Addressing socio-cultural barriers to improve contraceptive use in Ethiopia

Ethiopia encounters significant socio-cultural barriers to contraceptive use, affecting maternal health, poverty reduction, and women's empowerment. With a fertility rate of 4.6 children per woman and only 25.9% of women of reproductive age intending to use contraceptives, significant challenges remain. This policy brief analyzes data from the 2016 Ethiopian Demographic and Health Survey (EDHS) and 2019 Mini-EDHS, revealing key barriers such as fatalistic beliefs, religious prohibitions, postpartum amenorrhea, and spousal opposition. Socioeconomic factors, including wealth, literacy, and urban residency, greatly influence contraceptive use. Multivariable and structural equation modeling (SEM) analyses underscore the complex interplay of cultural norms, economic status, and individual autonomy in shaping contraceptive behavior. The result reveals both direct and indirect effects of socio-cultural factors such as fatalistic beliefs and religious prohibitions on contraceptive use. The findings of this brief provide direct policy relevance by identifying actionable pathways for engaging religious leaders, community influencers, and health workers in culturally responsive strategies to overcome socio-cultural barriers and improve contraceptive uptake. Findings recommend to enhance contraceptive uptake, the recommends culturally tailored education programs, such as community-led workshops, engaging religious leaders, and promoting male involvement strategies, alongside targeted interventions for underserved areas and strengthened healthcare systems to ensure equitable access. Implementing these evidence-based policies is essential for improving reproductive health and empowering women in Ethiopia.