Across Ethiopia’s cities, more young married women are choosing to use modern contraceptive methods, a sign of growing awareness and empowerment. Yet, new research shows, what drives these choices goes far beyond access to clinics or supplies.
A study, led by the Johns Hopkins Center for Communication Programs and published in BMC Public Health reveals that radio exposure, knowledge about contraceptives, and family size are among the strongest factors influencing whether young urban women use modern family planning methods. The research analyzed data from 680 married women aged 18 to 29 in 13 Ethiopian cities.
Overall, 59 percent of the women reported using a modern contraceptive method such as injectables, implants, or pills. But the differences between cities were striking. While 81 percent of women in Hawassa in southern Ethiopia reported modern contraceptive use only 10 percent of young married women in Jigjiga in eastern Ethiopia said they were using one.
“These wide gaps show that urban areas cannot be treated as one uniform category,” said CCP’s Ethiopia Country Representative Simon Heliso Kuka. “Each city has its own social, cultural and communication dynamics that influence contraceptive behavior.”
Among all the factors studied, Biruk Ayalew, CCP’s director of design and implementation in Ethiopia said, one stood out: radio.
Women who listened to the radio messages at least once a week were about 60 percentage points more likely to use a modern contraceptive method than those who did not. The finding is a reminder that, even in an age of smartphones and social media, radio remains one of Ethiopia’s most influential communication tools, particularly for reaching young married women.
Health communication experts say that’s because radio combines accessibility, language familiarity and trust. It reaches people in their homes, in their preferred languages and often through programs designed to entertain while educating.
For decades, radio dramas and talk shows in Ethiopia have helped dispel myths about family planning and encouraged open conversation about reproductive health. The new findings reaffirm that such communication strategies still matter – and work.
“Information delivered in the right way can transform lives,” Ayalew said. “When people hear voices they trust – on the radio, in their communities, or at the clinic – they’re more likely to take action that improves their health.”
The study also highlights the power of knowledge in shaping women’s decisions.
Women who could name at least two modern contraceptive methods were more than twice as likely to use one. This suggests that awareness is more than information. It’s agency. When women understand their options, they’re better equipped to make informed decisions about their health and futures.
In a country where discussions about reproductive health can still be sensitive, this finding underscores the importance of communication that is clear, factual and culturally appropriate. Education campaigns, peer discussions and health worker engagement all contribute to building this foundation of understanding.
Interestingly, the researchers also found that women with at least one child were more than three times more likely to use modern contraceptives. Larger family size may create stronger motivation to space or limit births, reflecting both economic considerations and growing awareness of maternal and child health benefits.
This aligns with broader evidence that family planning is not only a health issue but also an economic and social one for the role it plays helping families plan for stability and opportunity.
Despite the overall progress, the variation between cities remains a challenge. Differences in media access, cultural norms and service delivery all shape how women think about and use contraceptives.
The study’s authors suggest that family planning programs need to adapt. In some regions, this might mean investing more in local-language radio campaigns; in others, strengthening counseling and outreach for young couples.
As Ethiopia continues to urbanize, such insights are crucial.
“These findings point to an opportunity, not only to increase contraceptive use,” Kuka says, “but to ensure that every woman, regardless of where she lives, has the information and support she needs to make her own choices.”
The research was conducted under the now-shuttered USAID-funded Integrated Youth Activities (IYA) project led by Amref Health Africa to help empower young people in Ethiopia with the knowledge and skills they need to live successful lives.
“Modern contraceptive methods use behaviour among young married women in Urban Ethiopia: a multilevel mixed-effects binary logistic regression analysis,” was written by Tsion Habtu Tebeje, Habtamu Tamene Temesgen, Yihunie Lakew, Tigist Urgessa Wakene, Biruk Melaku Ayalew, Tsega Berhanu Zerihun, Betemariam Alemu Tiruneh, Simon Heliso Kuka, Chalachew Tiruneh Alemu, Wasihun Andualem Gobeze, Dereje Haddis Engida, Israel Lemma Hailu and Yimer Seid Adem.
