A multivariate decomposition analysis of urban-rural disparities in contraceptive use among women in Ethiopia.

Contraceptive use is a key public health indicator linked to maternal and child health, women’s empowerment, and sustainable development. In Ethiopia, despite efforts to improve family planning, a substantial urban-rural disparity persists. Consequently, identifying the factors of the urban–rural gap is vital for fostering healthier women and developing evidence-driven approaches to address these disparities for contraceptive use. Therefore, this study aimed to assess urban-rural disparities and identify contributing factors in contraceptive use from the 2019 EMDHS. This study was conducted using the 2019 EMDHS among 8,885 reproductive-age women. A decomposition analysis was used to analyze the factors associated with the urban–rural disparity of contraceptive use, and the results were presented using text and tables. and figures. Statistical significance was declared at p-values < 0.05, with effect sizes reported with 95% confidence intervals. The magnitude of contraceptive use among reproductive-age women was 23.80%. Urban women had significantly higher contraceptive use compared to rural women. Endowment factors were responsible for 95.3% of the discrepancy. Educational status for secondary (β = 0.013; 95%CL: 0.005, 0.02; p = 0.001), higher education (β = 0.023; 95%CL: 0.005, 0.041; p = 0.010), wealth status with middle (β = 0.021; 95%CL: 0.013, 0.090; p < 0.001), rich (β = 0.083; 95%CL: 0.036, 0.130; p < 0.001), more than two births in the last five years (β = 0.006; 95%CL: 0.002, 0.010; p = 0.001) and know contraceptive method (β = 0.022; 95%CL: 0.010, 0.034; p < 0.001) were contributed to the disparity. But primary education (β = − 0.002; 95%CI: −0.003, − 0.001; p = 0.001) and number of living children greater than or equal to six (β = − 0.015; 95%CI: -0. 024, − 0.006; p = 0.001) contributed to the widening of the gap between urban and rural in contraceptive use. There is a significant variation between urban and rural women in contraceptive use. The larger portion of the discrepancy was explained by the endowments. Age, educational status, wealth status, births in the last five years, number of living children, and known contraceptive method were the significant factors contributing to the disparity. Efforts to improve educational attainment, economic empowerment, and contraceptive awareness in rural areas are critical to closing this disparity.