Uptake of Intrauterine Contraceptive Device among HIV Positive Women at Selected Health Facilities in Nairobi City County, Kenya
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Date
2022
Authors
Asava, Diana Navalya
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
The increased maternal and neonatal mortality in Kenya among women living with HIV and AIDS can be attributed to high unmet needs of family planning at 52%. Family planning and use of antiretroviral in sub Saharan Africa and Southern Asia has helped in reducing the maternal and neonatal deaths up to 43% annually. In Kenya there are approximately 1.5 million people living with HIV and 36000 people die annually due to HIV related diseases. Intrauterine contraceptive device as a family planning method reduces unintended pregnancies among women living with HIV AIDS and is 99% effective when used correctly. World Health Organization considers it to be the most effective method of family planning. Despite all the potential benefits, the device is still underutilized. In Kenya the uptake of intra-uterine device in the general population is 3.4% compared to other modern methods. The study therefore aims at assessing the level of uptake of Intra-uterine contraceptive device uptake among women living with HIV/AIDS in selected health facilities in Nairobi City County, Kenya. The findings of this study would help relevant stakeholders in structuring programs and strategize on interventions to improve intra-uterine contraceptive uptake among women living with HIV/AIDS in the Nairobi City County and the country at large. This will discourage reliance on wrong knowledge on IUCD so as to reduce the unmet needs of family planning and reduce unintended pregnancies that crop up in the long run. The study specifically focused on socio-demographic factors, knowledge and barriers associated with intra-uterine device uptake in Nairobi City County. The researcher adopted a cross sectional-descriptive study design to collect data through questionnaires administered with the help of research assistants. A total of 353 participants were interviewed from the selected facilities of Mathare North health Center, Huruma Lions Health Center and Pumwani Majengo Health Center which were purposively chosen. The study used quantitative data collection methods. Systematic random sampling was used to select primary respondents at an interval of 8. Every 8th respondent exiting the family planning clinic was selected for interview until the required sample size was reached in each facility. The researcher obtained ethical clearance from the Kenyatta University Ethical Review Committee prior to data collection and a research permit from National Commission for Science, Technology and Innovation. Informed consent was sought from study respondents while the purpose of the study was explained them. Quantitative data was cleaned and entered into a Microsoft excel database before being analyzed by SPSS version 22.0. Descriptive statistics were presented (using percentages, frequency tables, graphs and pie-charts). Inferential statistics were calculated to establish the association between study variables using chi-square tests done at 95% confidence interval and p-values of less than 0.05 considered statistically significant. The results revealed that only 4.8% of respondents utilized intra-uterine contraceptive device. Socio-demographic factors such as age (p=0.029), number of children (p=0.001), level of education (p=0.009), occupation (p=0.001) and religion (p=0.001) significantly influenced uptake of intra-uterine device. The study established low knowledge levels on intra-uterine device among women living with HIV/AIDS in Nairobi City County. Knowledge levels were significantly associated with uptake of intra-uterine contraceptive device (p=0.047). A number of factors were identified as possible barriers which hindered intra-uterine contraceptive device uptake which included facility reception (p=0.026), provision of information (p=0.002), culture/religion (p=0.004) and spouse allows use (p=0.002). The study concludes that there were low uptake and low knowledge levels on intra-uterine contraceptive device. The study further concludes that socio-demographic factors and other barriers were possible reasons for low uptake of intra-uterine uptake among women living with HIV/AIDS in Nairobi City County. The findings of the study would help relevant stakeholders to sensitize and increase uptake of IUCD among women living with HIV.
Description
A Thesis Submitted in Partial Fulfillment of the Requirement for the Award of Master of Public Health (Reproductive Health) Degree in the School of Health Sciences of Kenyatta University, November, 2022
Keywords
Intrauterine Contraceptive Device, HIV Positive Women, Health Facilities, Nairobi City County, Kenya