Background: Reproductive health is a critical component of overall health and development. Unmet contraceptive needs are one of the regularly cited measures of the efficacy of family planning (FP) initiatives. This study set out to determine the magnitude and associated factors of unmet need for FP among women of reproductive-aged (15-49 years) in the provincial areas of The Gambia. Methods: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 643 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level of p<0.05. Binary logistic regression analysis was performed to examine the effect of sociodemographic and cultural determinants on unmet FP need, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 24 was used for data entry and analysis. Results: The unmet need for FP among the study participants was 25.2%; unmet need for spacing and unmet need for limiting was 17.4% and 7.8%, respectively. The total demand for FP was 59.4%, while the satisfaction of demand for FP was 57.6%. The significant predictors of unmet need for FP were woman’s age at first pregnancy (aOR=0.899, p=0.033), LGA of origin (aOR=0.240, p=0.001) and frequency of using contraceptives (aOR=1.587, p=0.032). Conclusion: The present study demonstrated a high unmet need for FP among rural women in The Gambia, with the most often cited reason for non-use being fear of side effects. Hence, it is necessary to concentrate FP services for rural populations, stressing education regarding contraceptive side effects, service quality, and gender equality. Additionally, the study suggests that male participation and religious leaders' involvement in FP programs be strengthened and mainstreamed, as well as the establishment of a communication program that specifically promotes inter-spousal communication.

Background: Family planning is one of the key cornerstones of safe parenthood and a reproductive rights issue. In underdeveloped nations, women experiencing unmet FP needs formed a considerable proportion of all women of reproductive age and are ongoing public health concerns in The Gambia. The study was set out to explore the influence of socio-demographic and cultural factors on contraceptive uptake among rural women in The Gambia. Methods: The study used a community-based cross-sectional analytical design. A multistage sampling strategy, comprising simple random and cluster sampling, was utilized to obtain a sample of 634 childbearing women (15-49 years) from rural Gambia's sampled clusters. Data collection was conducted using pre-tested structured interview questionnaires. The association was examined using chi-square/fisher's exact test with a significance level set at p<0.05. Binary logistic regression analysis was performed to examine the effect of socio-demographic and cultural determinants on uptake of contraceptives, with corresponding computed adjusted odds ratios (aOR). IBM SPSS version 25 was used for data entry and analysis. Results: The uptake of contraceptives among the study participants was 30.4%. The total demand for FP was 59.4% while the satisfaction of demand for FP was 57.6%. The significant predictors of FP uptake were the age of women (aOR=1.097, p=0.014), reason for using FP (aOR=1.139, p=0.011), use of contraceptives before (aOR=24.416, p<0.001) and reason for not discussing FP with a partner (aOR=1.787, p=0.029). Conclusion: The study showed low contraceptive uptake among women in rural communities. Thus, spousal communications on FP concerns are key intermediate steps towards eventual acceptance and sustained usage of FP services. The program should focus on improving access to and availability of FP services in rural areas. The program should prioritize addressing women's needs through consistent community-based interventions including targeted home visits.