Modern contraceptive use among young women in Kampala slums : research findings from the TOPOWA study

Abstract

Unintended pregnancies among adolescent and young women in low- and middle-income countries pose major public health challenges, underscoring the need for improved access to modern contraceptives. This study examined prevalence, preferences, and correlates of modern contraceptive use among young women living in urban slums of Kampala, Uganda, to inform targeted interventions. We analyzed baseline data from The Onward Project on Wellbeing and Adversity (TOPOWA), an NIH-funded, multi-component prospective cohort study on mental health among women aged 18–24 years. In 2023, 300 participants were recruited from three sites (Banda, Bwaise, Makindye). Interviewer-administered surveys assessed contraceptive choices, lifestyle, and demographic factors. Modified Poisson regression was used to examine correlates of contraceptive use. Among participants, 66.0% had ever used contraception, 40.0% were current users, and 38.0% reported modern contraceptive use. Multivariable analyses showed that having a consistent partner (PR = 3.28; 95% CI: 1.90–5.67), engaging in sex work (PR = 2.10; 95% CI: 1.46–3.02), older age (PR = 1.08; 95% CI: 1.01–1.16), and having children (PR = 1.72; 95% CI: 1.12–2.66) were associated with higher modern contraceptive use. Findings highlight important gaps in sustained contraceptive use and the need for tailored interventions addressing economic, social, and educational barriers to improve reproductive health in this low-resource setting.