Emergency contraception use and associated factors among reproductive age women in post conflict Southeastern Tigray Ethiopia

Emergency contraceptives (ECs) are interventions used to prevent pregnancy after unprotected sexual intercourse or contraceptive failure, including Emergency Contraceptive Pills (ECPs) and Copper Intrauterine Devices (IUDs). Despite their safety and effectiveness, young and unmarried women often face limited access due to lack of awareness, concerns about pelvic examinations, provider attitudes, and barriers to family planning services. Globally, 16 million teenage females give birth annually, with 95% of these births occurring in low-income countries. A community-based cross-sectional study was conducted among 910 women using a multi-stage sampling technique. Data were collected with a semi-structured questionnaire through Open Data Kit (ODK) and analyzed using descriptive statistics and multivariable logistic regression to identify factors associated with EC utilization. Emergency contraceptive utilization was 16.8%. Women who were merchants (AOR = 2.0; 95% CI: 1.24–3.43; ) and government employees (AOR = 3.2; 95% CI: 1.46–7.19 ) were more likely to use emergency contraceptives compared to housewives. Women whose decision-making was dominated by their husband only were less likely to use ECs (AOR = 0.3; 95% CI: 0.08–0.91). Access to mass media (AOR = 0.5; 95% CI: 0.32–0.79), good attitude toward ECs (AOR = 1.6; 95% CI: 1.07–2.48; ), and good knowledge about ECs (AOR = 1.8; 95% CI: 1.15–2.84) were also significantly associated with utilization. Emergency contraceptive use remains low in the study area. Targeted interventions to increase awareness through mass media, educational campaigns to improve knowledge, and strategies tailored to women’s occupational groups are recommended to enhance utilization.