Community and individual level factors influencing use of modern contraceptives among women aged 15-49 years in Uganda
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The major objective of this research was to determine significant community level factors influencing use of modern contraceptives among women aged 15-49 years in Uganda. Data used for analysis were from the 2011 UDH survey conducted by UBOS from 10 regions of Uganda. UDHS divided the country into statistical enumeration areas, which are small sub-populations (villages) that were used as the communities in this research. Individual level factors evaluated were; age of a woman, marital status, education level, employment status, age at first birth, desire for more children and health care decision maker. Also, community level factors evaluated were; urbanization of residence, community economic status, average number of children ever born to women in a community, community exposure to media family planning messages and community access to a health facility in terms of distance. These factors were evaluated using a multilevel mixed effects logistic regression model to identify significant individual and community level factors. Multilevel regression techniques indicated significant community level and individual level factors influencing modern contraceptive use among women 15-49 in Uganda. The significant (p < 0.05) individual level factors associated with use of a modern contraceptive methods were; desire for more children, age at first birth, education level of a woman and employment status of a woman. It was found out that the proportion of women who use a modern contraceptive method improves with women having some education compared to none (p<0.05), and declines among unemployed women. Similarly, significant community level factors were; urbanization of residence, community economic status and community exposure to media Family planning messages (p<0.05). Results showed that the probability of using a modern contraceptive method by women from the poorest, poorer, middle and richer communities significantly reduces (p < 0.05) by about 38%, 59%, 60% and 67% respectively as compared to other women from richest communities. In order to improve the proportion of women who use a modern contraceptive method, the government should intensify campaigns to keep girls in schools up to at least 20 years of age so as to ensure that majority if not all women have at least some education other than none and to reduce the number of teen mothers especially in rural places and should also step up media family planning messages aired out as advice to women in respective communities.