A systematic review examines factors influencing the continuity of contraceptive use and the optimization of the family environment by integrating analyses at the individual, community, and sociocultural levels within Bronfenbrenner's Ecological Systems framework

Abstract

Abstract Background Family planning is crucial for family well-being, human resources, and sustainable development, encompassing family planning, contraceptive use, and social support for continued use. However, there are still gaps in the sustainability of contraceptive use due to dropout rates, due to suboptimal performance of one environment family functions, resulting in suboptimal family planning. Therefore, a comprehensive understanding of the factors, especially family social support, is needed to maintain its sustainability. Materials and Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic search in ScienceDirect, Scopus, ProQuest, PubMed, and Web of Science databases from January to March 2026. The study design applied inclusive criteria covering individual-level, community-level, and sociocultural-level factors. This review used open-access articles, published between 2018 and 2025, using a combination of keywords: Family planning factors, Contraceptive use factors, Family support factors, Sociocultural factors in family planning, Individual influence on the continuation of contraceptive use, and Factors influencing contraceptive dropout. Results Data from 30 selected studies identified important determinants, ranging from the individual to the community, that influence the continued use of contraception. The main factors that can drive this are individual/microsystem factors, including the number of children, education, age, knowledge, and attitudes. At the community-level level, factors such as husband and family support play a significant role. Sociocultural-level determinants include marital dynamics and gender norms, so culturally sensitive strategies are needed. Conclusion Improving family well-being begins with good family planning, which can be regulated through sustainable contraceptive use. This requires education, improved service quality to prevent dropout, peer influence, and active support from partners. Collaborative programs among various stakeholders must be aligned to bridge gaps between individual motivations, family support, and the family and social environment, and to ensure the quality of contraceptive services meets established standards, thereby reducing the dropout rate. Therefore, sustainable contraceptive use requires strategies that focus not only on service provision but also on community-based behavior change. Evaluation, monitoring, and intervention are important steps toward improving family well-being and quality.