Factors that influence the choice and use of norplant among women of reproductive age in Nairobi province, Kenya

Abstract

Norplant is a provider-dependent method of family planning. It is a contraceptive method that depends on trained and qualified medical personnel who can insert and remove it. Women's satisfaction with Norplant therefore depends not only on the features of its high level of effectiveness, long acting duration and convenience, but also on the quality of the family planning services. Norplant is easy to use, convenient, long lasting and very effective. It is one of the latest in contraceptive technology. The last evaluation on Norplant in Nairobi Province was done in 1999, so there was a need to re-evaluate. Family planning is defined as the process of using a contraceptive, a device, means or behaviour that allows couples to enjoy uninhibited sexual relations but at the same time prevent or delay pregnancy. It enables couples to space their children and have the information and the means to do so. Maternal deaths which occur globally through unwanted pregnancy and unsafe abortion can be prevented through client centered family planning information and services. Family planning services require frequent evaluations. The objective of the study was to investigate the sociodemographic profiles of the study subjects, their choice and extent of using family planning methods and socio-cultural and economic factors associated with the use of Norplant. A prevalence study was then carried out among women of reproductive age between 15 years and 49 years in Nairobi Province with an aim of having an in-depth analysis of factors underlying the choice of this family planning method. Study sites were Ribeiro clinic, Phoenix House clinic, Marie Stopes Eastleigh Nursing Home and Mbagathi District Hospital. Subjects were selected mainly on their availability. These were women who had used Norplant before, women currently on Norplant and women using other methods of Family Planning. Collection of data was done using questionnaires. More information was elicited by interviewing illiterate and semi-illiterate clients and information was filled in the questionnaires by the interviewers. The data was kept in confidence before retrieval for coding Data was processed and analyzed using the SPSS (Statistical Package for Social Sciences). Chi-square test for association between the variables was used. The study revealed that, 18% of the study population had used Norplant at one time and 9.5% of the women had withdrawn from the method because they had experienced side effects such as irregular bleeding Women who had not used Norplant had little information about it (48%). Factors such as age (X2=10.837,df=4,); duration of marriage (X2=13.562,df=5) education (X2=9.765,df=4), occupation (X2=28.502,df=5), marital status ( =13.103,df=-6) and source of information (XZ=4l.807,df=4), had significant association with the use of Norplant (P<0.05,n=390). Religion (X2=5, 538, df =3), had no significant association with the use of Norplant (P>0.05, n=390). Friends and relatives were very effective in disseminating information about Norplant. The findings of this study will be useful to policy makers in developing new guidelines geared towards generating information on the management of the likely problems associated with the side effects of Norplant such as high blood pressure, disruption of menses, headache and loss of libido. The information from this study will also help in designing research projects to establish, for example the fertility of women after Norplant use.