Unmet need for contraception among men In Kenya: evidence from KDHS 1998

Abstract

The standard measure of unmet need for FP services focuses on married women and captures the apparent discrepancy between the women's fertility preferences and their contraceptive behaviour. Very few attempts have been made to define unmet need for men despite the growing support for increased participation of men in reproductive health (RH). As such, there is no generally agreed upon measure of men's unmet need for contraception, and where attempts have been made to define unmet need for men, no attempts have been made to study the determinants of such need. The present study aimed at analyzing unmet need for contraception among married men in Kenya using data from the 1998 KDHS. It specifically aimed at estimating the magnitude of such need using the measure that had been applied to the previous two surveys of 1989 and 1993. It also aimed at investigating the relationship between men's unmet need for contraception and the proximate determinants of the need as well as the nature of such relationship if men's background characteristics were controlled for. The current status model that helps to determine unmet need from the respondents' contraceptive behaviour and fertility preferences at the time of the survey was used to determine the magnitude of unmet need for contraception among men. Cross-tabulation with Chi-square was used to analyze the relationship between unmet need and each of the independent and intermediate factors considered in this study. Multivariate logistic regression analysis was used to analyze the determinants of unmet need for contraception among married men. According to the estimates from the 1998 KDHS, the level of men's UlU11etneed for contraception stood at 23.3 percent. This represents a decrease of only 0.02 percentage points v from the 1993 estimates of23.5 percent and a decrease of8.8 percentage points from the 1989 estimates of 32.1 percent made by Ngom (1997). All the independent factors i.e. age, education level, place of residence, region, ethnicity, religion and number of living children have significant associations with unmet need for contraception among men. None of the intermediate factors i.e. number of methods known spontaneously, discussion of FP with partner, and respondents' approval ofFP has significant association with men's unmet need. Results of multivariate analysis show that the proximate determinants alone fail to account for significant explanations of the variations in men's unmet need for contraception. When the background factors are controlled for, number of methods known spontaneously and discussion of FP with partner turn out to be significant. Among the background factors, age, number of living children and ethnicity emerge as the most powerful determinants of unmet need for contraception among men. For policy concerns, the study recommends programmes aimed at promoting spousal communication and increasing male involvement in RH including encouragement to turn the near universal knowledge of and favourable attitude toward contraception into practice. The slow pace of the decline in men's unmet need between 1993 and 1998 compared to between 1989 and 1993 should also form the basis of programme focus. For further research, the study recommends the need to formulate a standard measure of men's unmet need, to extend such a measure to the sexually active unmarried men, and the need to develop appropriate indicators for the proximate determinants of the need. It also recommends the need for the use of qualitative research techniques, especially for findings which do not conform to expectations or are not consistent with findings for women in other studies.