Inequities in contraceptive use among adults in Lebanon: a national study

Background: The use of contraception is a key component of sexual and reproductive health, yet Lebanon still faces barriers that hinder the effective and equitable use of contraceptives and related reproductive health services. We aimed to determine the prevalence of contraceptive use, unmet need for family planning, demand for family planning satisfied with modern methods, and determinants of contraceptive use and modern contraceptive use among adults in Lebanon. Methods: We performed a national cross-sectional telephone survey study among adult men and women of reproductive age in Lebanon from January 2024 to July 2024. Determinants included demographic-, socioeconomic-, and health-related variables. Primary outcomes were the utilisation of any contraception method, long-acting reversible contraception methods, modern methods, and natural methods. We fitted adjusted survey-weighted logistic regression models, stratified by sex, for each determinant/outcome pair, and reported odds ratios and 95% confidence intervals as analytical outcomes. Results: We included 3146 sexually active adults of reproductive age (mean age of 38.2 years, 43.4% female, 35.8% non-Lebanese, and 14.3% with pregnancy intentions). The prevalence of contraceptive use was 58.0%, with 31.3% of respondents using modern methods, 10.3% using long-acting reversible contraceptives, and 26.7% using natural methods. In terms of sex differences, 32.7% of women and 36.4% of men had unmet need for family planning, while 37.5% and 33.9% had their demand satisfied with modern methods, respectively. Age, nationality, marital status, employment status, self-rated physical health, depression, and food insecurity were associated with contraceptive use. Conclusions: Our results offer updated national estimates of the prevalence of contraceptive use among adults in Lebanon and point to inequities in contraceptive use. There is a need to strengthen sexual and reproductive health policies, and to implement national interventions that promote the use of modern contraceptive methods for everyone in need, irrespective of age, sex, nationality, marital, or socioeconomic status.