Background The attainment of targets set for modern contraceptive use remains a challenge in sub-Saharan Africa. Rwanda, in its new Family Planning and Adolescent Sexual Reproductive Health/Family Planning (FP/ASRH) Strategic Plan 2018–2024 has set the attainment of a contraceptive prevalence rate (CPR) of 60% by 2024. To achieve this, identifying factors that enhance modern contraceptive use among sexually active women is critical. Methods We used three Rwanda Demographic Health Surveys (RDHS) datasets collected in 2010, 2015, and 2019/2020 in a multivariable decomposition analysis technique to describe trends and identify factors influencing change in modern contraceptive use among sexually active women aged 15–49 years. Results presented as coefficients and percentages took into consideration the complex survey design weighted using StataSE 17. Results Modern contraceptive use increased from 40% in 2010 to 52.4% in 2020 among sexually active women. About 23.7% of the overall percentage change in modern contraceptive use was attributable to women’s characteristics which included women’s education levels, number of living children, and being told about family planning at health facilities. Coefficients contributed 76.26% to the change in modern contraceptive use. This change was attributed to modern contraceptive use among young women between the age of 20–24 years, women’s education level, the number of living children, changes in family size, and being visited by community health workers. Conclusion Rwanda remains on course to archive its 2024 family planning targets. However, there is a need to enhance programs that target sexually active adolescents and young adults, and women from rural areas to sustain the gains made. Furthermore, continuous support of community health workers will be key in exceeding the set targets of modern contraceptive use among sexually active women in Rwanda.

Background One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15—49 years had experienced sexual violence from their husband or partner. The prevalence of unintended pregnancies among women age 15—49 years has risen from 33% in 1992 to 38% in 2018. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study. Methods This study used the women's dataset from the 2018 Zambia Demographic and Health Survey, a cross-sectional survey. The study looked at a weighted sample size of 4,465 women age 15 – 49 years. Unintended pregnancy was measured by combining response categories of mistimed and unwanted pregnancy. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy. Results The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; CI 1.38—2.19). Ever use of contraception is also a significant predictor of unintended pregnancy (AOR 1.48; CI 1.16—1.88), even when other characteristics are taken into account. Results have shown that a woman who had ever used contraception and had experienced sexual violence was more likely to have an unintended pregnancy. Conclusion Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize women on reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.

Background: Intimate partner violence against women is acknowledged as a worldwide public health issue. One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15 to 49 had experienced sexual violence from their husband or partner. Since 1992, the prevalence of unintended pregnancies among women age 15 to 49 has risen to 38%. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study.Methods: The women's dataset from the 2018 Zambia Demographic and Health Survey was used in this study. The study looked at a weighted sample size of 5,132 women age 15 to 49. Descriptive, chi-square, bivariate, and multivariate binary logistic regressions were used in the data analysis. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy.Results: The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; 1.38 - 2.19). Contraception use is also a significant predictor of unintended pregnancy (AOR 1.48; 1.16 - 1.88), even when other characteristics are taken into account. Results have shown that if a woman had ever used contraception and had experienced sexual violence, she was more likely to have an unintended pregnancy.Conclusion: Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize on women reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.

Background Intimate partner violence against women is acknowledged as a worldwide public health issue. One of the outcomes of sexual violence is unintended pregnancy. In Zambia, 15% of married women age 15 to 49 had experienced sexual violence from their husband or partner. Since 1992, the prevalence of unintended pregnancies among women age 15 to 49 has risen to 38%. The link between sexual violence and unintended pregnancy in Zambia was investigated in this study. Methods The women's dataset from the 2018 Zambia Demographic and Health Survey was used in this study. The study looked at a weighted sample size of 5,132 women age 15 to 49. Descriptive, chi-square, bivariate, and multivariate binary logistic regressions were used in the data analysis. Multivariate binary logistic regression was performed to establish the net effects of sexual violence and each explanatory variable on unintended pregnancy. Results The findings suggest that sexual violence does have a role in unintended pregnancies (AOR 1.74; 1.38–2.19). Contraception use is also a significant predictor of unintended pregnancy (AOR 1.48; 1.16–1.88), even when other characteristics are taken into account. Results have shown that if a woman had ever used contraception and had experienced sexual violence, she was more likely to have an unintended pregnancy. Conclusion Spousal sexual violence is highly associated with unintended pregnancies in Zambia. Addressing intimate partner sexual violence is among the ways to prevent unintended pregnancies. It is also important to sensitize on women reporting acts of sexual violence to relevant authorities as this will not only prevent reoccurrence of sexual violence but also reduce unintended pregnancies and associated long-term effects.