Determinants of modern contraceptive use among married and sexually active unmarried women aged 15–49 years old in Cambodia: How are geographical and socio-demographic factors associated with access?

Using modern contraceptives is essential for promoting economics, limiting the space of pregnancies, and improving maternal and newborn health outcomes. Despite progress in Cambodia, disparities in contraceptive use persist, particularly across socio-demographic and geographic groups. This study examined the prevalence and determinants of modern contraceptive use among married and sexually active women of reproductive age (15-49 years) in Cambodia, focusing on geographic and socio-demographic factors. This cross-sectional analysis of individual women's data from the 2021-2022 Cambodia Demographic and Health Survey (CDHS), including those of 13,492 women. Modern contraceptive use was defined as the self-reported current use of methods such as sterilization, IUDs, implants, pills, injectables, condoms, and emergency contraception. Descriptive and logistic regression models were used to examine associations with factors such as geographic accessibility (distance to healthcare, transportation, residence, regions), socio-demographic characteristics, and healthcare access. The prevalence of modern contraceptive use was 45%, higher in rural areas (47%) than in urban areas (41.4%). Women living 20-40 minutes from healthcare facilities were less likely to use contraceptives (AOR = 0.87, 95% CI: 0.75-0.99) compared to those within 20 minutes. Motorcycle ownership was positively associated with contraceptive use (AOR = 1.29, 95% CI: 1.09-1.53). Higher odds of use were observed among women with two children (AOR = 29.33, 95% CI: 20.04-42.91) or three or more children (AOR = 30.76, 95% CI: 20.50-46.16). Contraceptive use was lower among wealthier women and those aged 35-49 compared to younger women (15-19). These findings highlight the need for targeted interventions, including expanded rural healthcare, transportation solutions, and tailored awareness campaigns, to improve equitable access to family planning services and support Cambodia's health goals.