Knowledge, utilization and barriers to family planning services among women of reproductive Age in Obunga informal settlement, Kisumu county, Kenya

Abstract

In Kenya knowledge of Family Planning (FP) is universal at 95% but this is not translating to utilization in Obunga slums. The rapid increase of population has got adverse effects on the economy as poverty levels are high at poverty incidence of 74% compared to 63% in Nyalenda A and B and 53% in Manyatta. Despite various strategies put by the government, in Obunga, unmet need is at 32% and Total Fertility Rate at 7%, the unplanned and unwanted pregnancies at 50% and 75% respectively. Every year about 156 girls in Obunga drop out of school due to accidental pregnancies, maternal deaths per 100,000 live births is 45. Knowledge, barriers and utilization of FP services is uncertain among women of reproductive age in Obunga. The objectives of this study were to find out the knowledge women of reproductive age have about FP methods, identify the barriers to use of FP methods and services, determine the utilization of FP and the association between socio-demographic characteristic and FP knowledge and utilization by women of reproductive age in Obunga slums. A cross-sectional study design and proportionate stratified random sampling was used to reach 352 study participants. Data was collected using questionnaires through direct interviews. Chi-square test was used to test the association between independent variables (socio-demographic variables) and the dependent variables (Knowledge and utilization of contraceptives). Findings showed that knowledge of FPS was (87.1%) among women of reproductive age with injections (80.6%) and Norplant (71.4%) mentioned FP method. Side effects (23.1%) and husband’s approval (15.4%) of family planning was a major barrier to FP use. Norplant (16.9%), injectable (18.6%) and oral pills (11.1%) were the most method used and approximately 63.1% of the respondents agreed to have discontinued FP. There was statistical significance between education level and knowledge on FP among women of reproductive age in Obunga as respondents who completed tertiary education were more likely OR= 1.91, 95% CI [0.27-2.95], p≤0.0461) to have knowledge on FP than those who did not complete primary and secondary education OR=2.27, 95% CI [0.94-5.48], p=0.86. There was statistical significance between age at first birth and utilization of contraceptives among women of reproductive age in Obunga as respondents who reported their first birth at ages 26-33 years were more likely OR=1.81, 95% CI [1.07-3.07], p=0.0270 to use contraceptives. The significance of this study is that if women have knowledge on FP and the barriers are adequately addressed, there will be consistency in use of FP and when there is utilization of FP in Obunga, women will be able to plan their families, provide proper education to the children, reduce the high incidence of abortion, unwanted and unplanned pregnancies which will in turn help reduce maternal mortality in Obunga.