Factors Associated with Modern Contraceptive Method Utilization Among Women of Reproductive Age (15–49 Years) in the Djombo Health Zone, Democratic Republic of the Congo

Abstract

Introduction: Modern contraceptive method (MCM) utilization remains a public health concern in rural areas of the Democratic Republic of the Congo. This study assessed MCM utilization and associated factors among women aged 15–49 years in the Djombo Health Zone.

Methods: A cross-sectional analytical study was conducted in September 2025 among 432 women selected through a three-stage sampling procedure. Data were collected using an electronic questionnaire and analyzed with SPSS version 25.0. Chi-square tests and logistic regression were used to assess associations.

Results: Among 432 participants, 141 used modern contraceptive methods, yielding a prevalence of 32.6%. Multivariable analysis showed that secondary or higher education (aOR = 2.46; 95% CI: 1.69–3.59; p < 0.001), living in a marital union (aOR = 1.70; 95% CI: 1.07–2.69; p = 0.024), and an inter-pregnancy interval of at least three years (aOR = 2.58; 95% CI: 1.08–6.16; p = 0.032) were associated with higher odds of utilization. Partner approval was positively associated with utilization (aOR = 3.61; 95% CI: 2.28–5.72; p < 0.001), whereas not knowing the partner’s opinion was associated with lower odds (aOR = 0.21; 95% CI: 0.10–0.42; p < 0.001). Lack of religious affiliation was associated with higher odds than Christian affiliation (aOR = 2.10; 95% CI: 1.20–3.68; p = 0.009). Living at least 5 km from a health facility was associated with lower odds (aOR = 0.48; 95% CI: 0.30–0.76; p = 0.002).

Conclusion: MCM utilization was 32.6%. Improving contraceptive information, partner communication, and geographical access may help address barriers to use while safeguarding women’s reproductive autonomy