| Sumario: | Background: Modern contraceptives are effective in preventing unintended pregnancies, which may consequently reduce the risk of unsafe abortions. However, their use among adolescent girls and young women (AGYW) in Tanzania remains low. Despite various national strategies, the fertility rate in the Mara region remains high at 6.1. Objectives: The first objective of this study was to determine the prevalence of modern contraceptive use among postpartum AGYW in rural Mara, Tanzania. The second objective was to identify factors influencing modern contraceptive use among postpartum AGYW. Design: An analytical cross-sectional study was conducted to assess modern contraceptive use among postpartum AGYW in rural Mara, Tanzania. Methods: A random multistage sampling technique was used to select 614 AGYW aged 15–24 years from rural Mara. Data were collected from January 5 to February 27, 2024, using a structured Swahili questionnaire. Analysis was performed using SPSS version 27.0, employing descriptive statistics, bivariate analysis to examine associations between categorical variables, and multivariate logistic regression to identify predictors of contraceptive use (p < 0.05). Results: Modern contraceptive use was reported by 21.7% (95% CI: 18.5%–25.0%) of postpartum AGYW. Women who had primary education were 4.83 times more likely to use contraceptives than those with no or incomplete primary education (AOR = 4.83, 95% CI: 2.61–8.91, p = 0.001). Women in the middle and highest wealth categories had significantly higher odds of contraceptive use (AOR = 1.83; 95% CI: 1.72–4.72; p = 0.04), representing an 83% increase compared to those in the lowest wealth category. In contrast, participants with two to three children were 60% less likely to use contraceptives compared to those with one child (AOR = 0.40; 95% CI: 0.22–0.72; p = 0.002). Conclusion: Modern contraceptive use among AGYW remains low. Education level, wealth status, and number of children significantly influence uptake, highlighting the need for targeted interventions to improve access and informed choice. Plain language summary: Many adolescent girls and young women in Tanzania become pregnant soon after giving birth, partly because they are not using modern contraceptives. These contraceptives can help prevent unplanned pregnancies and reduce the chances of unsafe abortions. In the Mara region, where many young women live in rural areas, families are still very large, with an average of six children per woman. This study looked at how many young mothers use modern contraceptives after giving birth and what factors influence their decisions. We surveyed 614 girls and young women aged 15â€"24 years from rural communities in Mara between January and February 2024. We found that only about 1 in 5 (21.7%) young mothers were using a modern contraceptive method. Young women who had completed primary school were much more likely to use contraception than those with little or no education. Women from families with higher economic status were also more likely to use contraceptives than those from poorer households. On the other hand, those who already had two or more children were less likely to use any contraceptive method. Overall, the study shows that contraceptive use is still low among young mothers in rural Mara. Improving education, reducing economic barriers, and supporting young mothers to make informed choices could help increase the use of family planning services and improve their health and well-being.
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