Alam Md Badsha, Billah Md Arif, Khanam Shimlin Jahan, Khalif Ibrahim Yasin, Khan Md Nuruzzaman
Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.
Health Systems and Population Studies Division, Icddr, b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh.
PLoS One. 2025 Aug 13;20(8):e0329491. doi: 10.1371/journal.pone.0329491. eCollection 2025.
Somalia has one of the highest rates of maternal and child mortality globally, accompanied by a significantly high total fertility rate. This indicates that women in Somalia face substantial challenges in accessing family planning and contraception, although evidence on this issue remains limited. This study aims to assess the current prevalence of unmet need for contraception in Somalia and identify the socio-demographic factors associated with it.
A total of 7,490 sexually active women of reproductive age with the ability to conceive were included in this study, based on pre-defined inclusion criteria, using data from the 2020 Somalia Health and Demographic Survey. The primary outcome variable was unmet need for contraception (yes/no), which included both unmet need for spacing and limiting births. A range of individual, household, and community-level variables were examined as explanatory factors. Multilevel logistic regression models were used to assess the associations between these factors and unmet need for contraception.
The overall prevalence of unmet need for contraception was 37.2% (95% CI: 35.3-39.1), with significant variations across socio-demographic groups. Women who married at age 21 or older (aOR: 1.25; 95% CI: 1.03-1.51), had five or more children (aOR: 2.41; 95% CI: 2.00-2.89), or lived in the central (aOR: 1.36; 95% CI: 1.05-1.76) and southern regions (aOR: 1.59; 95% CI: 1.00-2.54) were more likely to have an unmet need for contraception. In contrast, women aged 35 or older (aOR: 0.59; 95% CI: 0.43-0.79), and those residing in urban (aOR: 0.71; 95% CI: 0.52-0.98) and rural areas (aOR: 0.77; 95% CI: 0.59-0.99) were less likely to have an unmet need.
The prevalence of unmet need for contraception in Somalia is alarmingly high by global standards. This reflects a heightened risk of short birth intervals and unintended pregnancies, contributing to increased maternal and child mortality. To address this, the government should prioritize strengthening healthcare infrastructure and implementing targeted awareness programs on family planning to reduce the unmet need for contraception in the country.
索马里是全球孕产妇和儿童死亡率最高的国家之一，同时总生育率也显著偏高。这表明索马里妇女在获取计划生育和避孕措施方面面临巨大挑战，尽管关于这一问题的证据仍然有限。本研究旨在评估索马里目前未满足的避孕需求的流行情况，并确定与之相关的社会人口因素。
根据预先确定的纳入标准，本研究纳入了7490名有生育能力的性活跃育龄妇女，数据来自2020年索马里卫生和人口调查。主要结局变量是未满足的避孕需求（是/否），包括未满足的生育间隔需求和限制生育需求。一系列个人、家庭和社区层面的变量被作为解释因素进行考察。采用多水平逻辑回归模型来评估这些因素与未满足的避孕需求之间的关联。
未满足的避孕需求的总体流行率为37.2%（95%置信区间：35.3 - 39.1），不同社会人口群体之间存在显著差异。21岁及以上结婚的女性（调整后比值比：1.25；95%置信区间：1.03 - 1.51）、有五个或更多孩子的女性（调整后比值比：2.41；95%置信区间：2.00 - 2.89），或居住在中部地区（调整后比值比：1.36；95%置信区间：1.05 - 1.76）和南部地区（调整后比值比：1.59；95%置信区间：1.00 - 2.54）的女性更有可能有未满足的避孕需求。相比之下，35岁及以上的女性（调整后比值比：0.
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