Family planning provides married couples the opportunity to attain their desired number of children with the right spacing between each birth (WHO, 2024). Family planning has relevance in public health and, the socio-economic status of communities, and reduces the burden on resources (Grant, 2016). It is the most cost-effective health and development intervention available to many governments(Grant, 2016). Family planning brings enormous benefits to females, communities, and countries at large, and it helps women in achieving educational goals, and engage in economic activities (Starbird et al., 2016). Among the benefits of family planning (FP) is the reduction of unintended pregnancies(Ayaz & Mughal, 2022; WHO, 2024). These benefits extend to the reduction of the spread of HIV to newborns; reduced maternal mortality and morbidity as well as reduced neonatal, infant, and child mortality(Grant, 2016; WHO, 2024). Thus, these will serve as significant contributions towards the attaining targets of Sustainable Development Goals 3 (SDG3); universal access to reproductive health care, and prioritizing individuals’ exercise and enjoy their reproductive rights (Refaat, 2023).
Despite the enormous benefits of family planning services, the utilization of contraceptives remains low in Sub-Saharan Africa (United Nations, 2015).. Besides, several factors including socio-economic, geographical, or cultural may affect modern contraceptive utilization(United Nations, 2015). In The Gambia, access to family planning services has been increasing due to the expansion of reproductive and child health clinics, however, contraceptive intake is still on the decline, especially in rural Gambia (Barrow, 2020).. According to the results of this study, the overall contraceptive prevalence rate of women was 30.4%. The national multiple cluster indicator survey intimated the national prevalence of modern contraceptive uptake among married or in-union women is 17% (The Gambia Bureau of Statistics, 2019). As cases of maternal mortality in The Gambia increase, many factors influence this public health problem, one of these contributing factors is access to quality healthcare services. In addition, sociocultural practices may limit the resources available to women, resulting in adverse health consequences (Lowe, 2017). This study aims to explore married women's understanding of modern contraceptive methods. The results of this study could be used to develop or inform policies and interventions to promote the utilization of family planning services.
Countries with a high and rapid population growth relative to available resources experience a vastly high fertility rate. High fertility rates, are associated with inadequate birth spacing and, as a result, lead to high maternal and infant mortality (Khan & Harris, 2023a).
As at 2019 there were over 1.9 billion women of reproductive age, of these, 1.1 billion needed family planning; 842 million were using modern contraceptive methods, and 270 million still have unmet needs for contraception (Kantorová et al., 2020). Furthermore, less than half of the need for family planning was met in Middle and Western Africa considering the indicator 3.7.1 of the Sustainable Development Goals (Kantorová et al., 2020). However, the low uptake of family planning services and modern contraceptive methods suggests that most women in Sub-Saharan are either not planning their pregnancies or have challenges in accessing reproductive health services(Boadu, 2022; Michael et al., 2024; Ross et al., 2021) .
The underutilization of modern family planning methods among women in sub-Saharan Africa is largely attributed to low literacy and low socio-economic status(Anasel & Mlinga, 2014). Additionally, spousal communication on contraception has also been found to influence utilization(George K et al., 2020). In patriarchal societies, the desire for male children have been identified to influence women’s uptake of contraceptives (Dey et al., 2021; Hoq, 2020; Khan & Harris, 2023b). Circumstances like these can have negative consequences on the health and wellbeing of mothers and their children.
Current statistics revealed that about one-fifth of married women age 15–49 in The Gambia practiced a method of family planning—17% and 2% used modern and traditional methods respectively (GBoS, 2021). The most popular methods are injectables (8%), implants (6%), and the pill (2%) (GBoS, 2021). Even though the country is realizing a steady decline in maternal mortality rates from 374 to 289 in 2020, the need to further reduce it to SDG targets is more urgent than ever (GBoS, 2021). Many factors influence this public health problem, one of these contributing factors is access to quality healthcare services. In addition, sociocultural practices may limit the resources available to women, resulting in adverse health consequences (Lowe, 2017; Lowe et al., 2016).
This study wishes to determine the knowledge and prevalence of modern contraceptive methods among married women.