Assessing the magnitude of and factors associated to demand for long acting reversible and permanent contraceptive methods among sexually active women in Kenya

Abstract

AbstractIntroductionThough there has been an increase in use of long acting and permanent methods of contraception (LAPMs) globally over the last decade, the rates of unintended pregnancy still remain high. In Sub-Saharan African and especially in Kenya, while there has been increase in the uptake of LAPMs over the past years, there are limited recently available evidences on the real magnitude, recent trends and factors associated to demand for LAPMs among sexually active women in the reproductive age.MethodsIn this study, we used data from seven survey rounds (2014 to 2018) of a nationally representative Performance Monitoring and Accountability 2020 (PMA2020) household and female survey. PMA2020 survey is based on a multi-stage cluster sample design to draw a probability sample of households and eligible females. In this analysis, both descriptive and inferential statistics were used for data analysis and interpretations. Statistical significance was considered for p-values <0.05. STATA 16.0 software was used for all analyses.ResultsAmong the 17,455 sexually active women in the reproductive age included in this study, 83.1% had demand for LAPMs. The total demand for LAPMs significantly decreased from 85.0% in 2014 to 81.0% in 2018. Age of the respondents, marital status, parity, rural/urban residence, county of residence and access to Family Planning/contraceptives information via media in the last 12 months were significantly associated with demand for LAPMs.ConclusionThe total demand for LAPMs among sexually active women in Kenya is high, with the bigger share of the demand being unmet. Targeted programs to satisfy the existing demand of LAPMs and address the issue of unmet need for LAPMs should be put in place to ensure no woman is left behind. Similarly, programmers/advocates should utilize the locally available channels e.g. the media to generate new demand and overturn the decreasing demand for LAPMs.STRENGTHS AND LIMITATIONS OF THIS STUDYThe nationally representative Performance Monitoring and Accountability 2020 (PMA2020) surveys are modelled on the insight from Demographic and Health Survey (DHS).PMA2020 uses standardized questionnaires (with questions extracted from DHS which have been validated and are extensively used in FP programs) to gather data about households and individual females that are comparable across program countries and consistent with existing national surveys.There are strengths to the PMA2020 survey which include inclusion of a large sample of women, use of data collectors without medical training and real-time data collection with sufficient controls for quality assurance.There are some limitations to consider when interpreting the data. Some outputs of this study utilized pooled data from seven-rounds of PMA2020 survey.