Determinants of Informed Decision-Making on Sexual Relations, Contraceptive Use, and Reproductive Health among Women of Reproductive Age: A Case of Married Women in Tanzania

Background: The percentage of women aged 15-49 who have the autonomy to make informed decisions about sexual and reproductive health varies globally. According to recent data, approximately 57% of women in this age group can make decisions independently. However, regional disparities exist, with lower rates in many developing countries, particularly in Sub-Saharan Africa. Objective: Our goal was to ascertain the determinants of informed decision-making on sexual relations, contraceptive use, and reproductive health among women of reproductive in Tanzania. Methods: This cross-sectional study used secondary data from the Tanzania Demographic and Health Survey and Malaria Indicator Survey of 2022. The study population included married women aged 15-49 years. A multinomial regression model was used to identify determinants associated with making informed decisions on Sexual Relations, Contraceptive Use, and Reproductive Health. Results: A total of 6730 married women were included in the analysis. the majority resided in rural areas, had completed primary education, reported never hearing about family planning on the radio, not encountered family planning information on popular social media platforms like Facebook, Twitter, or Instagram, perceived distance to a health facility as a non-issue, were employed, and had 1-5 living children. On the other hand, Age, employment, husband employment, wealth index, distance to a health facility, and having living children were associated with higher odds of making all three informed decisions while hearing about family planning on the radio had lower odds. Conclusion: The study identifies factors influencing decision-making in married Tanzanian women of reproductive age. Older women and those with stable economic environments and financial independence are more likely to make informed choices. Access to healthcare facilities and good parenting experiences also improve women's decision-making autonomy. Targeted education and empowerment programs should be introduced to enhance informed decision-making among married women in Tanzania