Determinants of modern contraceptive use among women aged 18–49 years in the N’djili health zone, DRC

Background Family planning (FP) is a major public health intervention that contributes to reducing maternal and infant mortality. In the Democratic Republic of the Congo, the prevalence of modern contraceptive use remains low despite ongoing national efforts. This study aimed to identify factors associated with the use of modern contraceptive methods (MCMs) among women aged 18–49 years in the N’djili Health Zone. Methods A cross-sectional analytical study was conducted from May 1 to June 1, 2025, among 394 women selected using a three-stage probability sampling method. Data were collected through a structured questionnaire. Associations were assessed using chi-square tests and multivariable logistic regression, with statistical significance set at p < 0.05. Results The prevalence of modern family planning method use was 47%. The main reported reasons for use were avoiding pregnancy (56%) and spacing births (32%). In bivariate analysis, significant associations were observed with health area, occupation, number of children, wealth level, and knowledge of MCMs. After adjustment, only socioeconomic status and technical knowledge remained independent determinants. Women from poor (adjusted odds ratio, aOR = 0.34; p = 0.002) and middle-income households (aOR = 0.52; p = 0.037), as well as those with no knowledge of MCMs (aOR = 0.08; p = 0.001), were significantly less likely to use a modern method. Conclusions The use of modern contraceptive methods in N’djili remains constrained by economic insecurity and limited knowledge. Strengthening contraceptive education and ensuring equitable access to family planning services are essential to improve coverage and reduce maternal health risks.