Utilization of Contraceptives among Secondary School Adolescent Girls in Karuri, Kiambaa Sub-County, Kiambu County
Despite high sexual activity among adolescent girls in Kenya, contraceptive uptake is very low with only about 26 percent sexually active adolescent girls currently using a contraceptive method. This exposes them to HIV infections and unplanned pregnancies which consequently lead to school dropouts, unsafe abortions, and lack of employment opportunities. The study aimed at assessing the utilization of contraceptives among secondary school adolescent girls in Karuri Town Council, Kiambu County. The specific objectives were to establish the level of contraceptive uptake and factors influencing contraceptive utilization amongst secondary school adolescent girls in Karuri Town Council, Kiambu County. This was a cross-sectional study, employing stratified random sampling technique. The research instruments were self-administered semi-structured questionnaires and Focused Group Discussions (FGDs). Quantitative data from questionnaires was checked daily for completeness and coded for appropriate computer entry. Quantitative data analysis was conducted using IBM SPSS® 21.0 and involved univariate and bivariate analysis. Chi- square values were used to test the significance of the association between the dependent and independent variables. Qualitative data from FGDs was transcribed and analyzed by thematic content analysis technique. Overall, 421 girls aged between 13.0 to 19.0 years (mean age: 16.3±1.4 years) took part in the study. Findings showed that despite majority (77.5%) of the adolescent girls having had sexual debut by the age of 15 years, contraceptive utilization was low (43%) with majority of this (83.6%) using the Emergency pill. Age, knowledge on contraceptives, Accessibility and perception were cited as the major factors influencing utilization. Other factors identified included transactional sex, culture, unplanned sexual activity and sexual violence. The results revealed that age of the adolescent, knowledge of contraceptives, perception and accessibility had positive significant effect on contraceptive utilization. Adolescents aged 18 years and above were more likely to utilize contraceptives as compared to those of a lesser age (p=<0.001; OR: 9.870 (95% CI: 3.781-25.763)). Those with knowledge on contraceptives were OR 3.2 times more likely to use contraceptives p=0.025 similarly, accessibility was significantly associated with increased contraceptive utilization (p=0.34, 95% CI: 1.054-4.187). Adolescents who perceived use of contraceptives as wise were more likely to use a contraceptive than those of a divergent opinion (OR: 2.053, (95% CI: 1.024-4.115): p=0.041). Despite a high level of knowledge (90.1%) and an early age at sexual debut among secondary school adolescent girls; the study depicted that contraceptive utilization among secondary school adolescent girls remains low (43%). There exists a gap between contraceptive knowledge and practice among secondary school adolescent girls, indicating that knowledge does not always amount to practice. There is therefore need to develop age specific reproductive health messages to guide school education curriculum as well as parent or guardian - child communication. Developing adolescent friendly health services will improve adolescent’s sexual and reproductive health which will subsequently improve contraceptive utilization.