Trends and Determinants of Contraceptive Method Choice in Kenya

Abstract

This paper uses data from the , 1993 and 1998 Surveys to examine trends and determinants of contraceptive method choice. The analysis, based on two-level multinomial regression models, shows that, across years, use of modern contraceptive methods, especially long-term methods is higher in the urban than rural areas, while the pattern is reversed for traditional methods. Use of barrier methods among unmarried women is steadily rising, but the levels remain disappointingly low, particularly in view of the HIV/AIDS epidemic in Kenya. One striking result from this analysis is the dramatic rise in the use of injectables. Of particular program relevance is the notably higher levels of injectables use among rural women, women whose partners disapprove of family planning, uneducated women and those less exposed to family planning media messages, compared to their counterparts with better service accessibility and family planning information exposure. There is substantial evidence from existing literature that broadening the choice of contraceptive methods increases overall contraceptive prevalence (Freedman and Berelson, 1976;Phillips et al., 1988; Ja in, 1989). The provision of a wide range of contraceptive methods increases the opportunity for individual couples to obtain a method that suits their needs. A recent study of contraceptive method choice in the developing countries confirmed that prevalenc e is highest in countries where access to a wide range of methods is uniformly high (Ross et al., 2001). SSRC Applications and Policy Working Paper A03/13Contraceptive choice is also a central element of quality of care in the provision of family planning services and an important dimension of women's reproductive rights (Bruce, 1990, Diaz et al., 1999. It is recommended that family planning programs offer a variety of safe, effective, acceptable and affordable contraceptive methods to help women prevent unwanted pregnancies and sexually transmitted diseases (STDs) and to help them achieve their childbearing goals. In addition, method-mix is a key determinant of the fertility impact of contraceptive practice; the use of more effective methods even by a smaller proportion of eligible

Barriers to the Use of Modern Contraceptives and Implications for Woman-Controlled Prevention of Sexually Transmitted Infections in Madagascar

“…Campaigns to promote woman-controlled modern contraceptive methods in the context of main partnerships, even methods that could be used covertly, cannot ignore the attitudes of male partners. The husband's opposition has been identified as an important barrier to contraceptive use in studies conducted in the Philippines (Casterline et al, 1997), Guatemala (de Barrios et al, 1997), India (Yinger et al, 1998), Egypt (El-Zanaty et al, 1999, Nepal (Stash, 1999), Pakistan (Casterline et al, 2001), Kenya (Magadi & Curtis, 2003), and Turkey (Mistik et al, 2003). Correspondingly, the husband's approval of contraception was positively associated with contraceptive use in Ghana (Oheneba-Sakyi & Takyi, 1997) and with good communication between the spouses in previous studies (Oni & McCarthy, 1991;Oheneba-Sakyi & Takyi, 1997).…”

Method‐Specific Attributes that Influence Choice of Future Contraception Among Married Women in Nairobi's Informal Settlements

“…2016); counseling, client provider interactions, and provider bias, including studies in Kenya (Kim et al. 1998); sociodemographic correlates of method‐choice, again including studies in Kenya and neighboring Tanzania (Magadi and Curtis 2003; Chen and Guilkey 2003); desired attributes of methods and acceptability (Snow et al. 1997; Keller 1979); the behavior and views of sexual partners and members of persons’ social network (Godley 2001; Kimuna and Adamchak 2001); and a very large number of publications on opinions and fears about specific methods among Kenyan women and, less commonly, among men (Kamau et al.…”

Multivariate Analysis of Household Decision Making, Contraceptive Use and Fertility Behaviour among Ever-Married Men in Nigeria

“…This is because until recently, male involvement in reproductive health matters remains very limited and as such, has not been seen relevant in fertility-related issues (Caldwell and Caldwell, 1987;Oyediran et al, 2002;Akindele and Adebimpe, 2013). Similarly, majority of studies carried out on factors associated with contraceptive use and childbearing have overlooked men's crucial role and decision (Kaida et al, 2005;Ditekemena et al, 2012;Streefland et al, 2013), thereby making the idea of fertility performance a woman's sole concern (Mahmood and Ringheim, 1996;Wortham, 2002;Magadi and Curtis, 2003). Additionally, because it is generally seen that it is the woman that bear children, many studies conducted in past and even recently were presented as if men and women have similar fertility desires but which is not true in most cases.…”