Individual and community-level factors influencing modern contraceptive use among women of reproductive age in South Africa: a multilevel analysis
1
1 Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa
2
2 Department of Demography, Population Sciences and Monitoring and Evaluation, University of Zambia, Lusaka, Zambia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Contraceptive use is a major global public health priority, contributing to improved maternal and child health, gender equality, and sustainable development.*¹,² Despite progress in family planning coverage, women with sensory disabilities in low- and middle-income countries continue to face barriers to accessing modern contraceptives, resulting in lower utilisation.*³ In South Africa, limited evidence exists on how sensory disability status influences contraceptive use. This study examined the association between sensory disability status, individual- and community-level factors, and modern contraceptive use among women of reproductive age in South Africa.
METHODS:
Data were drawn from the 2016 South Africa Demographic and Health Survey (SADHS).*⁴ The analysis included 7,040 sexually active women aged 15–49 years. A two-level multilevel binary logistic regression model was employed to assess the association between sensory disability status, other individual- and community-level factors, and modern contraceptive use.
RESULTS:
The prevalence of modern contraceptive use among sexually active women was 57.32% (95% CI: 55.59–59.03). Women with sensory disabilities were less likely to use modern contraceptives (aOR = 0.81; 95% CI: 0.67–0.98). Additional factors negatively associated with use included desiring five or more children (aOR = 0.67; 95% CI: 0.47–0.97) and residing in communities with a high ideal number of children (aOR = 0.75; 95% CI: 0.63–0.90). Positive associations were observed for mobile phone ownership (aOR = 1.45; 95% CI: 1.15–1.82) and residence in communities with high employment levels (aOR = 1.32; 95% CI: 1.06–1.64).
CONCLUSIONS:
Sensory disability status significantly influences modern contraceptive use among women in South Africa. Family planning interventions should prioritise women with sensory disabilities by improving accessible communication (e.g., braille and sign language), strengthening disability-sensitive training for healthcare workers, and integrating reproductive health services within disability support programmes.
Contraceptive use is a major global public health priority, contributing to improved maternal and child health, gender equality, and sustainable development.*¹,² Despite progress in family planning coverage, women with sensory disabilities in low- and middle-income countries continue to face barriers to accessing modern contraceptives, resulting in lower utilisation.*³ In South Africa, limited evidence exists on how sensory disability status influences contraceptive use. This study examined the association between sensory disability status, individual- and community-level factors, and modern contraceptive use among women of reproductive age in South Africa.
METHODS:
Data were drawn from the 2016 South Africa Demographic and Health Survey (SADHS).*⁴ The analysis included 7,040 sexually active women aged 15–49 years. A two-level multilevel binary logistic regression model was employed to assess the association between sensory disability status, other individual- and community-level factors, and modern contraceptive use.
RESULTS:
The prevalence of modern contraceptive use among sexually active women was 57.32% (95% CI: 55.59–59.03). Women with sensory disabilities were less likely to use modern contraceptives (aOR = 0.81; 95% CI: 0.67–0.98). Additional factors negatively associated with use included desiring five or more children (aOR = 0.67; 95% CI: 0.47–0.97) and residing in communities with a high ideal number of children (aOR = 0.75; 95% CI: 0.63–0.90). Positive associations were observed for mobile phone ownership (aOR = 1.45; 95% CI: 1.15–1.82) and residence in communities with high employment levels (aOR = 1.32; 95% CI: 1.06–1.64).
CONCLUSIONS:
Sensory disability status significantly influences modern contraceptive use among women in South Africa. Family planning interventions should prioritise women with sensory disabilities by improving accessible communication (e.g., braille and sign language), strengthening disability-sensitive training for healthcare workers, and integrating reproductive health services within disability support programmes.
| eISSN: | 2654-1459 |
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