0.002); higher (AOR = 2.39, p <= 0.050)), wealth index (middle class, (AOR = 1.35, p <= 0.005); rich (AOR = 2.04, p <= 0.001) and richest (AOR = 1.95, p <= 0.034)), high parity (1-2 (AOR = 5.31, p <= 0.001); 3-4 (AOR = 7.06, p <= 0.001); 5+ (AOR = 8.02, p <= 0.001)), men older than women by <10 years (AOR = 1.50, p <= 0.026) and women sensitised about family planning at health facility (AOR = 1.73, p <= 0.001). However, old age (40-49 years (AOR = 0.49, p <= 0.001)), other religions (Protestants, African traditionalists and Muslims) (AOR = 0.77, p <= 0.007), ever had pregnancy miscarried, aborted or stillbirth (AOR = 0.78, p <= 0.026) and women without knowledge of number of children husband desires (AOR = 0.71, p <= 0.001) were negatively associated with contraceptive use. Conclusion Modern contraceptive use in rural Zambia among currently married women of reproductive age group is relatively low (43%). We recommend that appropriate interventions are instituted to increase contraceptive access and use especially among uneducated older rural Zambian women.