Utilization of long-term and permanent family planning methods among family planning clients at Westlands health facilities, Nairobi County, Kenya
Muthee, Justus Maitethia
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Access to family planning services and contraception is critical with the world‟s population currently at seven billion inhabitants. Unfortunately close to 250 million people do not have the means to control their fertility. According to KDHS of 2014, Kenya has a total fertility rate of 3.9%, the Contraceptive prevalence rate of 58 % and unmet need for family planning of 18 %. A discrepancy exists between the proportion of women who know about long-term and permanent family planning methods which are effective for 3 to 12 years or permanent contraception depending with the method of choice and those who utilize them as a choice of contraception. The objective of this study, therefore, was to assess the utilization of long-term/acting and permanent methods of family planning among women of reproductive age seeking birth control from Westlands Sub-county health facilities. The research design employed was a facility based cross-sectional service exit survey and Proportionate sampling technique used to collect data from eight service delivery points (health facilities) owned by the city-county government of Nairobi. 381 women of reproductive age who utilized contraceptives and met the eligibility criteria were identified through systematic sampling. Structured interview questionnaires for family planning clients and focused group discussion guide for service providers were used to collect data. Data was analyzed by SPSS version 19. Bivariate analysis was done to determine factorsinfluencing use of long-term and permanent methods of contraceptives and variables which were found to be significant at p values of <0.05 in bivariate analysis were taken to multivariate regression to test effect of independent variables on dependent variable. The usage of thelong-term and permanent method was found to be 33% while that of short-term contraceptives was 67%. Implants (22.6%) were the highly used among the long-acting reversible contraceptives.The factors found to influence use of long-acting and permanent contraceptives among women seeking birth control in Westlands health centres were; Help to client in choosing contraceptive method to use at P = 0.01 (client own choice 39%, health care provider choice 23%), partners/spouse opinion on contraceptives at P= 0.04, unsatisfactory management of contraceptive side effects (45%), P= 0.01 and long waiting time before FP service (56% waited for ¼ to ½ hour), P= 0.01.Altogether the role of health care providers during contraceptives method counseling could not be ignored as the client felt being greeted and welcomed to theclinic (85%) and being handled well during service delivery (24%) influences their method choice and subsequent use (P= 0.001).In conclusion, the utilization of LAPMs in Westland‟s sub-county is higher than the national figures though tubal ligation is less by 0.8%.It is of essence to recommend to the city-county government of Nairobi through the Department of health to readdress those negative factors that slow uptake of LAPMs through reorientation of contraceptive services and as well motivate contraceptive providers to encourage the eligible client to switch over from short-term methods of contraception to long-acting reversible methods which have a minimal failure rate.