Effect Of Decision-Making On Contraceptive Use Among Couples Of Child-Bearing Age In Kenya

Abstract

Due to the patriarchal nature of many African households, men hold power over many decisions, including family planning and family size. Decisions about contraceptive use and childbearing in a couple may be affected by lack of equality in power relations. Research has documented that secret use of contraceptives in Sub-Saharan Africa accounts for less than 20% of all contraceptive use which indicates a problem of women making decisions without involving their spouses. Women’s participation in family planning decisions has influence on their reproductive health, overall health, and family balance. In Kenya, a few studies have been conducted on contraceptive use decision-making which made this study necessary. The key objectives of this study were to determine the effect of decision-making on contraceptive use among couples in Kenya and, how the effect of decision-making on contraceptive use was affected by other study variables. KDHS 2014 couples data was used in this study. Descriptive statistics and Logistic Regression were used for analysis of the study. Bivariate logistic results revealed that decision-making was significantly and highly related to contraceptive use at 0.001 level. Couples who had contraceptive decisions being made by the husbands/partners and those engaging in joint decision making were more likely to use contraceptives compared to those that decisions were being made by women alone. Multivariate logistic results showed that the inclusion of background variables increased the effect of decision-making on contraceptive use. Further, the results revealed that desire for more children and education level of couples significantly influenced contraceptive use at 0.05 level. Wealth index and type of place of residence were highly related to contraceptive use among couples. Surprisingly, the results showed that couples for urban areas were less likely to use contraceptives compared to those from rural areas. The couples from wealthiest quartile (rich) were more likely to use contraceptives compared to those from the poor quartile. The results further showed that the strong and high significant effect of decision-making on contraceptive use was maintained net the effect of other variables. Couples who want more children were more likely to use to use contraceptive compared to those that wanted no more and those with secondary education and higher were more likely to use compared to those with no education. Additionally, given the results of this study, decision-making for contraceptive use stands out as important for family planning uptake. As recommended by ICPD 1994, male involvement remains critical for contraceptive use among couples and policy change in Kenya.