Contraception aims to control child bearing, timing, and spacing. It has been shown to have good maternal and infant health outcome. This effects the achievement of the third Sustainable Developments Goals (SDGs) by reducing child mortality, improving maternal health and universal access to reproductive health. Globally more than 95% of women of reproductive age, (15-49) years are aware of reproductive health services and products; however, unmet need is experienced by 42% of women of reproductive age in developing countries. In Kenya contraception is at 58 %, with a fertility rate of 3.7, unsafe abortions reported by 48/1000 women, all these contributing to pregnancy associated maternal and child morbidities and mortalities. This study sought to identify the contraceptive preferences, demographic and sociological factors that determine contraception practice in the HDSS area, with contraceptive use as the dependent variable. This cross-sectional public health survey, analyzed the reproductive health status of women in the HDSS. Descriptive statistics was used to determine the proportions of women in various categories of explanatory variables. Logistic Regression assessed for possible association between the covariates and contraception. Among the 39,006 participants enrolled, 22,298 (57.17%) reported having ever used contraceptive methods. Hormonal methods were preferred by 14,407 (36.94%) and 21,854 (53.03%) participants from the short term and long term categories respectively, whereas, 7,888 (20.22%) and 382 (0.99%) participants preferred the non- hormonal methods from the short term and long-term categories respectively. Participants aged 15-24 years were 8,428, (21.61%) of the 39,006 participants, where 4,572, (54.24%) of them were not practicing contraception. 69.75% of the participants reported being married, 71.30% had no stable occupation. Ever use of contraception was reported by 75.57 % of those who accessed family planning services information through multi-media sources. Contraception was significantly associated with age, parity and access to information at P<0.001. The odds of contraception in married women at 45 years and above was at (OR 0.85,95% CI 0.77 to 0.94) compared to the single women of the same age (OR 1.13,95% CI 0.99 to 1.30). Unmet needs were observed in 16,708 42.83% of the population, where 4,572 54.24% were youths aged 15-24 years. There is evidence of unmet needs in the adolescents and young adults. Implementation of strategic public health integrated policies that focus on the demographical and sociological status will support and promote subsidized access to reproductive health services.