Determinants of non-use of family planning among married women in Kabati Division Kitui District, Kenya
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Date
2002-06
Authors
Thuo, Julia Waithira
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Abstract
Family Planning (FP) is one of the most important interventions in health care. As the
demand for reproductive health care grows, advocacy for Family Planning is becoming
crucial. Yet and inspite of the efforts towards fertility control, there remains a substantial
proportion of women in reproductive age-group who are not using Family Planning
methods even though they do not want a pregnancy right away. A cross-sectional
descriptive population-based study was conducted to determine the reasons for the
discrepancy between fertility preferences and contraceptive practice in Kabati division,
Kitui district. A total of 450 married women in reproductive age (15-49 years) were
interviewed using a structured questionnaire in addition four focus group discussions
(FGDs).
The results indicated that majority of the women 281 (62%) did not use any
contraceptives (non-users) and only 169 (38%) were users. Majority 320 (71%) of the
respondents were aged between 25-39 years. Most respondents aged 15-19 years and
44-49 years were non-users and age-gr~mp 25-29 years had a high number of non-users
88 (60%). In terms of religion, the respondents were mainly of Protestant faith j
254 (56%) but most Catholics 131 (68%) were non-users compared to 147 (58%)
Protestants non-users (X2 = 5.02, P = 0.02). Majority 251 (58%) of the women had
attained primary level of education with 163 (65%) being Family planning non-users
(x2 = 17.98, P = 0.00044). Similarly, most respondents 363 (81%) were housewives and
majority 240 (66%) were non-users while among the professionals the users were the
majority 20 (65%) (X2 = 16.2, P = 0.0003). On account of more children, most
274 (60%) women did not intend to have more children and majority 160 (58%) were
(vi)
non-users. Economic reasons were cited by half of the respondents 140 (51%) as the
main reason for non-intention to have more children.
Most 153 (54%) non-users had inadequate knowledge of Family Planning while most
users 96 (57%) had adequate knowledge. A total of 163 (36%) respondents did not
discuss Family Planning issues with their spouse. Among these, 119 (73%) were nonusers
compared to only 44 (27%) users (X2 = 12.15, P = 0.0001).
The nearest health facilitywas reported to be the health centre and most respondents, 281
(62%) lived a distance of more than 5 km from the nearest facility and only 3 (2%)
obtained Family Planning methods from the Community Base<jDistributor (CBD). The
main reasons cited for Family Planning non-use were the fear of side-effects, 100 (29%)
and husbands' disapproval for Family Planning use, 88 (25%). In the multivariate
analysis, low socio-economic status (O.R. 3.5, P = 0.022), inadequate knowledge
(O.R. 2.9, P = 0.0001) and failure to discuss Family Planning issues with the spouse
(O.R. 1.69, P = 0.031) emerged as important determinants of Family Planning non-use.
Factors involving knowledge of Family Planning, spousal communication, improved
CBD services and male involvement in Family Planning use should be addressed to
increase contraceptive prevalence in the area through Information, Education and
Communication (l.E.C) programmes. Similarly, improvement of women's socioeconomic
status through encouraging education beyond primary level and encouraging
Income Generating Activities (I.G.As) can empower women arid improve their ability to
make reproductive health choices.
Description
A thesis submitted in partial fulfilment for the Degree of Master of Public Health and epidemiology of Kenyatta University. June, 2002