Family planning under sociocultural influence: evaluating knowledge, access, and utilization in Al Baha, Saudi Arabia

Unmet need for contraception remains a persistent global reproductive health challenge. In Saudi Arabia, national estimates indicate moderate contraceptive uptake; however, region-specific data on awareness, accessibility, and utilization of family planning (FP) services remain limited, particularly in semi-rural settings such as Al-Baha.

To evaluate awareness, access, and utilization of family planning and reproductive health services and to identify perceived barriers and sociodemographic determinants among adult women in Al-Baha, Saudi Arabia.

A population-based cross-sectional study was conducted using a 23-item online questionnaire administered to female residents aged ≥18 years between December 2024 and February 2025 through convenience sampling. Descriptive statistics summarized participant characteristics and FP-related variables. Associations between categorical variables were assessed using chi-square (χ²) tests. Univariable and multivariable logistic regression analyses were performed to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at a two-sided p < 0.05. Ethical approval was obtained from the Deanship of Scientific Research, Al-Baha University (Approval No. 46110701-20241117), and electronic informed consent was secured prior to participation.

A total of 892 women participated (mean age 38 ± 10.5 years). Awareness of FP initiatives was reported by 24%, and 18% had previously received FP consultation/services. Although 94% reported geographic access to a healthcare facility within 30 min, routine reproductive health service utilization remained limited, with 53% reporting infrequent visits. Current contraceptive use was reported by 42%, predominantly oral contraceptive pills (15%) and intrauterine methods (9%). Overall, 32% reported at least one barrier to contraception access, with "other barriers" (14%) and limited availability (11%) cited most frequently. Several outcomes demonstrated significant sociodemographic variation (p < 0.05). In multivariable analysis, age >30 years independently predicted current contraceptive use (aOR 3.97; 95% CI 2.64-5.98; p < 0.001).

Despite reported geographic accessibility, awareness and counselling uptake remain suboptimal in Al-Baha. Targeted, culturally responsive primary care-based interventions and strengthened service availability are warranted to improve informed reproductive health decision-making.