Unmet need for modern contraceptives and its associated factors among postpartum adolescent girls and young women in rural Mara, Tanzania: A facility-based cross-sectional study

BACKGROUND: Modern contraceptives are proven to prevent unintended pregnancies and reduce unsafe abortions; however, their utilization among adolescent girls and young women (AGYW) in sub-Saharan Africa, including Tanzania, remains low. Despite ongoing interventions, the Mara Region continues to experience a high fertility rate. This study assessed the unmet need for modern contraceptives and its associated factors among postpartum AGYW in rural Mara, Tanzania. METHODOLOGY: A facility-based cross-sectional study was conducted among 614 AGYW aged 15-24 in rural Mara, Tanzania, selected through systematic random sampling. Data were collected in January-February 2024 using a structured Swahili questionnaire via Kobo Toolbox. SPSS v27 was used for analysis, including descriptive statistics, bivariate tests, and multivariable logistic regression, with significance set at p ≤ 0.05. RESULTS: Among AGYW surveyed, 21.7% were using modern contraceptives, while 37.3% had an unmet need for family planning. Unmet need was significantly higher among adolescents aged 15-18 years compared to those aged 19-24 (AOR = 1.70, 95% CI: 1.15-2.51, p = 0.008), those whose partners had no or incomplete primary education compared to those with secondary education or above (AOR = 1.66, 95% CI: 1.95-2.92, p = 0.02), and participants in the lowest wealth quintile compared to those in higher quintiles (AOR = 1.70, 95% CI: 1.11-2.60, p = 0.01). CONCLUSION: Unmet need for family planning remains high among AGYW, especially younger adolescents and those from disadvantaged backgrounds. Targeted efforts are essential to improve access to contraceptive services for these groups.