High unmet need for modern contraception among married women of reproductive age (15–49 years) in Mogadishu, Somalia: a community-based cross-sectional study

Abstract

Introduction: Unmet need for modern contraception is measured as the proportion of fertile women who do not use contraception despite wanting to delay or limit their childbearing. The persistently high unmet need for modern contraception among ever-married women of reproductive age in Somalia highlights the importance of understanding the individual determinants of this unmet need. This study aims to identify the unmet need for modern contraception and examine the factors associated with this need among married women of reproductive age in Mogadishu, Somalia. Methods: A community-based, cross-sectional study with 462, randomly selected, married women of reproductive age (15-49 years) was conducted from October 2024 to January 2025. A pretested questionnaire was used to collect data from the participants. Descriptive and logistic regression analyses were employed using Stata V.18. Results: A total of 117 (25%) had an unmet need for modern contraception. Illiterate women had significantly higher odds of unmet need for modern contraception compared with those with higher education levels (Adjusted odd ratio(AOR)=3.6, 95% CI 1.64 to 7.88). Similarly, women whose first pregnancy occurred at the age of ≤18 had significantly higher odds of unmet need for modern contraception compared with those whose first pregnancy occurred after 18 years (AOR=1.8, 95% CI 1.10 to 2.98). Furthermore, women who did not receive antenatal care (ANC) during their last pregnancy had higher odds of unmet need for modern contraception (AOR=1.5, 95% CI 1.01 to 2.44) compared to those who did. Conclusion: The unmet need for modern contraception among married women of reproductive age in Mogadishu remains very high. Literacy, age of first pregnancy and ANC attendance were shown to be important predictors of unmet need for modern contraception. Improving women's education, preventing teenage pregnancy and enhancing ANC attendance would play an important role in increasing the use of modern contraceptives in Somalia.