Factors influencing uptake of long-term family planning methods among women of reproductive age in Nyaribari chache sub- county, Kisii county, Kenya

Abstract

Family planning (FP) is a key strategy for achievement of Sustainable Development Goals (SDGs) 1, 3, 4, 5 and 10. It provides an opportunity to ensure a balance between population size and available resources and directly contributes to improved maternal and newborn health. Promotion of FP in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. In Sub-Saharan Africa (SSA), the rate of population growth is one of the highest in the world at 2.8%. In Kenya, use of long-term family planning methods also referred to as long acting reversible contraceptives (LARC) remains relatively low compared to other methods; with Total Fertility Rate (TFR) at 3.9, while Contraceptive Prevalence Rate (CPR) and unmet need for FP being estimated at 58% and 18% respectively. Kisii County is one of the populous counties in Kenya with total fertility rate of 3.7 children per woman hence the need to maximize use of LARCs. This study sought to assess factors that influence uptake of long-term family planning methods in women of reproductive age in Nyaribari Chache Sub-County. Specifically, the current study assessed the knowledge, socio–cultural and facility-related factors influencing uptake of long-term family planning methods (LARC) in women of reproductive age (15-49yrs) in Nyaribari Chache Sub-County, Kisii County. A cross-sectional study design was adopted. Women of reproductive age (n=406) residing in Nyaribari Chache Sub-County identified as the sudy population. Simple random sampling was adopted for individual questionnaire administration while key informant interviews were conducted to get views of the health facility to establish facility-related factors influencing the use of long-term FP methods. Data analysis was done by entering data in Statistical Package for Social Science (SPSS) version 22.0. Important summary statistics were obtained and associations were examined using Chi-square test. Study participants grouped into two categories, non-user of LARC (n=294) and users of LARC (n=112) Logistic regression conducted while controlling for age and marital status showed that knowledge of LARC had a two-fold increase in the use of LARC by women of reproductive age (P=0.001), women whose income was above Ksh10,000 (P=0.001), those who interacted with women groups (P=0.001) had increased use of LARC while decreased use of LARC was observed in casual labourers and peasant farmers (P=0.001), those with 4 and above living children (P=0.041). Attending a government health facility increased the uptake of LARC (P=0.020) in Nyaribari Chache Sub-County, Kisii County, Kenya. Results presented are crucial in informing the government, health care organizations, program managers and policy makers on knowledge, socio–cultural and facility-related factors influencing uptake of long-term family planning methods to design specific FP initiatives in order to achieve the SDGs and decrease the unmet need for contraceptives.