Abstract:
Unmet need for modern family planning methods is an important health issue for women. The purpose of this study was to determine factors associated with utilization of family planning among women aged 15-49 years in Mandera County. This cross-sectional study enrolled 117 eligible women from April 2015 to September 2015. Data were collected using semi structured questionnaire; key informant interviews (KIIs) and focused group discussions (FGDs). Twelve (12) FDGs were conducted among women in health, leadership, education and religious sectors. Twelve (12) KIIs among influential and knowledgeable members of the county were also conducted to gather qualitative data. The FGDs and KIIs were conducted to confirm and clarify any pending or new issues described in the structured questionnaires. STATA version 13 was used for quantitative data analysis. The thematic content analysis was used to analyze qualitative data. The mean age of the respondent was 29.9 (SD± 9.8) years. 80% of these 117 women were aware of contraceptive and family planning methods mainly through family and friends (52.1%). Of the 41.9% who reported using family planning (FP) methods, 26.5% used condoms. In multivariate analysis, women who were from either the Northern (OR 4.3, 95% CI 1.1 to 18.2), Southern (OR 7.5, 95% CI 1.7 to 33.4) or Eastern of Mandera County (OR 4.7, 95% CI 1.1 to 20.8); had either secondary (OR 11.1, 95% CI 2.7 to 46.1) or tertiary (OR 11.9, 95% CI 2.6 to 55.9) level of education; were employed (OR 4.3, 95% CI 1.2 to 19.1); used either condoms (OR 5.7, 95% CI 1.3 to 24.5) or hormonal family planning methods (OR 5.8, 95% CI 1.4 to 25.2) were independently associated with utilization of FP. The FGDs and KIIs confirmed the continuous increase in the level of utilization of FP. The thematic analyses of FGDs and KIIs identified location of origin, awareness, income, employment, religion and cultural practices as some of the factors limiting the utilization of FP. In conclusion, a high proportion of women from Mandera County an arid region in the North Eastern Kenya, were aware and embraced FP. Factors such socio-cultural, lack of education and awareness were major deterrent to utilization of FP in this region. Ultimately for the improvement in the proportion of women embracing FP in Kenya especially in the initially marginalized counties experiencing hardship (such as droughts) and insecurity; it is recommended that concerted efforts must be undertaken by the County and National government to promote and to tackle the socio-cultural deterrents of FP utilization. Further, improvement in the general awareness rate of FP among women at family level should be rolled out by the Mandera County Government in conjunction with the National Government. Should this be achieved, then this County could record one of the highest utilization rates of FP in Kenya.
