ArticleContraception and reproductive medicine2026
Exploring the socioeconomic and education-based inequalities in modern and traditional contraceptive use among women in Africa.
Article in Contraception and reproductive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundContraceptive use is integral to improving reproductive health outcomes, but disparities in access and use persist across Africa, influenced by socio-economic, educational, and age-related factors. This study explores socioeconomic and education-based inequalities in modern and traditional contraceptive use among women in 41 African countries.
methodsSecondary data from the World Health Organisation’s Health Equity Assessment Toolkits and national demographic surveys (2010–2022) were analysed. The study focused on women aged 15–49, categorised by socio-economic status, education level, and age. Descriptive and inferential statistical methods were used, employing inequality measures such as D (Estimate), R (Estimate), PAF (Estimate), and PAR (Estimate) to assess disparities in contraceptive use.
resultsThe study found significant variation in contraceptive prevalence, ranging from high-prevalence nations such as Zimbabwe (66.8%), Malawi (65.6%), and Lesotho (64.9%). South Sudan (4%) and Chad (8.2%) had very low prevalence rates. Age-related disparities were also significant, with contraceptive use generally higher in the 20–49 years age group compared to the 15–19 years age group. Again, Ghana exhibited 17% use among 15–19-year-olds compared to 53% in the 20–49-year-old group. The D revealed substantial inequalities in contraceptive use, particularly in countries like Kenya (22.5) and Malawi (20.6). The R highlighted greater disparities in countries such as Nigeria (4.0), indicating a significant socio-economic divide. The PAF demonstrated that socio-economic inequalities contributed to disparities, with Mozambique (5.8) and Niger (8.1) showing higher contributions. PAR further revealed that countries like Malawi (1.6) and Gambia (1.0) had a higher burden of inequality in contraceptive use.
conclusionThis study demonstrates persistent and intersecting age-, wealth-, and education-related inequalities in contraceptive use across Africa. By applying standardised inequality metrics in a cross-country comparative framework, the findings extend beyond prevalence-based analyses and provide actionable evidence to inform equity-oriented family planning policies and programmes. CLINICAL TRIAL NUMBER: Not applicable.
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