Decision-making power among women of reproductive age towards family planning use and its associated factors: A cross-sectional study in Simiyu region, Tanzania

Abstract Background: One of the Sustainable Development Goals (SDGs) to be achieved by 2030 is to empower women in decision-making. It is universally agreeable that women's decision-making power influences their use of family planning. However, due to disparities in social and cultural norms and beliefs, the percentage of women with decision-making power varies across societies. Furthermore, unintended pregnancies and unsafe abortions have remained a public health concern, with serious consequences such as death, physical and mental complications, as well as social and economic problems for a woman and her family Objective: To assess women’s decision-making power towards contraceptive use and its associated factors in Simiyu region. Methodology: The study utilizes data from a cross-sectional study conducted by Amref Health Africa among women of reproductive age in the Simiyu region. An interviewer-administered questionnaire was used for data collection. Stata 15 was used for data analysis. Categorical variables were summarized using frequency and percentage. The Chi-square test was used to compare the proportion of women’s decision-making power across independent variables. To identify factors associated with women's decision-making power regarding contraceptive use, a multinomial logistic regression model was used. Results: A total of 917 women were investigated. Of these, 304 (33.1%) reported making their own decision on contraceptive use, 421 (45.9%) made a joint decision with their spouse, and 192 (20.9%) had their decision made by another person. Age, marital status, previous use of contraceptives, husbands using force for sex, and family planning being considered as women's health issues were all associated with women's decision-making power. Conclusion; The findings of this study underscores that one in every five women has no decision on contraceptive use. It is high time for early women empowerment interventions, particularly among young women, to strengthen, promote, and encourage their decision-making on general health issues, particularly contraceptive use. This study calls for a qualitative study to get an in-depth understanding of the socio-cultural issues behind this power dynamic among women.