Female surgical contraception in Kenya-- the Kenyatta National Hospital experience.

Abstract

Surgical contraception is regarded as the most effective and widely used method of contraception today in the world. Female sterilization (FS) is currently more popular particularly in Africa, as compared to male sterilization. Compared to other parts of the world, Kenya has one of the lowest acceptancy rates for FS. It is suggested that age, parity, marital status and religions contribute to this low rate. 1,551 FS procedures performed at Kenyatta National Hospital (KNH) between January 1981 and December 1985 are studied. Of the 2 widely employed techniques for FS, minilaparatomy and laparoscopy, the latter was more favored at KNH during the study period, accounting for 48.9% of the cases. The peak parity was in the range of 6-8. Many sterilizations were performed on women in the age group of 30-34 (40.8%). Given the current early marriage age for girls in Kenya (16-18), the high parity and the age of sterilization would make this method demographically ineffective. Marital consideration for provision of this service contributed to the high parity among the single women in the study. For improved acceptance rate and wider application of surgical contraception in Kenya, it is suggested that the use of local anesthesia, service delivery points on an outpatient basis, public education and dramatic counseling, and above all, liberal attitude of service providers and administrators to such factors as age, parity and marital status are essential.