Knowledge and utilization of contraceptives by women with mental illness attending psychiatric outpatient services at Mathari National Teaching and Referral Hospital

Abstract

Background Reproductive health is a basic human right enshrined in the Kenya constitution 2010.All women should be able to make informed reproductive health choices in order to attain safe motherhood. This requires family planning, for which contraception is essential. Women with psychiatric illness have reproductive health needs and psychiatrists should be able to offer them as necessary, inclusive of contraception .This is because reproduction has greater risks in patients with mental health problems than in the general population. Aims This study aimed to establish knowledge and utilization of contraceptives among women with psychiatric diagnosis attending MNTRH outpatient services. Other associated factors assessed were contraceptive counseling, place of sourcing, awareness of their side effects and what to do in case they occured. Methods The study was descriptive cross sectional and involved 306 women attending Mathari psychiatric outpatient services, systematically sampled. A face to face interview took place with each patient after they signed an informed consent. Data collection instruments were a researcher designed social demographic and the woman questionnaires from Kenya demographic health survey (KDHS).Mini International Neuropsychiatric Interview Plus {MINI PLUS} questionnaire was used to establish patient diagnosis. Data Analysis Data was analysed using SPSS version 21. The standard MINI PLUS guide was used to establish psychiatric diagnosis. Chi square or analysis of variance (ANOVA) were used to determine association where the predictor variable was categorical or continous respectively. Results are presented in tables and text narratives Results Knowledge of contraceptives was high with 99% of respondents knowing atleast one method. Modern methods were more known than tradition ones. Factors that influenced knowledge of contraception were high education (OR 1.39, CI 1.02 – 1.90, p < 0.04), counseling by a x clinician (OR 2.69, CI 1.52 – 7.22, p< 0.029) and if lack of employment was not due to illness (OR 3.331, CI 1.11 – 6.57, p< 0.003). Current contraceptive utilization was 42.2% while previous was 53.6%. There was greater utilization of modern methods than tradition one’s. Factors associated with current utilization were counseling by a clinician (OR 4.69, CI 1.11 – 6.51, p< 0.0001) and employement (OR 1.60, CI 1.14 – 2.24, p<0.007). Conclusion Contraceptive counseling by clinicians increases both knowledge and utilization of methods. Counseling should be enhanced among those with poor education and the unemployed, especially due to illness.