Determinants of non-use of family planning among married women in Kabati Division Kitui District, Kenya
Thuo, Julia Waithira
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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.
- MST-Zoological Sciences