Modern contraceptive uptake in Ugandan border district stays below national average

Modern contraceptive prevalence among women aged 15 to 49 years in Kisoro District, a mountainous cross-border district in south-western Uganda, stands at 27.3 percent, according to a community-based cross-sectional study published in Contraception and Reproductive Medicine. That figure sits well below Uganda’s national average of 38 percent, and the study identifies knowledge, religious affiliation, education and occupation as the factors most strongly shaping uptake, rather than distance to health facilities or household wealth.

Age emerged as a significant factor in the multivariable analysis. Women aged 34 to 41 years had more than twice the odds of modern contraceptive uptake compared with women aged 18 to 25 years (adjusted odds ratio 2.08, 95 percent confidence interval 1.24 to 3.50, p = 0.006), and women aged 42 to 49 years also showed significantly higher odds (adjusted odds ratio 2.02, 95 percent confidence interval 1.07 to 3.80, p = 0.030). The authors note that these are cross-sectional associations, so the study cannot establish why older women in the district use modern contraception more often.

Religious affiliation was also linked to uptake. Muslim women had substantially lower odds of using modern contraception than Anglican women (adjusted odds ratio 0.14, 95 percent confidence interval 0.04 to 0.51, p = 0.003). Education mattered as well: women with primary or no formal education had lower odds of uptake than women with certificate-level education (adjusted odds ratio 0.61, 95 percent confidence interval 0.40 to 0.93, p = 0.021). Occupation showed one of the strongest associations in the analysis, with women in occupations other than peasant farming, entrepreneurship or professional work having markedly lower odds than entrepreneurs (adjusted odds ratio 0.12, 95 percent confidence interval 0.06 to 0.24, p = 0.001).

Two knowledge-related variables moved in the opposite direction. Higher health literacy was associated with higher odds of uptake (adjusted odds ratio 1.38, 95 percent confidence interval 1.02 to 1.86, p = 0.039), and better access to information was similarly linked to greater uptake (adjusted odds ratio 1.44, 95 percent confidence interval 1.04 to 1.99, p = 0.028). By contrast, distance to health facilities and household economic status were not significant predictors in the adjusted models, a finding the authors highlight in their conclusion as evidence that uptake in the district is shaped more by knowledge, religious affiliation, education and occupation than by distance or wealth.

The qualitative strand of the study added context to these statistical patterns. Participants in the focus groups and key informant interviews identified fear of side effects, male opposition and cultural norms as barriers to modern contraceptive use. At the same time, community radio and peer support were described as facilitators that helped women learn about and access contraceptive services.

In their conclusion, the researchers state that modern contraceptive uptake in Kisoro District remains substantially below the national average and call for faith-sensitive, information-focused and occupationally targeted interventions to close the gap. Because the study was conducted in a single district using a cross-sectional design, the findings describe associations within that population at one point in time rather than causal effects or trends elsewhere in Uganda.

The study was published as an open-access research article on 3 October 2026, and the version shared at publication is subject to further editorial edits before the final version of record appears.

For a district where roughly one in four women of reproductive age uses a modern contraceptive method, the study’s central message is that the barriers are concentrated in information, beliefs and social position rather than in physical access or income. The authors conclude that faith-sensitive, information-focused and occupationally targeted interventions are needed to close the gap between uptake in Kisoro District and the national average.

Subject of Research: Factors associated with modern contraceptive uptake among women aged 15 to 49 years in Kisoro District, south-western Uganda

Article Title: Closing the contraceptive gap: factors associated with modern contraceptive uptake among women aged 15–49 years in a cross-border district of south-western Uganda

Article References: Emmanuel, B., & Kibonire, R. A. (2026). Closing the contraceptive gap: factors associated with modern contraceptive uptake among women aged 15–49 years in a cross-border district of south-western Uganda. Contraception and Reproductive Medicine. https://doi.org/10.1186/s40834-026-00484-6

Image Credits: AI Generated

DOI: 10.1186/s40834-026-00484-6

Keywords: contraception, Uganda, Kisoro District, reproductive health, cross-sectional study, health literacy, women's health, family planning, public health, Africa, Closing, contraceptive