Published in PLOS One on 2026-05-05, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Didier Mbombo Ndombe, Ester Lucia Rizzi, Vandana Dabla, Adewale Ashimi
Source: PLOS One • DOI 10.1371/journal.pone.0331236
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Intimate partner violence (IPV) has harmful effects on women’s physical, mental, and reproductive health. This study investigates the relationship between experiencing IPV and unmet need for family planning in two provinces of the Democratic Republic of the Congo (DRC), emphasizing the potential mediating effect of reproductive coercion. To our knowledge, this is the first examination of the connection between IPV and unmet need for family planning in the DRC, particularly regarding the underlying mechanisms of this association.
This research utilized secondary data from the third wave of the Performance Monitoring for Action (PMA) surveys carried out in two provinces of the DRC during the period from 2021 to 2022. The analysis focused on a sample comprising 1,387 women in unions aged between 15 and 49 years. To investigate the relationship between IPV and unmet need for family planning, linear probability models were employed and various factors were controlled. Additionally, we explored the moderating influence of reproductive coercion in this context.
The linear probability model indicated that experiencing sexual IPV within the past 12 months was linked to an unmet need for family planning [aCoef = 0.12, CI95% = 0.04–0.21]. When sexual IPV occurred alongside reproductive coercion, a stronger correlation with unmet need was detected [aCoef = 0.24, CI95% = 0.03–0.44].
We showed that sexual IPV is associated with an unmet need for family planning in the DRC. While IPV should be considered a policy target, these results emphasize the importance of responding appropriately to IPV when sexual and reproductive health services are provided to women. This was the first study on the DRC and, more generally, on sub-Saharan Africa (SSA) to illuminate the underlying mechanisms of the association, revealing the moderating role of reproductive coercion.
Introduction
The term “unmet need for family planning” refers to the absence of contraceptive use among sexually active women of reproductive age who express a desire either to avoid having additional children or to postpone the arrival of their next child for a minimum period of two years [1]. Worldwide, 257 million women of reproductive age still have an unmet need for modern contraception [2], and three quarters live in low- and middle-income countries (LMICs) [3]. In sub-Saharan Africa (SSA), which is characterized by low contraceptive usage rates [4], the estimated prevalence rate of unmet need for family planning is 23.7%. This study includes 15.8% of women seeking to space their births and 7.9% aiming to limit the number of births [5].
Unmet reproductive health needs are linked to increased fertility rates, preterm birth, fetal mortality, low birth weight, neonatal death, and unintended pregnancies [3]. In LMICs, the annual occurrence of unintended pregnancies is projected to be approximately 74 million; this situation can result in approximately 25 million abortions conducted under unsafe conditions [6], thereby heightening the risk of maternal mortality. In regions such as Latin America and Africa, it is estimated that 75% of abortions are performed unsafely [7].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Didier Mbombo Ndombe, Ester Lucia Rizzi, Vandana Dabla, Adewale Ashimi. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Prevalence and associated factors of intimate partner violence against reproductive-age women in Africa and Asia regions: Insights from 2022–2024 DHS datasets
- Evidence brief: Antenatal intimate partner violence and breastfeeding practices: Evidence from a national longitudinal study in Ethiopia
- Evidence brief: Assessing the relationship between male alcohol consumption and intimate partner violence against women in Sub-Saharan Africa: A dual-dataset secondary analysis of recent DHS surveys
