Factors Associated with Choice of Long Acting Contraceptive Methods among Women of Reproductive Age in Bungoma East Sub-County

Abstract

Background: In Kenya, the utilization of long acting contraceptive methods remains low, more so in the rural population. This study assessed the factors associated with the choice of long acting contraceptive methods among women of reproductive age in a rural population in western Kenya. Objective: To describe the factors associated with choice of long term contraception among women of reproductive age in a rural Health and Demographic Surveillance System’s population in western Kenya. Design and methodology: A cross-sectional community based study was conducted between March and August 2013. Computer generated random sampling was used to select 500 participants for the survey. An interviewer -administered questionnaire was used for quantitative data collection. A community baraza and four focus group discussions were conducted to collect qualitative data. Descriptive statistics were used to summarize data. Chi2 test was used for association between categorical variables. P-values of less than 0.05 were considered significant. Qualitative data were presented in verbatim in triangulation with the quantitative data. Results: A total of 490 women successfully participated in the survey (response rate 98%). The mean age of the respondents was 31 years with a standard deviation of 9.01. Majority were married (76%), Christians (99.6%) and had attained primary level of formal education. The total fertility rate was 4.6 children per woman. The awareness of contraception was 90% with 57% unplanned fertility. Awareness of long acting contraceptive methods was 64% with 28% currently using long acting contraception. 19%, 9%, 1% were currently using implants, sterilization and IUD respectively. Factors associated with choice of long term contraceptive methods were found to be awareness of implants (AOR 0.42 , 95% CI 0.21 – 0.83, P value 0.013) and current reproductive goal of permanent limitation (AOR 3.10, 95% CI 1.35 – 6.69, P value 0.007). Emerging themes included lack of awareness, fear of procedures, number and gender of living children, side effects and myths. Study Limitations: Supply factors and spousal involvement in choice of long acting contraceptive methods were not studied. Conclusions and recommendations: Use of long term methods of contraception was low in relation to short term methods. There was significant association between awareness of implants, the current reproductive goal to family size with their choice by the respondents. We recommend formulation of targeted community oriented health education policies to increase awareness of long term methods and to conduct further research to describe the role of male partners in the choice of long term contraceptive methods.