Factors contributing to oral contraceptive user failure among clients attending antenatal clinics in Eldoret Municipality, Uasin Gishu County, Kenya
Chemutai, Tallam Edna
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Contraceptive is a regimen of one or more actions, devices, sexual practices, or medications followed in order to deliberately prevent or reduce the likelihood of pregnancy, or childbirth. Contraceptive is a key intervention for improving the health of women, men, and children. It is an important component of reproductive health. Quality contraceptives are recognised as a human right, having great importance in the field of preventive medicine; being essential to the health and welfare of the individual, families and whole communities. As society becomes more affluent, fertility decreases. This is in response to the use of contraceptives. Once neglected by the health profession, it can lead to contraceptive failure where a woman finds herself with an unwanted pregnancy which can be psychological and physical strain. The aim of the study was to determine the factors contributing to oral contraceptive use failure at Eldoret Municipality Ante-natal clinics. A descriptive Comparative study design was used. This was a twelve week study in Selected Ante-natal Clinic in Eldoret Municipality, Kenya. The study population included all clients who attended the ante- natal clinic during the study period and conceived while on a contraceptive method while the comparative group were clients who conceived deliberately after stopping contraceptive method to get pregnancy. Systematic random sampling was employed and interviewer administered questionnaire was used to collect data. Data on socio- demographic characteristics, pre-use counselling and clients' views on contraceptive failure were obtained. Descriptive quantitative data were coded as per the study's questionnaire and data entry template. The statistical package for social scientists (SPSS) was used for data analysis. Chi square tests and multivariate analysis were generated to check for relationships between parameters. A total of 192 subjects completed the questionnaires where 103 had contraceptive failure while 89 did not experience failure. Majority 132 (69%) were from peri-urban areas, while more than half 112(58.3%) were married. Three quarters 143 (75.5%) had undergone pre- contraceptive use counselling, slightly more than half 76 (52.1 %) were counselled by a nurse, whereas 41 % were not happy with the index pregnancy. Analysis of socio- demographic factors showed that marital status (single verses married) had an OR= 3, Income (KSh.l,000-5,000 versus KSh. >10,000) OR=4.67 and source of contraceptives (Clinic versus donor agency) OR=6.6 as having high risk of contraceptive failure. Others factors found to be associated with risk of contraceptive failure were occupation p=0.007, duration of method use p=0.044, education level p=0.005, age p=0.005, Compliance to the method p<O.OOl. Results also indicated that 93.2% of respondents who had failure in contraceptives were not willing to repeat the same method in future. The study findings indicate that better counselling on contraceptive options, suitability, and compliance of the methods and efficacy would reduce contraceptive failure. Importance of client compliance should also be emphasized. Counselling of clients on acceptance of the index pregnancy will minimize any chances of negative psychological sequel of the failure. The study recommends that at every contact with family planning clients, compliance must be re-emphasized in response to the socio-economic risks of contraceptive failure witnessed in the current study.