Exploring Geographic Inequalities and Determinants of Contraceptive Use Among Married Adolescent Girls in Bangladesh: Findings from the 2019–20 Adolescent Health Survey

ABSTRACT Background and Aims Bangladesh has made notable progress in increasing contraceptive use, but it has not yet fully achieved its Sustainable Development Goal (SDG) targets aiming to reduce the unmet need to 6% by 2030. This study explored geographical disparities, sources, and determinants of contraceptive use among married female adolescents using the Bangladesh Adolescent Health and Wellbeing Survey 2019–20. Methods A sample of 4802 married female adolescents aged 15–19 years was used, and their contraceptive use patterns, sources, and associated risks were assessed. Various statistical tools, including geographical disparities analysis using GIS tools, bar diagrams, proportion z‐tests, and a multinomial binary logistic regression model, were employed in the data analysis. Results Contraceptive use among adolescents was 65.1%, higher in urban (70.56%) areas. The married adolescents frequently use modern methods (88.86%), while 10.1% use traditional methods. The predominant method was pills (65.36%), followed by condoms (17.72%) and injections (13.26%). Contraceptive use was lowest in Sylhet, with non‐use linked to childbearing desire, husband's opposition, or absence. Regional disparities were evident, with Chittagong showing higher contraceptive use among rural adolescents (19.4%) and Dhaka among urban adolescents (26.9%). Multinomial logistic regression identified division, TV watching, mobile phone use, and residence as key factors influencing contraceptive use. Urban adolescent girls showed 37% (AOR: 1.37; 95% CI: 1.17–1.62; p = < 0.001) more likely to use contraceptive. Conclusion Contraceptive use among adolescents varies significantly in Bangladesh, with higher usage in urban areas. The pill is the most used method, but many adolescents avoid contraception due to wanting children or their husband's opposition. Addressing regional disparities and sociocultural factors is crucial to improving adolescent contraceptive use in Bangladesh and achieving the maternal and child health SDGs.