Trends in Inequalities in Use of Family Planning Among Women of Reproductive Age in Kenya

Abstract

This study focused on inequalities in use of family planning among women of reproductive age in Kenya with the main objective of the study being to assess the performance and thus the effectiveness of the national family planning programme. To assess the effectiveness of the FP programme, emphasis was placed on the extent the programme had narrowed down the inequalities gap by socioeconomic factors and by regions from the 2003 survey to the 2014 survey. This is a departure from the usual methods that place emphasis on averages of contraceptive prevalence levels and total fertility levels at the national level, to measure the effectiveness of the FP programme. The study used secondary data. The data were derived from three national surveys in Kenya conducted in the year 2003, the year 2008-09 and the year 2014. The survey captured information on background characteristics and health issues from a sample of women from the reproductive ages of 15 to 49 years. The attention of this study was on fecund women in Kenya. Methods of data analysis used were descriptive statistics, logistic regression and multilevel logistic regression. Bivariate analysis was used to test for associations between the dependent variable and independent variables through cross-tabulation and the Chi-square statistic. A logistic regression analysis was conducted to estimate the crude coverage gap with multilevel logistic regression being conducted to estimate the adjusted coverage gap by background factors among fecund women in Kenya. The technique was deployed to determine the extent of the inequality gap after controlling for confounding. This study established that the percentage of women using contraceptives significantly increased from the year 2003 to the 2014 survey. The most preferred contraceptive methods were the modern ones such as injections and pills with their sources being from government clinics or pharmacies and private clinics. Also, background characteristics at the individual, community and family planning programme level were seen to have a significant effect on modern contraceptive use by women. Results from the three surveys have confirmed that the direction of the national family planning programme's performance in increasing contraceptive use among women is positive-from 28 per cent in the 2003 survey, 30 per cent in 2008/09 survey and 39 per cent in 2014 survey. Background characteristics of a woman such as age, marital status, education, wealth index, employment status, region and place of residence were found to have a significant influence on use. Additionally, women who heard information on family planning through radio and television were more likely to use contraceptives compared to those who read newspapers/magazines. However, despite the improved use over time even by background characteristics, inequalities in use by socio-economic factors still exist in all the three surveys. Inequalities in modern contraceptive use were therefore found to be an important indicator to consider in assessing the performance and thus the effectiveness of the FP programme.