Linking women’s empowerment to modern contraceptive use: evidence from the Tanzania demographic and health survey 2022

Abstract

Background: High fertility rates in sub-Saharan Africa underscore the importance of contraceptive use in managing population growth. While previous studies have linked women’s empowerment to contraceptive behavior, this study adopts a multidimensional approach, emphasizing decision-making autonomy, resource access, and negotiation skills. By examining these distinct dimensions, the study provides a more comprehensive understanding of how empowerment influences modern contraceptive use among women in Tanzania, offering insights for targeted reproductive health strategies. Methods: This cross-sectional study analyzed data from the 2022 Tanzania Demographic and Health Survey (TDHS), which focuses on 8236 currently married, non-pregnant women aged 15–49 years. The empowerment indicators included participation in household decision-making, attitudes toward intimate partner violence, negotiation of sexual relationships, property ownership, and social independence. Descriptive and bivariate analyses were conducted, followed by multivariate logistic regression to assess associations. The analyses incorporated complex survey design adjustments for national representativeness. Results: Modern contraceptive use was reported by 34.9% of women. The significant factors associated with greater contraceptive use included education, household wealth, employment, media exposure to family planning messages, and empowerment indicators. Women participating in all three household decision-making domains (AOR 1.64, 95% CI 1.36–1.98), negotiating sexual relationships (AOR 1.41, 95% CI 1.19–1.67), and owning both a house and land (AOR 1.47, 95% CI 1.27–1.70) presented significantly higher odds of modern contraceptive use. Conclusions: Women’s empowerment significantly influences modern contraceptive use. Enhancing women’s autonomy, decision-making power, and socioeconomic opportunities should be prioritized in family planning initiatives. Addressing structural and social barriers that limit women’s agency will help ensure informed reproductive health choices, ultimately promoting gender equity and sustainable development. © The Author(s) 2025.