Perceptions and Barriers to Contraceptive Use among Adolescents Aged 15 - 19 Years in Kenya: A Case Study of Nairobi

Abstract

Even after the launch of family planning program in Kenya, in 1967, contraceptive use among adolescents has remained below 10 percent while child bearing has increased from 2 percent at age 15 to 36 percent at age 19. To understand the roles of perceptions and barriers on contraceptive use, a mixed method study design was applied to a conceptual framework that operationalized these concepts using data from different sources of social interactions in Nairobi, Kenya. Quantitative data were collected from 1119 adolescents aged 15 -19 years. Qualitative data were collected from adolescents, adolescents' parents and their school teachers. The later were analyzed and interpreted together with the results from cross-tabulations and logistic regression in order to understand the roles of perceptions and barriers. Contraceptive use was found to be 8.6 percent among the adolescents. Overall, unfavourable perceptions among adolescents, parents and teachers seemed to have contributed to low contraceptive use. Unfavourable perceptions played greater role compared to barriers such as sexual partner communication, opinion on adolescents to use a contraceptives and ability to seek contraceptives. Qualitative data show that teachers and parents lack adequate information and skills to discuss sexuality issues. Linking data among adolescents, parents and teachers help to understand the roles of perceptions and barriers to contraceptive use in Kenya. The findings suggest capacity building of teachers and parents on accurate sexuality information for adolescents while services should be youth-friendly. KeywordsContraceptive Use, Perceptions and Barriers, Sexuality Information J. Kinaro et al. 86

Gender norms associated with adolescent sexual behaviours in Uganda

“…From the findings, the GEM scale seemed to work for CHC programme needs of depicting perceptions and attitudes among adolescents towards gender equitable norms. Our findings also support previous studies that demonstrate a link between HIV risks, teenage pregnancy risks and gender equitable norms (Kinaro ; Murigi et al . 2010; Pulerwitz and Barker ; Shattuck et al .…”

“…The unmet need for contraception is high among adolescent girls. In Kenya, 65 per cent of parents or guardians reportedly objected to contraceptive use by unmarried adolescents, and 68 per cent of the adolescents disapproved of contraceptive use by unmarried adolescents (Kinaro 2011). Childbearing beliefs indoctrinated among community members -such as "a man should have the final word about decisions in his home" -limit girls from using contraception if perceived as being bound to the will of her husband (Paek et al 2008).…”

Socio-Cultural Barriers Influencing Utilization of Sexual and Reproductive Health (SRH) Information and Services among Adolescents and Youth 10 - 24 Years in Pastoral Communities in Kenya

“…According to Hulton [9], socio-cultural factors influence how decisions are made and the confidence to use contraceptives and other RH services [10]. Both theoretical and empirical literatures show that the influence of family or com-munity on adolescent behavior represents the central ways in which parents influence healthy adolescent development [11] [12]. Undesired perceptions could be as a result of myths and misconceptions acquired through socialization and interactions in the community [12] [13].…”

“…Both theoretical and empirical literatures show that the influence of family or com-munity on adolescent behavior represents the central ways in which parents influence healthy adolescent development [11] [12]. Undesired perceptions could be as a result of myths and misconceptions acquired through socialization and interactions in the community [12] [13]. Evidence has shown that cultural values and beliefs of health care providers play a critical role in deciding whether or not to provide contraception to adolescents [13].…”

“…Women have been found to do very little to influence condom use by their partners to protect themselves from HIV due to the perception that condom use implied infidelity and they could not space or stop having children without their male partner's permission [19] [20]. Partner communication has also been found to be significant in contraceptive use among adolescents aged between 15 -19 years old [12]. Studies have also shown that programs that emphasized specific skills, such as partner communication on negotiation skills tended to increase utilization of SRH services than programs that stress general knowledge [11] [21].…”