Determinants of contraceptive use among women of reproductive age in North Eastern Kenya

Abstract

Background Contraceptive use is the expression of individual desire to space or to limit birth.By practicing family planning, couples can improve the health of mothers and children through birth spacing and avoiding high risk pregnancies. In addition to this, family planning can help to slow down population growth thereby contributing to economic benefits such as poverty reduction. North Eastern Province has the lowest prevalence of contraceptive use in Kenya. The determinants of contraceptive use among women in this province are increasingly attracting attention from researchers and policy makers. However policies aimed at increasing uptake of contraceptives need to be based on a sound assessment of the sources, reasons and determinants of contraceptive use since policy decisions based on intuition are likely to be misguided. Objectives The study investigated the factors related to contraceptive use by women in North Eastern Province of Kenya. The specific objectives were; 1. To determine the methods of contraceptives available to women and their use in North Eastern Kenya 2. To determine the factors related to Contraceptive use by women of reproductive age in North Eastern Kenya Methods Data from Kenya Demographic and Household Survey (KDHS, 2008/09) was used for the analysis. The study design was a population based Cross Sectional Survey. Eligible women were 15 years or older but less or equal to 49 years old and resident in the province at the time of the survey. Sampling involved a two stage cluster design. Tables were used to present the methods of contraceptives available, their use by women and reasons for not using contraceptives. Logistic regression model was used to model the association of various covariates on Contraceptive use taking into account potential confounders. Results A total of 608 women who were 15 years or older but less or equal to 49 years old were included in the sample. Over 97.5% of the women were Muslims. The methods of contraceptives available were Pill, Injections and Norplant. Over 97.7% of the sample of women did not use any method of contraception. Only 1.48% used Injection method. 37.76% of the women indicated that the Muslim religion prohibits the use of contraceptives. Univariate Logistic regression models found associations between the covariates, residence, education, socioeconomic status, occupation religion and mass media on contraceptive use. Specifically, urban residents were more likely to use contraceptives compared with their rural counterparts. Women with primary, secondary and higher education were more likely to use contraceptives and the magnitude of effect increased with increasing level of education. Women who were exposed to media were more likely to use contraceptives compared to those who were not. Muslims were less likely to use contraceptives compared to Protestants. In the multivariate analysis only religion and watching television remained statistically significant. Muslims were 98.98% [Adjusted OR = 0.02, P < 0.003, 95% CI (0.002, 0.0267)] less likely to use contraceptives compared to protestants. Women who were accessible to television were about 10 times [Adjusted OR = 10.65, P = 0.031, 95% CI (1.23, 91.84)] more likely to use contraceptives compared to those who did not. Conclusion Religion and Mass media were significantly associated with Contraceptive use among women in North Eastern province of Kenya. Muslims were less likely to use contraceptives compared to Protestants. Women who were exposed to television were more likely to use contraceptives than those who were not. Involving Muslim leaders in design, planning and implementation of family planning programs in this province is critical for the success of family planning programs in the province.