Determinants of contraceptive use among postpartum women in a county hospital in rural KENYA

Abstract

BackgroundThere is a high unmet need for limiting and spacing child births during the postpartum period. Given the consequences of closely spaced births, and the benefits of longer pregnancy intervals, targeted activities are needed to reach this population of postpartum women. Our objective was to establish the determinants of contraceptive uptake among postpartum women in a county referral hospital in rural Kenya.MethodsSample was taken based on a mixed method approach that included both quantitative and qualitative methods of data collection. Postpartum women who had brought their children for the second dose of measles vaccine between 18 and 24 months were sampled Participants were interviewed using structured questionnaires, data was collected about their socio-demographic characteristics, fertility, knowledge, use, and access to contraceptives. Chi square tests were used to determine the relationship between uptake of postpartum family planning and: socio demographic characteristics, contraceptive knowledge, use access and fertility. Qualitative data collection included focus group discussions (FDGs) with mothers and in-depth interviews with service providers Information was obtained from mothers’ regarding their perceptions on family planning methods, use, availability, access and barriers to uptake and key informants’ views on family planning counseling practices and barriers to uptake of family planningResultsMore than three quarters (86.3%) of women used contraceptives within 1 year of delivery, with government facilities being the most common source. There was a significant association (p ≤ 0.05) between uptake of postpartum family planning and lower age, being married, higher education level, being employed and getting contraceptives at a health facility. One third of women expressing no intention of having additional children were not on contraceptives. In focus group discussions women perceived that the quality of services offered at the public facilities was relatively good because they felt that they were adequately counseled, as opposed to local chemist shops where they perceived the staff was not experienced.ConclusionContraceptive uptake was high among postpartum women, who desired to procure contraceptives at health facilities. However, there was unmet need for contraceptives among women who desired no more children. Government health facility stock outs represent a missed opportunity to get family planning methods, especially long acting reversible contraceptives, to postpartum women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4510-6) contains supplementary material, which is available to authorized users.

Family planning knowledge, experiences and reproductive desires among women who had experienced a poor obstetric outcome in Lilongwe Malawi: a qualitative study

“…Just as in the general population of Malawi, we found that the majority of women in our study who were using a family planning method were using the DMPA injectable [ 5 ], while a few reported use of pills or condoms. This finding also corroborates with a study conducted in Kenya which showed that women preferred the DMPA injection method [ 19 ]. In contrast, our results revealed that women with no living child were not in favour of using longer-acting methods like DMPA and suggested that women with a poor obstetric outcome, particularly those with no living child should use very short-acting methods or no method at all.…”

The role of maternal health care services as predictors of time to modern contraceptive use after childbirth in Northwest Ethiopia: Application of the shared frailty survival analysis

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Utilization of Family Planning Contraceptives among Women inthe Coastal Area of South Buru District, Maluku, 2017

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