Determinants of family planning pratice among Ethiopian women refugees living in Kakuma camp, Kenya

Abstract

Family planning promotion is a unique intervention because of its potential benefits which include reduction of poverty, maternal and child mortality. Access to family planning methods is increasing from time to time. However, unwanted and unplanned pregnancy is still a worldwide problem accounting for 30% of total pregnancies (Choge, 2013). Evidence shows that most of the refugee women live in developing countries which are among the worst in maternal mortality rates y (Krause et al, 2000). The main objective of this study was to establish determinants of contraceptive use among Ethiopian women refugees living in Kakuma camp. This research used a descriptive crosssectional study design to examine factors affecting FP practice of Ethiopian refugee women residing in Kakuma camp who are in reproductive age (15-49 years). Results of the study revealed that although most of the respondents had knowledge on family planning, two-thirds (66.8%) indicated that they were not using any form of contraceptive. The study also found that 56.2% of the respondents have not discussed about contraceptives with their spouses. The study further indicated that 49.9% of the respondents’ use of contraceptives decisions was made by their husbands. The chi-square test showed that current use of family planning is associated with age, marital status, number of children ever born, current place of residence and fear of side effects (p value < 0.05). The study showed that education greatly influences family planning practices among the Ethiopian women refugees living in Kakuma refugee camp. While only one in every four uneducated women used contraceptives, two in every three women with university education use contraceptives. The study revealed that family planning methods availability in general and availability of the needed methods in particular at the refugee camp health facility were associated with current use of contraception (p< 0.05). This shows that wide range of contraceptive choices and continuous availability of methods enhances high usage of contraceptives. The study also indicated that women who discussed about family planning with their spouses are more likely to use contraceptives than who did not discuss (46.6% vs 25.9%) and higher contraceptive prevalence (53.1%) is observed among women whose husband’s approve family planning as opposed to those who do not approve (24.0%). Thus, there is a significant association between these two proximate determinants. The study concludes a positive correlation between knowledge, attitude, access and use of contraceptives. This research also identified the gaps and determinants of family planning use among Ethiopian women refugees and came up with appropriate recommendations. It is recommended that health institutions working in Kakuma refugee camp should have a wide range of contraceptive choices and stocks/supplies to meet the FP needs of the refugees on a continuous basis. For the success of FP programs, male involvement is critical as they play an important role in the decision making process and use of contraceptives. Hence, programs targeting men in general and husbands and partners in particular need to be developed and implemented by Kakuma camp. Finally, the study recommended that a comparative study be conducted among refugees of different nationalities in Kakuma camp to come up with a comprehensive strategy to improve FP use among refugees.