Vernon Mochache 1 2 3, Amyn Lakhani 4, Hajara El-Busaidy 5, Marleen Temmerman 6 7 4, Peter Gichangi 6 7 8
Affiliations
- 1International Centre for Reproductive Health, Mombasa, Kenya. vmochache@yahoo.com.
- 2University of Ghent, Ghent, Belgium. vmochache@yahoo.com.
- 3, P.O. Box 3921, Nakuru, 20100, Kenya. vmochache@yahoo.com.
- 4Faculty of Health Sciences, Aga Khan University, Nairobi, Kenya.
- 5Department of Health, County Government of Kwale, Kwale, Kenya.
- 6International Centre for Reproductive Health, Mombasa, Kenya.
- 7University of Ghent, Ghent, Belgium.
- 8University of Nairobi, Nairobi, Kenya.
PMID: 29310654 PMCID: PMC5759252
DOI: 10.1186/s12905-017-0497-5
Abstract
Background: Contraceptive usage has been associated with improved maternal and child health (MCH) outcomes. Despite significant resources being allocated to programs, there has been sub-optimal uptake of contraception, especially in the developing world. It is important therefore, to granulate factors that determine uptake and utilization of contraceptive services so as to inform effective programming.
Methods: Between March and December 2015, we conducted a cross-sectional survey among women of reproductive age (WRA) from the Digo community residing in Kwale County, Kenya. The study aimed to describe the pattern and determinants of contraceptive usage in this population. Respondents were selected using stratified, systematic sampling and completed a household sexual and reproductive health (SRH) questionnaire.
Results: We interviewed 745 respondents from 15 villages in 2 out of 4 sub-counties of Kwale. Their median (interquartile range, IQR) age was 29 (23-37) years. 568 (76%) reported being currently in a marital union. Among these, 308 (54%) were using a contraceptive method. The total unmet need, unmet need for spacing and for limiting was 16%, 8% and 8%, respectively. Determinants of contraceptive usage were education [adjusted Odds Ratio, aOR = 2.1, 95% confidence interval, CI: 1.4-3.4, P = 0.001]; having children [aOR = 5.0, 95% CI: 1.7-15.0, P = 0.004]; having attended antenatal care (ANC) at last delivery [aOR = 4.0, 95% CI: 1.1-14.8, P = 0.04] as well as intention to stop or delay future birth [aOR = 6.7, 95% CI: 3.3-13.8, P < 0.0001].
Conclusions: We found high levels of contraceptive usage among WRA from the Digo community residing in Kwale. To further improve uptake and utilization of contraception in this setting, programs should address demand-side factors including ensuring female educational attainment as well as promotion of ANC and skilled birth attendance.
Keywords: Contraception; Demand-side; Determinants; Digo; Kenya; Kwale; Unmet need; Uptake; Utilization.
Conflict of interest statement
Authors’ information
At the time of the study, VM was a Project Manager at the International Centre for Reproductive Health, Kenya and is currently a doctoral candidate in Health Sciences at the University of Ghent, Belgium. AL is an Associate Professor, Department of Family Medicine and Director of the Community Health Department, Aga Khan University in East Africa. HEB is the Kwale County Director of Health. MT is a Professor, Department of Obstetrics and Gynecology at the University of Ghent, Belgium and the Director of Women’s Health, Faculty of Heath Sciences, Aga Khan University in East Africa. PG is an Associate Professor at the Univ [22]ersity of Ghent and the Country Director at the International Centre for Reproductive Health, Kenya.
Ethics approval and consent to participate
Ethical approval for the study was obtained from the Research Ethics Committee of the Aga Khan University, Nairobi (2014/REC-51) and the Ethics Review Committee of the University of Nairobi and Kenyatta National Hospital (P502/08/2014). We also obtained a research permit from the National Commission for Science, Technology and Innovation (#4703) to facilitate the conduct of research activities in the community. All participants provided written informed consent.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
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