Key Social Norms Take-aways Social norms—particularly religious beliefs, gender roles, and expectations around fertility—strongly shape contraceptive use in pastoralist communities. Norms that value large families, discourage contraception on religious grounds, and reinforce male-dominated decision-making limit women’s agency. Misperceptions and community-level expectations further sustain low uptake, indicating that interventions must address normative beliefs and couple dynamics, not just knowledge gaps.

Objectives To examine the factors influencing modern contraceptive use among married couples in the Fentale District, with a focus on socio-cultural, economic, and relational dynamics.

Methods The study used a mixed-methods design combining a cross-sectional quantitative survey with qualitative focus group discussions (FGDs) and in-depth interviews. The survey measured demographic characteristics, contraceptive knowledge and use, couple communication, and socio-cultural and economic influences, including perceived social norms . Qualitative data explored community perceptions, gender roles, and cultural beliefs shaping family planning decisions. Thematic analysis with triangulation was used to integrate findings .

Results Contraceptive use was influenced by multiple intersecting factors. Quantitative findings highlighted the importance of communication between partners, media exposure, and mobility patterns. Qualitative findings revealed widespread misconceptions about contraceptive methods and limited knowledge of their use. Religious beliefs and social expectations favoring childbearing were major barriers, with many participants viewing children as a blessing and contraception as socially or morally inappropriate. Spousal opposition and gendered decision-making dynamics further constrained use, with religious objections cited by a majority of respondents .

Conclusions Contraceptive uptake in this context is shaped not only by access and knowledge but by deeply embedded social norms and relational dynamics. Efforts to improve family planning should incorporate community-level norm change, address religious and cultural beliefs, and promote equitable couple communication to shift expectations around fertility and contraceptive use.