Peter Gichangi 1 2 3, Michael Waithaka 3, Mary Thiongo 3, Alfred Agwanda 4, Scott Radloff 5, Amy Tsui 5, Linea Zimmerman 5, Marleen Temmerman 3 6
Affiliations
- 1Technical University of Mombasa, Mombasa, Kenya.
- 2Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
- 3International Centre for Reproductive Health, Mombasa, Kenya.
- 4Population Services Research Institute (PSRI), University of Nairobi, Nairobi, Kenya.
- 5Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg school of public Health, Baltimore, Maryland, United States of America.
- 6Aga Khan University, Kenya, Nairobi, Kenya.
PMID: 33836006 PMCID: PMC8034745 DOI: 10.1371/journal.pone.0248393
Abstract
Background: Demand for family planning met/satisfied with modern contraceptive methods (mDFPS) has been proposed to track progress in Family Planning (FP) programs for Sustainable Development Goals. This study measured mDFPS among married women of reproductive age (MWRA) in Kenya to identify which groups were not being reached by FP programs.
Materials and methods: Performance, Monitoring and Accountability 2020 (PMA2020) survey data from 2014-2018 was used. PMA2020 surveys are cross-sectional including women 15-49 years. PMA2020 used a 2-stage cluster design with urban/rural regions as strata with random selection of households. Univariate and multivariate analysis was done using stata V15.
Results: Of the 34,832 respondents interviewed from 2014 to 2018, 60.2% were MWRA. There was a significant decrease in demand for FP from 2014 to 2018, p = 0.012. Lowest demand was among 15-19 and 45-49 years old women. Overall, modern contraceptive prevalence rate increased significantly from 54.6% to 60.8%, p = 0.004, being higher for women from urban areas, home visits by health care worker (HCW), educated, wealthy, visited health facilities and exposed to mass media. Unmet need for FP decreased from 23.0-13.8% over the 5-years, p<0.001. Married adolescent 15-19 had the highest unmet need and those from rural areas, poor, uneducated and not exposed to mass media. mDFPS increased significantly from 69.7-79.4% over the 5-years, p<0.001, with increase in long acting reversible contraception/permanent methods from 19.9-37.2% and decrease in short acting methods from 49.9-42.2%. Significant determinants of mDFPS were age, rural/urban residence, education, wealth, health facility visitation, exposure to FP messages via mass media in the last 12 months, year of study and county of residence.
Conclusions: Results show a good progress in key FP indicators. However, not all MWRA are being reached and should be reached if Kenya is to achieve the desired universal health coverage as well as Sustainable Development Goals. Targeted home visits by HCW as well increase in mass media coverage could be viable interventions.
Conflict of interest statement
The authors have declared that no competing interests exist.
Link
https://pubmed.ncbi.nlm.nih.gov/33836006/
