A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

Reproductive Health

Regien Biesma¹  Jelle Stekelenburg²  Mark Kabue³  Susan Ontiri⁴  Violet Naanyu⁵  Lilian Mutea⁶ 

[1] Department of Health Sciences, Global Health, University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands;Department of Health Sciences, Global Health, University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands;Department of Obstetrics and Gynecology, Leeuwarden Medical Centre, Leeuwarden, The Netherlands;Jhpiego Corporation, Johns Hopkins University Affiliate, Baltimore, MD, USA;Jhpiego Corporation, Johns Hopkins University Affiliate, Nairobi, Kenya;Department of Health Sciences, Global Health, University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands;School of Arts and Social Sciences, Moi University, Eldoret, Kenya;USAID Kenya and East Africa, Nairobi, Kenya;

关键词: Contraceptive discontinuation;    Contraceptive side effects;    Counseling;    Quality of care;    Kenya;    Unmet need for family planning;   

DOI  :  10.1186/s12978-021-01094-y

来源: Springer

【 摘 要 】

BackgroundAddressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives.MethodsQualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach.ResultsUse of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods.ConclusionThis study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

【 授权许可】

CC BY