Trends and determinants of modern contraceptive use among sexually active adolescent females in Bangladesh: Evidence of four national surveys (2011–2022)

Modern contraceptive methods (MCM) reduce the risk of unintended pregnancy and short birth intervals. Despite growing attention to reproductive health, the factors influencing the use of MCM among sexually active adolescent females in Bangladesh remain underexplored. The objectives of this study are to examine trends in the use of MCM and to identify the significant factors associated with the usage of MCM among sexually active adolescent females in Bangladesh. In this study, we used secondary data from the 2011, 2014, 2017-18, and 2022 rounds of the Bangladesh Demographic and Health Surveys (BDHS) to examine trends in the use of MCM. Additionally, we analyzed data from the selected surveys to identify factors associated with the use of MCM. Male and female sterilization, intrauterine devices (IUDs), injectables, implants, contraceptive pills, male and female condoms, emergency contraception, the standard days method, and the lactational amenorrhea method were considered modern contraceptive methods in the study. A logistic regression model was used to identify the factors influencing the use of MCM. This study revealed that the proportion of the use of MCM among overall surveys was found to be 53.2%, and MCM was more used in urban areas compared to rural areas. It was noted that no consistent pattern was observed in urban, rural, and overall survey. The model identified seven factors associated with the use of MCM among adolescent females: (i) living in the Barisal, Dhaka, Khulna, and Rajshahi divisions; (ii) residing in an urban area; (iii) mass media exposure; (iv) living with one or more children, (v) terminating pregnancy, (vi) visits by a family planning worker; (vii) knowledge on family planning; and (viii) moderate contraceptive-using autonomy. This study highlights key factors influencing the use of MCM among sexually active adolescent females. Addressing these factors-such as strengthening public health sector services, improving access to education, enhancing socioeconomic status, and promoting contraceptive autonomy-is essential to increasing MCM usage among adolescent females.