Prevalence, Unmet Need of and Factors Associated With Unmet Need of Modern Contraception Among Married Somali Women of Reproductive Age in Selected Facilities in Nairobi County, Kenya 2023

Abstract

Background: Low contraceptive uptake exposes women to unintended pregnancies resulting in obstetrics complications leading to maternal and neonatal deaths. Globally 295,000 women die annually from pregnancy and childbirth complications with most deaths occurring in LMICs. Somali women have high fertility rate of 6.6 births per woman compared to the global fertility rate of 2.5 births per woman. This is due to the high unmet need for family planning consequently from religious and cultural beliefs. However, with increase in level of education and socio-economic status there has been an upward rise in the use of modern contraception among the Somali women living in Nairobi County. Study objective: To determine the prevalence, unmet need of and factors associated with unmet need of modern contraception among married Somali women of reproductive age in selected facilities in Nairobi County, Kenya 2023. Methodology: using a quantitative cross-sectional study design, 300 participants attending 3 selected facilities from January 2023 to March 2023 were recruited into the study. Structured interviewer questionnaires were administered to collect data on socio-demographic and clinical variables. Data analysis was done using SPSS version 25 IBM Corp. Categorical data were reported in frequency tables, pie charts and expressed in percentages. Continuous data were reported using mean, standard deviation and IQR. Pearson’s Chi- square was used to measure significance of association between contraceptive use and each of the independent variables. Multivariate Logistic regression was carried out to evaluate significant factors associated with unmet need of modern contraception. Strength of relationship was determined by calculating odds ratio (OR) with 95% confidence interval (CI). Statistical association was significant at p-value less than 0.05 Results: The findings are based on a sample of 300 married Somali women. Mean age of participants was 30.68 with a SD of 6.89 years. Prevalence of modern contraception was 15.3% (95% CI; 11.45,19.92) (N=46). 21.7% used implants, 8.6% injections (DMPA), 47.8% IUD, 4.3% condoms and 17.4% used contraceptive pills. Unmet need for contraception was 17.3% (95% CI; 13.22,22.10) (N=48). A married woman whose husband approve use of contraception is 92% less likely to have her family planning needs unmet (aOR= 0.077, 95% CI: 0.029 – 0.204), (p<0.001). A woman whose attitude on contraception use is strongly influence by Islamic religion is two times more likely to experience unmet need for family planning as opposed to those are not influenced by Islamic view on contraception use (aOR= 2.855, 95% CI: 1.026 – 7.946), (p=0.045). The desired number of children by a woman significantly determined her unmet need for family planning (aOR=0.041, [95% CI: 0.002- 0.719), (p=0.029)...