Understanding the Link Between Reproductive Coercion and Covert Use of Contraception as a Safety Strategy for Women Experiencing Violence in Nairobi's Urban Informal Settlements

Author:

Wood Shannon N.1ORCID,Kennedy S. Rachel2,Akumu Irene3,Tallam Catherine3,Asira Ben3,Zimmerman Linnea A.1,Glass Nancy245,Decker Michele R.126ORCID

Affiliation:

1. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

2. Johns Hopkins School of Nursing, Baltimore, MD, USA

3. Mashinani Department, Ujamaa-Africa, Nairobi, Kenya

4. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

5. Center for Global Health, Johns Hopkins University, Baltimore, MD, USA

6. Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Abstract

This mixed-methods study examined the relationship between reproductive coercion (RC) and covert contraceptive use among intimate partner violence survivors in Nairobi, Kenya. Quantitative analyses utilize baseline data from the myPlan Kenya trial ( n = 321). Purposive in-depth interviews (IDIs) ( n = 30) explored women's reproductive safety strategies. Multinomial analyses indicated increased covert use and decreased overt use compared to nonuse, for women experiencing RC; logistic models similarly report increased odds of covert use with RC experience. Qualitative data contextualize women's reasons for use and challenges faced. Integration of reproductive safety strategies into family planning and violence services can improve the safe use of contraception.

Funder

Ideas42

Publisher

SAGE Publications

Subject

Law,Sociology and Political Science,Gender Studies

Reference50 articles.

1. African Population and Health Research Center (APHRC). (2014). Population and health dynamics in Nairobi’s informal settlements: Report of the Nairobi cross-sectional slums survey (NCSS) 2012. https://aphrc.org/publication/population-and-health-dynamics-in-nairobis-informal-settlements-report-of-the-nairobi-crosssectional-slums-survey-ncss-2012-2/

2. Committee Opinion No. 554

3. Covert Contraceptive Use: Prevalence, Motivations, and Consequences

4. The Effect of Power in Sexual Relationships on Sexual and Reproductive Health: An Examination of the Evidence

5. Women’s and girls’ experiences of reproductive coercion and opportunities for intervention in family planning clinics in Nairobi, Kenya: a qualitative study

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