Determinants of Contraceptive Use among Unmarried Young Women in Kakamega County, Kenya

Abstract

Adolescent pregnancies adversely impact mental and reproductive health as well as educational and socio-economic outcomes. In Kakamega County, Kenya, 20% of adolescents begin childbearing by age 19. To inform interventions to reduce adolescent pregnancy, Jhpiego used the Barrier Analysis methodology, which is based on the Doer/Non-Doer study model, in which participants are categorized according to whether they are “Doers” or “Non-Doers” of the study behavior. This study examines the determinants of the behavior, “young unmarried women currently use modern contraceptive methods”. Participants included young women aged 15–19 who were sexually active, unmarried, and were using (“Doers”) or not using (“Non-Doers”) modern contraception. The findings reveal that the majority of Doers (88%) and Non-Doers (80%) understand the pregnancy risk associated with non-use, and there is no statistically significant difference between Doers’ and Non-Doers’ understanding of contraceptive benefits. Knowledge of side effects and misconceptions, such as the belief that contraception causes infertility, does not deter Doers from using contraception. Seventy percent of Doers note that contraception is accessible/available, while 39% of Non-Doers state the opposite. Doers are almost three times more likely than Non-Doers to say that most people approve of their contraceptive use, while Non-Doers are twice as likely as Doers to say that most people would not approve. Doers are four times more likely to indicate approval from their mothers and boyfriends. Non-Doers are five times more likely than Doers to have specific professional goals for the future. These findings illustrate the importance of moving away from fear-based messaging and instead highlighting social acceptability and contraception’s role in achieving future goals.