| dc.description.abstract | Despite the increasing contraceptive prevalence rate and declining fertility in Kenya,
there are still substantial levels of unmet need. Most researches on unmet need have been
based on data from women with modicum inferences made for men and couples.
However, reproductive decisions are not made by the women only, but are dyadic in
nature. This study uses the married couple as the unit of analysis, rather than the
individual man or woman.
The overall objective of the study was to analyse couples' unmet need in Kenya, with the
aim of gaining a fuller understanding of this undesirable phenomenon, and to recommend
strategies for policy makers and programme managers, based on the findings
Specifically, it aimed at estimating the level of unmet need, and to determine the
significant factors influencing unmet need for couples in Kenya.
A review of literature confirms the fact that most studies on unmet need are on women,
and use women's data. Even the current shift to the study of men's unmet need may not
be the panacea, but to analyse both husbands and wives jointly. The framework adopted
here is the one developed by Casterline and colleagues (1997), which documented such
factors as costs of contraception and motivational factors to be explaining unmet need for -ca
women. Background socio-economic, socio-cultural and demographic factors are
introduced in the model.
This study used the matched couple recode data of the 1998 KDHS, which consisted of
1170 monogamous couples. On dropping the pregnant and the amenorrheic, the sample
reduced further to 641, on which my analysis was based. The methods of data analysis
included simple frequency distribution, cross-tabulation with chi-square tests statistic,
and multivariate logistic regression.
Results reveal that most couples in the sample were from Rift Valley, rural, protestant,
KikuyulMerulEmbu, had 3-5 children, had primary level of education, approve of Family
Planning, and discuss FP with their partners. Highest levels of unmet need for spacing
were exhibited by couples from Western province, rural, no-education,
Mijikenda/Swahili, below 250f age, and had 0-2 children. As for limiting, those with the
highest levels were from Rift Valley, rural primary education (husband) no education
(wife), Kalenjin, 35 and above age group, protestant, and had 6 or more children. The
level of couples unmet need was found to be 16.5 percent, which is 7.5 percent lower
than the level of unmet need for currently maried women and 3.7 percent higher than the
Bankole-Ezeh estimate of couples' unmet need, using 1993 KDHS.
Results from Regression analysis show that intermediate variables, except discussion of
FP are not significant in explaining couples' unmet need on their own. Even when put in
the same model with background factors, only discussion of FP still emerges significant.
All background variables save for husband's and wife's age, husband's education,
religion and place of residence were significant in explaining couples unmet need, with
region and number of living children being significant at 99 percent level of confidence.
ethnicity, wife's level of education, and husband's discussion of FP with wife were
significant at 95 percent, while wife's were significant at 95 percent, while wife's
discussion ofFP with husband was significant at 90 percent level of confidence.
The conclusion of this study is that couple approach to unmet need reduces the level
substantially, because of the inclusion of the husbands' variables. Secondly, that some
background factors affect couples' unmet need while others do not. Region and number
of living children are the most significant background factors affecting couples' unmet
need. Couples' discussion proves to be important in determining couples' unmet need,
since the use or non-use of contraceptives, coupled with the desire for more children is
subject to the agreement between spouses. Except education, other variables found to be
significant were for both husbands and wives, confirming the fact that both partners are
important for the reduction of the level of unmet need
The recommendation based on the findings of this study are that policy makers and
programme managers should emphasize on the programmes that are region-specific,
given the fact that region of residence was found to influence couples' unmet need most
significantly. Furthermore, programmes that encourage couple discussion through lEC
can prove efficacious since they can result in removal of some of the obstacles to
contraceptive use such as husband's opposition. For research, the study recommends
further research on the couple approach to unmet need, especially the comparative study
between the determinants of men's. and the women's unmet need. More studies are
needed on the subject of couple discussion of FP as well. | en |
