Assessment of hormonal contraceptive use among women at Kenyatta National hospital

Abstract

Background Contraceptives are used mainly to prevent unintended pregnancies and this is ensured by consistent and correct use of contraceptives to prevent contraceptive failure. Appropriate use and counselling on side effects contribute to the consistent and correct use of contraceptives therefore maintaining the desired effectiveness. Objectives To assess the prevalence, types, level of knowledge on the correct use and prevalence of side effects of hormonal contraceptives among women of reproductive age at Kenyatta National Hospital. Methodology A cross-sectional study was carried out between 1st May 2014 and 30th June 2014 targeting 400 women in their reproductive age. Convenient sampling was used to identify study sites while participants were selected using simple random sampling. Ethical approval was sort from the Kenyatta National Hospital and University of Nairobi Ethical and Research Committee. Data was collected using an interviewer administered questionnaire and analyzed using the statistical software, Statistical Package for the Social Sciences version 20. Results The study population comprised mainly of married women between 18-37 years with secondary and post-secondary education in formal employment and others unemployed. Majority were Christians. The use of contraceptives was at 42.8%. Contraceptive use was associated with number of children [OR 1.7 (1.3-2.1)] p<0.0001. 56.1% of contraceptive users were on hormonal contraceptives. Injectable contraceptives were the most preferred followed by implants and pills while the contraceptive patch, coitus interruptus and lactational amenorrhoea method were least used. The choice of contraceptive methods was associated with age [OR 2.003 (1.330-3.017)] p=0.001 and level of education [OR 1.697 (1.135-2.539)] p=0.010. Least side effects, long duration of action and effectiveness were the main criteria of choosing a hormonal contraceptive method among the users. Health practitioners were the main source of contraceptive information while government facilities were the main source of the contraceptives. The level of knowledge on the correct use of hormonal contraceptive use was limited and it was associated with the level of education [OR 1.389 (1.144-2.051)] p=0.000. The prevalence of side effects among hormonal contraceptive users was 75% and it depended only on the type of hormonal contraceptive (p=0.037). Conclusion The gap between contraceptive knowledge and use is still wide. Injectable contraceptives are the most preferred hormonal contraceptives. The level of knowledge on the correct use of hormonal contraceptive is low and contraceptive side effects are common. Recommendations Programs should be developed to increase the use of contraceptives and contraceptive counseling should be made mandatory at every visit to the family planning clinic. Studies should be carried out to investigate the gap between contraceptive knowledge and use while others investigate how to increase correct use of contraceptive.