Factors influencing the use of contraceptive services among adults in the Marrakech-Safi region of Morocco

Abstract

Ensuring access to contraception plays a vital role in enhancing women’s health and advancing progress toward Sustainable Development Goal 3. Although social and cultural norms are recognized as important barriers, quantitative evidence examining the relationship between gender norms and contraceptive service use in Morocco using validated population-level measures remains limited. This study examined whether gender norms influence the use of contraceptive services in the Marrakech-Safi region. A cross-sectional study was conducted among 632 individuals, both men and women, aged 18 and older, residing in the Marrakech-Safi region. Participants were recruited through a convenience sampling, and data were collected using a structured and pre-tested questionnaire, which was administered through both online and face-to-face methods to ensure comprehensive data collection. To identify factors associated with contraceptive use, both bivariable and multivariable binary logistic regression analyses were performed. Associations are presented as odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at p < 0.05. Our findings revealed no significant association between adherence to gender norms, as measured by the Moroccan Arabic gender-equitable men (MA-GEM) scale, and contraceptive use. However, sociodemographic characteristics played a crucial role in determining contraceptive services use. Age and employment status emerged as significant predictors. Individuals under 30 years of age were significantly less likely to use contraceptive services, with an adjusted odds ratio (AOR) of 0.517 (95% CI [0.281–0.950]; P-value = 0.034). Similarly, unemployed participants faced significant barriers, with an AOR of 0.520 (95% CI [0.281–0.962]; P-value = 0.037). Although gender norm adherence showed no significant impact, our study highlights age and employment status as important social determinants of contraceptive services use in the Marrakech Safi region. These findings point to underlying structural and economic barriers that disproportionately affect young and unemployed individuals. Tailored public health strategies, such as youth-responsive contraceptive services and community-based outreach and education, along with inclusive policies are essential to advance equitable access to reproductive health services and improve health outcomes.