Predictors of uptake of modern family planning services among pastoralist women in Garbatulla sub-county, Isiolo county, Kenya

Abstract

Family Planning (FP) improves the quality of life for women, however, global unmet need for family plannings remains high, especially in developing countries. In Kenya, health care delivery, including delivery of FP services, for pastoralist communities has serious shortcomings as often it must be delivered under difficult circumstances. In Isiolo County, where majority are pastoralists, Modern Contraceptive Prevalence (mCP) is too low; 26.3% compared to the country’s 58.0%. While this is attributable to the high maternal mortality rate of 790 deaths per 100,000 live births in Isiolo, no documented studies have been done to determine the predictors of the low mCP. This study investigated predictors of uptake of modern FP services by pastoralist women in Isiolo County. The study objectives were to; determine socio-cultural, health system, and knowledge and perceptions factors that predict uptake of FP services by pastoralist women in Garbatulla Sub-County, Isiolo County. A cross-sectional descriptive survey utilizing quantitative and qualitative data collection approach was undertaken a sample of419 women aged 14 to 49 years. Key Informant Interviews collected qualitative data. A structured questionnaire was used to collect quantitative information on study variables. Quantitative data were summarized descriptively and presented in charts; qualitative data were analysed manually based on emerging themes. Chi-square test was used to establish associations between study variables at α ≤ 0.05. Binary logistic regression was used to identify predictors of FP uptake. Most of the participants were young; aged 25 to 35 years. Almost all of the participants were Muslims and mCP was 25.3%. There were no significant associations between both religion and male involvement and FP uptake; p=0.082, p=0.574 respectively. Health system factors; time taken to reach health facility and type of health facility were predictive of FP uptake (OR=1.6, 95% CI, p=0.024, and OR=1.4, 95% CI, p=0.000) respectively. Likelihood of knowledge on contraception methods influencing FP uptake was low (OR=0.4). Perceptions on use of FP by fecund women to post pose child birth showed a high likelihood of predicting FP uptake. The study provides useful insights on appropriate interventions that can be designed to enhance uptake of FP in Isiolo County, Kenya. The study concludes that health systems factors are core predictors of family planning uptake by the pastoral population of Isiolo County. The study recommends that the Department of Public Health, Isiolo County should come up with health promotion programs intended to enhance knowledge and positive perceptions on modern family planning.