Determinants of contraceptive non-use among Kenyan youth
The study set out to investigate determinants of contraceptive non-use among ever sexually active youth aged 15-20 years in Kenya. Specifically the study sought to determine the demographic, socioeconomic and cultural factors affecting non-use with or without an unmet need among youth in Kenya using data from the 1998 Kenya Demographic and Health Survey (KDHS). This analysis of non-users of family planning is based on KDHS data collected in 1998. A total of 3394 women aged 15-24 were interviewed in KDHS, 2148 of whom were sexually active (ever had sex), who were included in this study. The analysis focused particularly on youth aged 15-24 who were not using contraceptives at the time of the survey. The key program questions addressed in the analysis are who are the non-users of contraception among youth aged 15-24 in Kenya and what factors are associated with non-use of contraception among this group. Frequencies, cross tabulation with chi square and multivariate logistic regression were used to analyze the relationship between non-use and each of the independent and intermediate factors selected for this study. The study adopted the framework developed by Casterline, Perez and Biddlecom explaining unmet need for contraception. This framework was adopted and modified to explain non-use of contraception among youth in Kenya. The formulated hypotheses were tested using the dependent variable defined as non-use of contraception. Frequencies were first run to give the socio-demographic profile of the ever sexually active youth who were not using any family planning method at the time of the survey. Bivariate analysis was then done by use of cross tabulations and the Chi square to assess the strength of association between each of the explanatory variables and the dependent variable. Standard logistic regression was applied to assess the effect of factors, said in the study to be associated with contraceptive non-use. Logistic regression analysis was chosen because the dependent variable (contraceptive non-use) is dichotomous. Further more the use of a dichotomous dependent variable in logistic regression analysis refocuses the analysis from examining in general the determinants of contraceptive non-use to a detailed examining of determinants of contraceptive non-use versus use. Besides, the nature of the explanatory variables under study were categorical, calling for the application of logistic regression model. Results of the bivariate analysis show that youth who are married and those who live in rural areas comprise majority of non-users of contraception among youth in Kenya. The results further reveal that non-use of contraception among youth in Kenya varies according to education, age, place of residence, region of residence, ethnicity, marital status, exposure to mass media together with knowledge of family planning An insignificant association is however exhibited between religion and non-use of contraception. Bivariate results in this study also reveal a strong association between the intermediate variables, Knowledge on contraception source, attitude towards family planning and Interpersonal communication with non-use of family planning. Multivariate analysis of socio-economic, socio -cultural and demographic factors indicated that place and region of residence had a strong effect on contraceptive non-use among youth in Kenya. Multivariate analysis further indicated that attitude towards family planning, discussion about family planning and knowledge of source of contraception also had the strongest effect on contraceptive non-use among youth in Kenya. The findings of this study are useful for both policy and research. Measures to enhance contraceptive use among the married youth, those resident in the rural areas and those who have never used any contraception ought to encouraged by policy makers since this group is characterized by high levels 0: non-use. The study concluded that contraceptive non-use among the ever sexually active women aged 15-24 is very high in Kenya and that a big gap between knowledge of contraception and actual contraceptive use .The study thus suggests a comprehensive investigation into the barriers to contraceptive non-use among youth in Kenya in order to explain the large discrepancy between knowledge and use. This will be important to family planning policy makers if they have to specifically address these barriers to increase the level of use among this target population.