The intervening role of community-based health education in reducing unmet family planning needs among women of reproductive age 15 and 49 years in Siaya County, Kenya
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Date
2025-10
Journal Title
Journal ISSN
Volume Title
Publisher
Pan African Medical Journal
Abstract
Introduction: unmet family planning needs remain
a significant health challenge. In Kenya, 14% of
women have an unmet need. In Siaya County
unmet need is 21% among the women, and this is
high. This study seeks to determine the intervening
role of community health education on the
reduction of unmet needs among women of
reproductive age in Siaya County. Methods: the
study employed a quasi-experimental design with
non-randomized, geographically distinct clusters.
Assignment to the intervention and control arms
was based on geographic allocation to avoid
contamination into an intervention group that
received structured health education for six
months, and a control group, which did not. Data
were collected at two time points (baseline and
end line). The design enabled a difference-indifferences analysis to determine changes in
outcomes between the groups over time. The
FANTA formula by Robert Magnani determined the
sample size of 1,448 respondents for the study. The
WHO 30 by 30 two-stage cluster sampling method
was used to sample the number of women of
reproductive age. Data analysis was done using
IBM SPSS version 28.0, with both bivariate and
multivariate analyses conducted. Unmet needs for
family planning were modeled using a generalized
linear mixed-effects model (GLMM). Results: one
thousand four hundred and forty-seven (1447)
women of reproductive age (WRA) were
interviewed at baseline and end line. There was a
17.1% increase in high family planning (FP)
knowledge and a 12% rise in positive attitudes in
the intervention, and a decline in the control
group. Despite an increase in unmet need for FP in
both study arms, the rise was lower in the
intervention (6.7%) compared to the
counterfactual (20.8%). The intervention had a
protective effect against worsening of unmet need
(aOR=0.31, 95% CI=0.10-1.00; p=0.051). This effect
had borderline statistical significance (p=0.051).
Family planning (FP) uptake decreased in the
control group by 11.3% but increased in the
intervention group by 6.6%, with (aOR=2.42, 95%
Description
Research Article
Keywords
Citation
Ruth Anyango Ameso et al. The intervening role of community-based health education in reducing unmet family planning needs among women of reproductive age 15 and 49 years in Siaya County, Kenya. Pan African Medical Journal. 2025;52(89). 10.11604/pamj.2025.52.89.48467