Women’s Autonomy and Contraceptive Use in Kenya: a Multilevel Analysis

Abstract

Background: Modern Contraceptive Prevalence Rate (mCPR) in Kenya has steadily increased from 39% in 2008-09 to 58% in 2014. Nonetheless, the modern contraceptive need of 18% of women aged 15 – 49 years is still unmet with marked geographical variations. It is documented that women’s status and ability independently decide on their reproductive health is influences their uptake of reproductive health services. However, previous studies on how contraceptive use in Kenya is influenced by women’s level of autonomy have not isolated the contextual effects emerging from the status of women in the community. The overall objective of was to scrutinize how women’s autonomy influences the use, discontinuation, and unmet need for modern FP among adolescents and women aged 15 – 49 years in Kenya. Methods: A pooled cross-sectional design using secondary dataset from KDHS 2014, 2008/9, and 2003 was used. KDHS use a two-stage sampling technique where clusters or primary sampling units (PSU) are sampled first then households identified from the clusters. Data was analyzed using Multilevel Logistic Regression Model. Results: The findings of this study show that modern contraceptive use, unmet need for modern FP and modern contraceptive discontinuation is not only influenced by women’s individual level factors including women’s level of education, level of decision-making autonomy, and household wealth status but also by cluster level factors like the region of residence, cluster level of women’s autonomy and socioeconomic development. Conclusion: In Kenya, while high women’s autonomy level is related to increased use of modern FP and decreased unmet need for modern FP, it is linked to increased rates of modern contraceptive discontinuation. RH Programmes must therefore not only focus on scaling up access to FP services, products, and information, but also put more emphasis on improving the individual and collective position of women in communities.