Reproductive Empowerment and Pattern of Contraceptive use Among Married Women in Agago District, Northern Uganda

Abstract

Background: Reproductive empowerment significantly influences contraceptive use and maternal health. In Agago District, cultural and gender norms shape reproductive decisions. This study examined the relationship between reproductive empowerment and patterns of contraceptive use among married women. Methods: A cross-sectional study was conducted in March 2025 among 465 married women aged 15-49 using multistage sampling. Data were collected via a pretested, interviewer-administered questionnaire in Acholi language, covering socio-demographics, contraceptive use, and reproductive empowerment. Data were analyzed in Stata v17. Descriptive statistics summarized key variables, and Chi-square and binary logistic regression assessed associations. Variables with p < 0.2 were included in multivariable analysis; significance was set at p < 0.05. Results: Current contraceptive use was 37%, with 76.1% having ever used modern methods. Discontinuation (7.8%) and method switching (51.5%) were mainly due to side effects or desire to conceive. Over half (51.2%) had low reproductive empowerment. Decision-making autonomy did not differ by empowerment level (p = 0.121), but higher empowerment was strongly associated with increased contraceptive use (AOR=15.10; 95% CI: 3.80-60.00) and lower likelihood of discontinuation (AOR=0.20; 95% CI: 0.06-0.65) and switching (AOR=0.25: 95% CI; 0.07-0.85). Surprisingly, formal employment (AOR = 0.05; 95% CI: 0.01-0.26) and moderate income (AOR = 0.25; 95% CI: 0.08-0.76) were linked to lower contraceptive use; other sociodemographic were not significant. Conclusion: Reproductive empowerment strongly promotes contraceptive use but does not always translate into independent decision-making. Interventions should enhance empowerment, provide side-effect counselling, and engage men in reproductive health in rural Uganda