Contraceptive use intention and determinants among nonuser reproductive-aged married women in Ethiopia based on the theory of planned behavior
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social norms—particularly perceived approval from partners and communities—play a central role in shaping contraceptive intentions. Positive subjective norms, supportive partner attitudes, and community environments that reduce stigma and encourage discussion significantly increase women’s intention to use contraception, highlighting that shifting normative climates is critical for improving reproductive autonomy and uptake.
Objectives This study aimed to assess the prevalence of contraceptive use intention among married, non-contraceptive-using women in Ethiopia and to identify key socio-psychological, demographic, and contextual determinants using the Theory of Planned Behavior (TPB).
Methods The study used cross-sectional, nationally representative PMA Ethiopia 2020 data (n=3025). It applied a quantitative approach guided by TPB constructs—attitudes, subjective social norms, and perceived behavioral control—measured Likert-scale indices. Multilevel binary logistic regression was used to assess associations, accounting for clustering at the community level. Social norms were operationalized as “subjective social norms” reflecting perceived approval or disapproval of contraceptive use by important others.
Results Approximately 46.4% of married women reported intention to use contraception. Key predictors included favorable attitudes (AOR≈3.34), positive subjective social norms (AOR≈2.17), and high perceived behavioral control (AOR≈1.71). Partner approval was especially influential (AOR≈5.04). Additional positive correlates included higher contraceptive knowledge, larger family size, facility visits, and residence in certain regions. Older age was associated with lower intention. Regional variation was substantial, reflecting differing sociocultural contexts.
Conclusions Contraceptive use intention remains moderate and largely unchanged over time, indicating persistent barriers. TPB constructs—especially social norms—are critical drivers of intention. Programs should prioritize norm-shifting strategies that promote supportive partner and community attitudes, reduce stigma, and foster open dialogue. Strengthening women’s knowledge, autonomy, and access to services, alongside engaging partners and communities, is essential to translate intention into actual contraceptive use.
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