Associated factors for low modern contraceptive use and high unmet needs among postpartum women in Nepal: A cross-sectional study

<h2>Abstract</h2><h3>Problem considered</h3> Postpartum family planning (PPFP) plays a crucial role in reducing unintended pregnancies. However, many low-resource countries, including Nepal, have limited uptake of modern contraceptives. This study assessed PPFP use and unmet contraceptive needs among women within six months postpartum and identified factors associated with it. <h3>Methods</h3> This was a cross-sectional study. Of the 33 healthcare facilities screened, eight met the inclusion criteria. A total of 241 women who provided consent were enrolled in the study. Descriptive analyses were conducted using Jamovi version 2.6.2.0, and multivariate logistic regression was performed in R version 4.4.2 to identify predictors of modern contraceptive use. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with statistical significance set at p < 0.05. <h3>Result</h3> Logistic regression revealed key predictors of modern family planning: higher parity (OR = 2.55, 95% CI: 1.02–6.39, p=0.045), knowledge of ovulation (OR = 3.20, 95% CI: 1.03-9.88, p=0.043), and past family planning (FP) use (OR = 4.57, 95% CI: 1.86–11.22, p < 0.001) were significantly associated with modern contraceptive use. Conversely, having a last child under two years (OR = 0.49, 95% CI: 0.25–0.98, p=0.043) was associated with a negative outcome. <h3>Conclusion</h3> Almost two-thirds of the women wish to delay or prevent a future pregnancy, and one in six women adopted modern contraceptives within six months postpartum. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed to reduce unmet needs and improve maternal and child health outcomes.