Factors determining the use of modern contraceptive among married women in Cambodia: Does their decision-making matter?

2021 
Introduction In Cambodia, modern contraceptive use has increased slightly from 35.0% to 39.0% between 2010 and 2014. However, this proportion remains low in the South-East Asia regions; and more efforts are needed to increase the use of modern contraceptive (MC). Our study aimed to explore the determinants of MC use and to assess whether women’s decision-making power on contraceptive use is more influential determinant. Methods We analyzed data from the Cambodia Demographic Health Survey 2014 in which a total of 611 clusters (urban and rural) from 15,825 households with selected samples of 17,578 women aged 15-49 years old. They were interviewed about sexual, and reproductive health. We restricted our analysis to married women (n=11,668). Bi-variate and multivariate logistic regression were performed using STATA version 14. Sampling weight was taken into account in all analyses. Results The prevalence of modern contraceptive use in 2014 was 39.0%. Factors independently determining the use of modern contraceptive methods include decision on contraceptive use made by women alone (AOR=5.31, 95% CI=4.01-7.04) and made jointly with husband or partner (AOR=1.59, 95% CI=1.29-1.96) compared with that decision made by husband or partner alone. Women aged more than 35 years old (AOR=0.73, 95% CI= 0.61-0.87) was less likely to use MC than those who aged between 15 and 34 years old. Also, the lower odds of using MC was found among women who completed secondary or higher education (AOR=0.70, 95% CI=0.54-0.90) compared with those who had no education, and women living in the urban area (AOR=0.73, 95% CI= 0.60-0.88) compared to those living in the rural area. Conclusions Married women’s participation in decision-making on contraceptive use is the influential determinant of modern contraceptive use. Future interventions to improve the use of MC methods should focus on empowerment of women to actively participate in making decision on the use of contraceptive methods and other health services.
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