Unmet need for contraception among men In Kenya: evidence from KDHS 1998
Abstract
The standard measure of unmet need for FP services focuses on married women and captures
the apparent discrepancy between the women's fertility preferences and their contraceptive
behaviour. Very few attempts have been made to define unmet need for men despite the
growing support for increased participation of men in reproductive health (RH). As such, there
is no generally agreed upon measure of men's unmet need for contraception, and where
attempts have been made to define unmet need for men, no attempts have been made to study
the determinants of such need.
The present study aimed at analyzing unmet need for contraception among married men in
Kenya using data from the 1998 KDHS. It specifically aimed at estimating the magnitude of
such need using the measure that had been applied to the previous two surveys of 1989 and
1993. It also aimed at investigating the relationship between men's unmet need for
contraception and the proximate determinants of the need as well as the nature of such
relationship if men's background characteristics were controlled for.
The current status model that helps to determine unmet need from the respondents'
contraceptive behaviour and fertility preferences at the time of the survey was used to determine
the magnitude of unmet need for contraception among men. Cross-tabulation with Chi-square
was used to analyze the relationship between unmet need and each of the independent and
intermediate factors considered in this study. Multivariate logistic regression analysis was used
to analyze the determinants of unmet need for contraception among married men.
According to the estimates from the 1998 KDHS, the level of men's UlU11etneed for
contraception stood at 23.3 percent. This represents a decrease of only 0.02 percentage points
v
from the 1993 estimates of23.5 percent and a decrease of8.8 percentage points from the 1989
estimates of 32.1 percent made by Ngom (1997). All the independent factors i.e. age, education
level, place of residence, region, ethnicity, religion and number of living children have
significant associations with unmet need for contraception among men. None of the
intermediate factors i.e. number of methods known spontaneously, discussion of FP with
partner, and respondents' approval ofFP has significant association with men's unmet need.
Results of multivariate analysis show that the proximate determinants alone fail to account for
significant explanations of the variations in men's unmet need for contraception. When the
background factors are controlled for, number of methods known spontaneously and discussion
of FP with partner turn out to be significant. Among the background factors, age, number of
living children and ethnicity emerge as the most powerful determinants of unmet need for
contraception among men.
For policy concerns, the study recommends programmes aimed at promoting spousal
communication and increasing male involvement in RH including encouragement to turn the
near universal knowledge of and favourable attitude toward contraception into practice. The
slow pace of the decline in men's unmet need between 1993 and 1998 compared to between
1989 and 1993 should also form the basis of programme focus. For further research, the study
recommends the need to formulate a standard measure of men's unmet need, to extend such a
measure to the sexually active unmarried men, and the need to develop appropriate indicators
for the proximate determinants of the need. It also recommends the need for the use of
qualitative research techniques, especially for findings which do not conform to expectations or
are not consistent with findings for women in other studies.
Sponsorhip
The University of NairobiPublisher
population studies and research Institute