Demand for and use of modern contraception among young women aged 15-24 years in Malawi: evidence from the Malawi demographic health survey, 2015-2016.

Introduction: This study examined the determinants of the demand for and use of modern contraception among young women aged 15-24 years in Malawi, focusing on the met demand for family planning with modern methods (mDFPS). Previous studies in Malawi have primarily assessed contraceptive prevalence or intentions to use, while limited attention has been given to mDFPS, a key indicator of reproductive autonomy. Data and methods: The analysis used data from the 2015-16 Malawi Demographic and Health Survey (MDHS). After excluding cases with missing values, the final analytical sample comprised 7,643 young women aged 15-24 who had a demand for family planning. Weighted descriptive, bivariate, and probit regression analyses were conducted to identify factors associated with modern contraceptive use, demand for contraception, and mDFPS. Results: Bivariate analysis showed significant associations between mDFPS and age, education, marital status, parity, employment, and exposure to health workers (p < 0.001). Multivariate probit regression indicated that higher education, employment, and later sexual debut increased the probability of mDFPS by 11%, 3%, and 7%, respectively, while being married reduced it by 14% (p < 0.01). Parity remained the strongest predictor, with women having one or more children being 44%-55% more likely to have mDFPS. Factors such as wealth, residence, and information exposure were not significant after adjustment. Conclusion: By focusing on mDFPS rather than overall contraceptive prevalence, this study advances understanding of reproductive autonomy among young Malawian women. The findings suggest that educational attainment, empowerment, and gender-sensitive service delivery are more decisive than economic access alone. Efforts to improve mDFPS should therefore address social norms, marital dynamics, and health system barriers to youth-friendly contraceptive services.