The Kenya Demographic and Health Survey (KDHS 2014) revealed changing patterns in the contraceptive use of young women aged 15–24, shifting from injectable methods to implants. Long-acting reversible contraception (LARC) is user friendly, long-term, and more effective than other modern methods. It could be a game-changer in dealing with unintended pregnancies and herald a new chapter in the reproductive health and rights of young women. This study determined the factors associated with LARC use among adolescent girls and young women to expand the evidence of its potential as the most effective method of reducing unwanted pregnancies among the cohort. This study analysed secondary data from KDHS 2014 using binary logistic regression. The findings showed a rise in LARC use (18%), with identified predictors of reduced odds being aged 15–19 [OR = 0.735, 95% CI = 0.549–0.984], residence (rural) [OR = 0.674, CI = 0.525–0.865], religion (Protestant/other Christian) [OR = 0.377, CI = 0.168–0.842], married, [OR = 0.746, CI = 0.592–0.940], and region (high contraception) [OR = 0.773, CI = 0.626–0.955], while the number of living children showed increased odds for 1–2 children [OR = 17.624, CI = 9.482–32.756] and 3+ children [OR = 23.531, CI = 11.751–47.119]. This study established the rising popularity of LARC and identified factors that can be addressed to promote it. Its increased uptake could help Kenya achieve the International Conference on Population and Development 25’s first and second commitments on teenage pregnancies and maternal and new-born health, thus promoting the health, wellbeing, educational goals, and rights of this critical cohort. This study can guide the accelerated efforts needed in Kenya’s march towards the five zeros of unmet need for contraception, teenage pregnancies, unsafe abortions, preventable maternal deaths, and preventable neonatal/infant deaths.
Background: Kenya has 12 million female adolescents and youths aged 10-34 years whose reproductive behavior will determine the growth and size of its population for the next decade. The anticipated momentum of births can be slowed by the use of long-acting reversible contraception (LARC) methods as they are more effective, need no user adherence, and hence have no risk of incorrect or inconsistent use. However, in spite of the many health and social benefits, LARC is underutilized because of myths and misconceptions. Kenya is in the ultimate decade towards Vision 2030 and investing in LARC can save costs of health care and accelerate the achievement of the development goal. The objective of this study was to establish factors associated with LARC use, with a view of establishing the potential for increasing demand. Methods: The study was national and used secondary data from the three waves of the Kenya Demographic Health Survey from 2003, 2008/09 and 2014 in a sample of all women of reproductive age who reported currently using modern contraceptive methods at the time of interview. Descriptive and logistic regression analysis was employed to profile and examine LARC users. Results: LARC use was low but picking up rapidly, especially among contraceptive users of higher social economic status in a major shift between 2008/09 and 2014. Consistent factors that influenced its use were age, wealth, and number of living children, while education and residence were of influence some of the time. Conclusions: There is huge unexploited potential for more LARC uptake based on the identified predictors of its use. Scaling up of LARC uptake is critical to deal with issues of poor user adherence, incorrect and inconsistent use, and method failure that characterize short-acting contraception, resulting in increased unintended pregnancies, incidences of unsafe abortions and maternal and infant mortality.
Studies show a gap in addressing the reproductive health Background: goals of younger women whose inconsistent use of contraception is high in spite of their great need for it. The women aged 15-24 present high potential for unintended pregnancy and increase the challenge for retention of users which is key in maintaining and pushing up the current gains in contraceptive prevalence rate (CPR).The objective of the study was to examine trends in Objective: contraceptive method choice for young women aged 15-24 years using modern methods and to determine factors associated with their choices.The study used data from KDHS of 2003, 2008/9 and 2014 in Methods: descriptive analysis and logistic regression to determine the socio-economic variables that influence the choice of contraceptive methods for young women.Results showed a general shift in use towards long term modern Results: contraceptives with the shift being more pronounced among young women with primary education, from rural areas, lower wealth households, and low contraceptive use regions. Women with secondary education and higher wealth status are shifting towards short term methods. Findings confirmed socio-demographic factors of age, education, wealth status and type of region as predictors of contraceptive use.Contraceptive information and services should be enhanced Conclusions: for young women to make informed choices concerning their reproductive and sexual health to enable them complete school and transition to colleges to acquire relevant skills that will make them optimally productive and lead Kenya to achieving the demographic dividend. PubMed Abstract | Publisher Full Text | Free Full Text 21. Gribble J, Bremner J: The Challenge of attaining the Demographic Dividend. Policy Brief. Population Reference Bureau. 2012. Reference Source 22. Magadi MA, Curtis SL: Trends and determinants of contraceptive method choice in Kenya. Stud Fam Plann. Population Council. 2003; 34(3): 149-159. PubMed Abstract | Publisher Full Text 23. Kimani M, Njeru M, Ndirangu G: Regional variations in contraceptive use in Kenya: Comparison of Nyanza, Coast and Central Provinces. Afr Popul Stud. 2013; 27(1): 43-52. Publisher Full Text 24. Bbaale E, Mpuga P: Female Education, Contraceptive Use, and Fertility: Evidence from Uganda. Hardee K: Trends in the contraceptive method mix in low-and middle-income countries: analysis using a new "average deviation" measure. Glob Health Sci Pract. 2015; 3(1): 34-55. PubMed Abstract | Publisher Full Text | Free Full Text
Background: The overwhelming uptake of contraception in Kenya at 58% suggests huge potential for a continued increase, but discontinuation threatens efforts to achieve new targets. Further increases in contraceptive prevalence will depend more on continuation and re-adoption amongst past users because unintended pregnancies would increasingly result from discontinuation. Eliminating discontinuations from side effects and method failure could increase continuation rates by 10%.Aim: To establish the prevalence and factors associated with contraceptive discontinuation.Setting: Kenya, with a successful family planning programme, but also the challenge of discontinuation rates of 31%.Methods: Contraceptive calendar data from the 2014 Kenya Demographic and Health Survey were used in the survival analysis approach.Results: Overall discontinuation rates were 37% (24 months) and 74% at (36 months), whilst discontinuation in need was 36%. Side effects accounted for 40% of discontinuations, whilst injection and pill recorded the highest rates. Current method emerged as a predictor of discontinuation at 24 months with the following hazard ratio (HR) at 95% confidence interval [CI]; intrauterine device (IUD) (HR = 0.466, CI = 0.254–0.857), injection (HR = 0.801, 95% CI = 0.690–0.930), implants (HR = 0.580, 95% CI = 0.429–0.784) and at 36 months, injection (HR = 0.808, 95% CI = 0.722–0.904) and implants (HR = 0.585, 95% CI = 0.468–0.730). Age (15–24 years) displayed influence only at 36 months (HR = 1.219, 95% CI = 1.044–1.424).Conclusion: The study showed a close link between contraceptive method used and discontinuation and thus the need to address method-related issues in an attempt to minimise discontinuation in Kenya. Expanding contraceptive options and improving the quality of service can scale up switching and thus help reduce discontinuation and unintended births.
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