One of the Sustainable Development Goals (SDGs) to be accomplished by 2030 is the empowerment of women in decision-making (1). A fundamental human right is a freedom of choice for women regarding the number, spacing, and timing of their pregnancies which is also regarded as the cornerstone of women's rights to reproductive health and contributes to their quality of life (2, 3).
Globally unintended pregnancies have been increasing and remained a public health concern. Unwanted pregnancies are associated with serious consequences such as death, physical and mental complications as well as social and economic problems for a woman, families and communities thus effective use of family planning prevents unwanted pregnancies (5, 6) Globally, approximately 1.1 billion women of reproductive age (15–49 years) have a need for family planning, of these 270 million have an unmet need for contraceptives (7). In sub-Saharan Africa (SSA) about 25% of women reported to have unmet need for modern contraceptive (8). Unmet need for family planning among married women of reproductive age in Tanzania is approximately 22% and contraceptive use amongst married women is 38% (6) Simiyu region is amongst the region with low prevalence rate of family planning use, only 17% of women of reproductive age used contraceptive (6).
Effort to improve women access to maternal and child health care together with reproductive health services have been implemented in the country. Despite the effort, the rate of modern contraceptive uses in the country is 32% in 2016 and very low in Simiyu region 17% (6). Studies show that, family planning decreases pregnancy-related risks that can be caused by a lack of birth spacing (9). Infant mortality is reported to be 40% higher when birth spacing is less than two years compared to when the birth spacing are two to three years apart (10). In addition, a short inter-pregnancy interval is reported to increase the risk of pre-pregnancy obesity, gestational diabetes and postpartum hemorrhage, and to women with a previous cesarean delivery increase the risk of uterine rupture (11, 12). Beside, family planning is important in economic growth since it offers benefits like extended education and empowerment of women and control overpopulation growth (7).
Women decision making power has been reported to influence family planning use (13). However, the percentage of women with decision-making power varies across societies due to difference in social cultural norms and beliefs (24, 25). Among other factors includes women’s age, young women aged below 20 are less likely to participate in decision making towards contraceptive. However, other studies shows that older women aged above 35years have less odds of decision making. Furthermore, occupation, level of education, religion, believes towards contraceptive methods, husbands use force for sex and prior experience on contraceptive influence decision making (14–18). Evidence shows that, 92.2% of women in India whether jointly with their partners or by themselves have the power in decision making towards contraceptive use (19). In Africa, a range from 67.4–70% of women who jointly with their partner make decisions toward contraceptive use (15, 16). Moreover, Studies have shown that, effective communication between partners can increase family planning uptake and continuation (20–22). However, little is known about the factors that influence women’s decision-making power on use of contraceptives in the country. Therefore, this study aimed at assessing women’s decision-making power towards contraceptive use and its associated factors in Simiyu region.