Utilization of Family Planning Services and Associated Factors among Women Aged 18-49 Years Living with Disability in Kajiado County, Kenya
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Currently it is estimated that about 10 percent of the world's population experience some form of disability. Across the world, women with disabilities suffer more from poor maternal health outcomes as compared to their counterparts thus need contraception more. However, the rate of contraceptive use among women with disabilities is low despite their higher risk of pregnancy related complications. Therefore, this study sought to establish the utilization of family planning services and associated factors among women living with disabilities in Kajiado County, Kenya. The study specifically focused on socio-demographic factors, the nature of attitude towards family planning, family planning accessibility factors and awareness on utilization of family planning services among women living with disabilities. A cross-sectional descriptive study design that made use of both quantitative and qualitative data collection methods was used. Quantitative data was collected using semi-structured questionnaires from women with disabilities while qualitative data was collected using key informant interview schedules with selected Key Informants and Focused Group Discussion guides with primary respondents. The respondents were sampled from Kajiado Central, Kajiado North and Kajiado West sub-counties which were randomly selected. The study respondents were sampled using systematic sampling with a predetermined interval of 3. A total of 316 respondents were recruited for interview with the aid of disability registered groups; Key informants and focused group discussants were purposively selected for inclusion in the study. The researcher sought all required approvals from relevant authorities and obtained informed consent from respondents prior to the conduct of the study. Descriptive data was analyzed using Statistical Package for Social Sciences version 22.0 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Qualitative data results were triangulated with quantitative data as direct quotes or narrations as presented by focused group discussants and key informants. Inferential statistics were calculated using Chi-Square tests done at 95% confidence interval and a margin of error of 0.05 to establish the association between study variables. The results of this study revealed that 32.0% of women living with disability in Kajiado County utilized family planning services with 57% of respondents reporting to be having low awareness on family planning. The common method known by majority of respondents was injection (26.6%) and the common method of family planning method utilized by majority of respondents was Implant (31.2%). Majority of socio-demographic factors such as age (p=0.014), education (p.001), occupation (p=0.018) and level of family income (p=0.001) were significantly associated with utilization of family planning services. 61% of respondents had negative attitude towards family planning. The nature of attitude (p=0.001) was significantly associated with utilization of family planning services. Most of the family planning accessibility factors such as distance to the nearest health facility (p=0.024), cost of seeking family planning services (p=0.001) availability of family planning services (p=0.004) and healthcare workers friendliness (p=0.011) were significantly associated with utilization of family planning services. The study concludes that the rate of utilization of family planning services among women living with disability in Kajiado County was relatively low as compared to the general population. The study recommends scaling up and sensitization of family planning programs to increase utilization rates among women living with disability. These results would be useful to policy makers, health researchers and other stakeholders to develop action plans to improve the utilization of family planning services which would further lead to improved maternal outcomes as well reduce maternal deaths associated with pregnancy related complications among people living with disability.