Determinant factors in the use of modern contraception in urban and rural areas in Western Indonesia

Background: Family planning remains essential to ensure women’s autonomy, health, and maternal health outcomes and safeguard population expansion. Knowledge is needed to understand how modern contraceptives are used in both urban and rural areas in Indonesia. The objective of this study was to analyze the utilisation of modern contraceptives between rural and urban areas in Western Indonesia as well as associated factors. Methods: A cross-sectional study using secondary data from the nationally representative 2017 Indonesian Demographic and Health Survey (IDHS). Bivariate and multiple logistic regression were conducted to analyse the data. Results: Twelve thousand eight hundred thirty-one married women aged 15 to 49 became the sample of this study, with 6,955 (54.2%) residing in urban areas and 5,876 (45.8%) in rural areas, utilising current contraceptive methods. The research revealed that from the users-only data, 86.3% of married women in urban areas and 92.2% in rural areas used modern contraception. Rural married women aged 20–44 exhibited greater odds of utilising modern contraception compared to their urban counterparts. Married women aged 15–24 in rural areas had 4.0 times higher odds of using modern contraception than their urban counterparts. Married women with no education had higher odds of using modern contraceptives in both urban (4.8 times) and rural areas (3.9 times). In urban areas, those with 1–3 children had 5.9 times higher odds compared to women with ≥ 7 children, while in rural areas, women with no children had 5.0 times higher odds. Urban women in the second wealth index had 1.2 times higher odds compared to those in the lowest, and in rural areas, women in the highest wealth index had 1.9 times higher odds. Conclusion: Modern contraceptive use is similar in urban and rural areas of Western Indonesia, with sociodemographic factors significantly influencing use. Key differences include the impact of education, number of children, and wealth index, with lower use among women with secondary education and those in the lowest wealth group. Family planning efforts should target education gaps, promote early family planning, and expand access to services for low-income women, while also strengthening outreach to wealthier urban women.