Association Between Contraceptive Knowledge and Decision-Making Autonomy on the Use of Modern Contraception in Parakou, 2025
Klikpezo R, Edayé BJD, Olowo BI, Obossou AAA, Agonnoude MT, Amouzoun S, Ezinmegnon MBP and Chabi A
ABSTRACT
Introduction : The use of modern contraception remains insufficient in sub-Saharan Africa. This study examines the influence of contraceptive knowledge and women’s decision-making autonomy on modern contraceptive use in Parakou.
Methods : An analytical cross-sectional study was conducted in 2025 among 421 women of reproductive age in Parakou. Contraceptive knowledge and decision-making autonomy were assessed using composite scores. Probit and multivariable logistic regression models, adjusted for age, parity, and exposure to information, were applied. Predictive performance was evaluated using receiver operating characteristic (ROC) curves.
Results : The mean age of participants was 31.8 ± 10.1 years. The contraceptive knowledge score was strongly and independently associated with modern contraceptive use in multivariable logistic regression (β = 0.19; p < 0.001), corresponding to an approximate 21% increase in the odds of use for each additional unit increase in knowledge. Probit regression analysis confirmed a significant dose–response relationship between contraceptive knowledge and the predicted probability of modern contraceptive use. Women’s decision-making autonomy showed a positive association with modern contraceptive use, reaching borderline statistical significance (p ≈ 0.06). The combined logistic model demonstrated moderate discriminative ability, with an area under the ROC curve of 0.657, indicating predictive performance better than chance.
Conclusion : Contraceptive knowledge is the primary determinant of modern contraceptive use in Parakou, while women’s decision-making autonomy remains constrained by social and relational contexts, which limits its independent effect on contraceptive uptake.
