Determinants Of Family Planning Option Among Women Aged 15-24 Years Seeking Postnatal Care Services In Nairobi County, Kenya

ABSTRACT

Sub-Saharan African countries largely are characterized by high fertility and correspondingly high rates of population growth for the foreseeable future. In most countries, the majority of women want around five children and more than one-third of population growth is attributable to the effect of wanted fertility. Kenya fertility level has declined over the years to the current level of approximately five children per woman, which is still high. According to KAIS study by Kenya government in 2007, there is a large (52.4%) unmet need for contraception in the country. Fertility would decline only modestly if women had no undesired childbearing. This is if greater access to quality family planning services responds to unmet needs. A high proportion of pregnancy among women aged 15-24 years in Kenya is undesired. Therefore this study identifies the factors that influence realization of unmet contraceptive needs among women aged 15-24 attending postnatal clinic in selected health facilities in Nairobi. The study used a cross sectional descriptive design where 418 respondents attending postnatal clinic were interviewed. Systematic random sampling was used to select the respondents. Data was collected using structured interviews, focus group discussions and key informant interviews. The collected data was analyzed using SPSS software. Descriptive statistics was used to summarize and organize the data. Chi- square statistic was used to test for association between variables and level of significance. In addition, responses from open-ended questions, key informant interviews and FGDs was analyzed qualitatively according to emerging themes. The qualitative data was used to supplement, explain and interpret the quantitative data. Results from this study show high prevalence in use of family planning where 95.2% were using at least one method. There is low proportion use of FP method in the age group (15-19) whereas majority of women using FP method are married (63.8%). Occupation was found to be one of the important socio-economic status indicators that influence the contraceptive behavior of women. The study also found educational level as significant factors affecting the adoption of family planning. Findings show an association between wife-husband discussion on family planning use and use of family planning. There is also a strong association between partner‟s approval and use of family planning. In the study, religion was found to be a significant determinant of the use of contraceptive. Muslims and Hindus showed a significant lower use of contraception. From the study, respondents used short-term methods when they needed limiting and using long-term methods when they needed spacing. The study concludes that condom is the most commonly used method followed by oral pill, injectable and natural method. Education, age, marital status, occupation, income, religion, discussion with, and approval of partner were significant and influence family planning use. Contraceptive methods used did not match contraceptive needs. The study recommends for education at the point of service to enable choice of method based on need focusing on the lower age (15-19 years). There is also need to economically empower women to make them self sustaining. The study also recommends for men to be continuously involved in family planning education as their approval influences family planning. The information obtained from the study will be used by decision makers to develop policies and program planning that addresses the unmet need for contraception in Kenya.