Modern contraception methods usage trend among Egyptian females and its determinant factors: results from five national surveys

BACKGROUND: Family planning is considered one of the most effective health-promoting strategies, with the ability to prevent approximately 30% of maternal mortality and 10% of child mortality. In Egypt, there have been remarkable governmental efforts and legislation for over 50 years. This study aims to conduct a secondary data analysis of existing survey datasets to compare and explore trends in the prevalence of modern contraception use across five national surveys conducted between 2000 and 2014 in Egypt. METHODS: This secondary data analysis relies on the five most recent Egyptian Demographic and Health Surveys (EDHS) conducted in the years 2000, 2003, 2005, 2008, and 2014. EDHS is a nationally representative survey following a multistage stratified cluster sampling design, producing estimates generalisable to the Egyptian national population and providing information on important maternal, child health and family planning indicators. Ever-married females aged 15-49 years were included, and those who were pregnant, infecund, or never-married were excluded. The total population included in the five surveys was 82,458, while the eligible females for this analysis were 51,329, for whom modern contraceptive prevalence use and factors associated with it, including sociodemographic, birth-related, and access to health care factors, were assessed. RESULTS: The mean age was 32.8 (± 8.1) years. The mean modern contraception (MCC) usage was 74.4% over all surveys. The most recent survey (EDHS 2014) showed a decline to 73.1%, down from 75.4% in 2008. Women aged 35 to 44 had a higher chance of having MCC (OR 95% CI 1.42 (1.18-1.70)), while women aged 15 to 24 had a lower chance (0.73 (0.60-0.88)). Women with middle and high household wealth indices, professional working women, and women with more than three living children showed higher odds of using MCC compared to their counterparts, with odds ratios of 1.33 (1.15-1.55), 1.88 (1.53-2.31), 1.25 (1.04-1.51), and 1.23 (1.07-1.42). Mode and place of last delivery, together with the source of contraception method, play a vital role in MCC use [1.23 (1.07-1.42), 1.31 (1.03-1.68) & 2.49 (2.19-2.83)]. CONCLUSION: Although MCC usage averaged 74.4% across the five surveys, this study highlights persistent differences in modern contraceptive use in Egypt, with notable gaps by age, residence, and socioeconomic status.