Factors that affect uptake of contraceptives at Garissa provincial hospital in Kenya
Background: Family planning is one of the great public health achievements of the 20th century. Worldwide acceptance has risen to three-fifths of exposed couples. In many countries however, uptake of modern contraception is constrained by limited access and weak service delivery and the burden of unintended pregnancy is still large. Family planning is achieved through use of contraceptive methods and treatment of involuntary infertility. Objective: To determine factors that affect uptake of contraceptives by mothers attending Maternal Child Health clinic at Garissa Provincial Hospital. Methods: A hospital based cross sectional design was used. Two hundred and ten mothers were conveniently selected and interviewed using a structured questionnaire. Data analysis: Data was analyzed using statistical package of social sciences version 21, whereby descriptive analysis were determined and p value were used to determine statistical significance of the association between independent variables and contraceptive use determined at 0.05 level of significance. Qualitative data was analyzed using thematic content analysis. Results: The uptake of contraceptives by women attending Maternal Child Health clinic at Garissa Provincial Hospital was found to be 49% in comparison with the national average which was 58%. The factors that were associated with contraceptives uptake were level of education, place of origin, partner support and comprehensive contraceptive counseling all statistically significant (p value<0.0001). Barriers to contraceptive uptake included culture, religion, distance to the hospital and failure to offer contraceptive counseling during pregnancy and discharge from maternity. Other barriers were lack of involvement of clinicians and pharmacists in family planning and contraceptives. Conclusion: Contraceptive use is low in the study area compared to the current national average. Culture, lack of formal education, low empowerment of women, distance to the hospital and lack of multidisciplinary approach to contraceptive use counseling specifically low involvement by Pharmacist and clinicians were among the identified factors behind the low level of use. Recommendations for policy and practice: The County Government to Incorporate mobile clinics offering family planning services among other Maternal Child Health services as part of the counties family planning services outreaches and to decongest Garissa Provincial Hospital, a multidisciplinary approach on FP service provision to include clinicians and pharmacist should be encouraged to improve uptake of FP, community outreaches to raise awareness of contraceptives targeting both men and women and clinical Pharmacist to come up with standard operating procedures for contraceptive services. Recommendation for further studies A study on perception of the local men and religious leaders on family planning matters will give more insight into some of the reasons behind their opposition to contraception.