Factors Influencing Choice and Use of Contraceptive Methods among Women in Kibera Slum, Nairobi, Kenya

Abstract

The choice and use of contraceptive methods has remained a challenge in sub- Saharan Africa. Women from Kibera slum in Nairobi, Kenya have been faced with the problem of unplanned pregnancies due to low use of contraceptive methods. Contraceptives would reduce maternal and infant mortality resulting from unplanned pregnancies. Therefore, the main objective of this study was to establish factors that influence choice of contraceptives among women in Kibera slum. A cross-sectional study was carried out and a total of 384 women attending MCHlFP clinics at different health facilities in Kibera participated in the study. Data was collected using pre-tested, structured, open-ended questionnaires for respondents; unstructured questionnaire was used for service providers as well as for focused group discussions. Data was analyzed using the Scientific Package for Social Sciences (SPSS) software version seventeen. Chi-Square test for goodness-of-fit was used to test relationship between variables. Results indicated that the minimum age was 17 years; the maximum was 45 years while the mean age was 24.2 years. Most of the respondents (84.1%) were married and were aged between 20 -24 years. Sociodemographic and economic variables had a statistical relationship with choice and use of (p < .05). Knowledge on Contraceptive methods' side effects and community perception did not have a statistical relation with choice and use of contraceptives. Health system factors influencing choice and use investigated were health provider's variables which included the provision of contraceptive methods, offering contraceptive methods' health education and counselling. All the variables apart from providing contraceptive methods counselling had a statistical relationship with choice and use (p < .05). Choice and use of contraceptive methods was measured using four variables which included: whether the respondent has ever used contraceptive; currently using contraceptive and used a contraceptive in last intercourse and whether the respondent had a preferred contraceptive method. The study found that less than half (46%) of the respondents used a contraceptive method. This outcome was influenced by respondents' age, marital status, parity, sex of the children, home area, village residence, education, religion, main source income, income per month, knowledge on type of contraceptive methods, sources and side effects of contraceptive methods, discussing contraceptive methods with spouse, teen age son! daughter, partner involvement in contraceptive method choice and main decision maker, also provision of contraceptive method, offering contraceptive methods' health education and counselling. This study recommends on-going contraceptive health education and counselling services .for young women and men, including partners. The results of this study has generated information that will help explain the emerging decline in the use of contraceptives in different social settings in Kenya and particularly generated data that may help revise approaches used to disseminate information on choice of contraceptives methods to different social settings. These results may be used by policy makers to improve policy frameworks and to determine issues that need to be stressed in the design of future family planning campaigns.