Contraceptive utilization and associated factors among reproductive-age women attending psychiatric outpatients' services in sub-Saharan Africa

Abstract Background Family planning is essential for women of reproductive age and is particularly critical for women with mental illness, who are at increased risk of unintended pregnancy, sexual violence, and adverse maternal and neonatal outcomes. Despite this, contraceptive utilization among women with psychiatric disorders remains suboptimal, especially in low- and middle-income countries such as Ethiopia, where unmet need for family planning is high. Methods A systematic search of published studies was conducted using relevant electronic databases. Studies reporting contraceptive utilization and associated factors among women with psychiatric disorders were included. Data were extracted, and pooled estimates were calculated using appropriate meta-analytic techniques. Heterogeneity and publication bias were assessed using standard statistical methods. Results The finding of this meta-analysis showed that the pooled prevalence of contraceptive utilization among reproductive age women with psychiatric outpatients is 47.63% (95% CI: 30.31–64.95, I 2 = 98.9%). Intention to have children in the future (OR = 4.46, 95% CI:0.65–8.26), Marital status (OR: 9.04, 95% CI: 2.93–21.00), educational status (OR: 5.01, 95% CI: 3.20–6.82), counseled by a physician (OR: 1.70, 95% CI: 0.95–2.46). Fear of drug side effects (OR = 1.79, 95% CI: 0.91–2.65) and knowledge (OR = 3.95, 95% CI: 1.05–6.84) were identified as factors associated with contraceptive utilization among reproductive-age women. Conclusion Family planning utilization among women with psychiatric outpatients remains inadequate despite their high reproductive health risks. Improving access to integrated mental health and reproductive health services, strengthening counseling, and enhancing awareness are essential to improve contraceptive uptake in this population. Policymakers and healthcare providers should prioritize tailored interventions that address both psychiatric and reproductive health needs.