Social and socioeconomic determinants of health and contraceptive decision-making among women: a cross-sectional study from southeastern Iran.

BACKGROUND: Women's ability to choose contraceptive methods and shape their reproductive behaviors can significantly improve their reproductive health. However, various factors influence these patterns. This study aimed to examine the socioeconomic determinants affecting contraceptive method choice among women in Zahedan. METHODS: This study included 3,140 women from the Zahedan Cohort Study (October 2015-January 2019). Demographic, fertility, anthropometric, and disease data were collected using a validated questionnaire. Analyses were performed using SPSS version 26. Chi-square tests assessed associations between categorical variables, and variables with p < 0.20 or clinically relevant were entered into a multivariable logistic regression model (effective vs. less-effective contraceptive methods). Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported; p < 0.05 was considered statistically significant. RESULTS: Use of less effective contraception was significantly associated with several factors: it decreased with age (OR = 0.60, p = 0.002) and higher education levels (OR = 1.60, p = 0.001). Underweight individuals were more likely to use less effective methods compared to obese individuals (OR = 1.75, p = 0.007). Higher rates of less effective contraception use were also observed among the very poor (OR = 1.36, p = 0.002) and poor (OR = 1.28, p = 0.01), while women with gestational hypertension (OR = 0.74, p = 0.02) or diabetes (OR = 0.62, p = 0.001) were less likely to use these methods. CONCLUSION: The results of this study indicate that contraceptive method choice is influenced by various factors, including age, body mass index, economic status, and pregnancy complications. These findings underscore the importance of targeted educational interventions and socioeconomic support to encourage the use of safer contraceptive methods among women.