BARRIERS TO UPTAKE OF FAMILY PLANNING SERVICES AMONG WOMEN OF REPRODUCTIVE AGE (18-45 YEARS) IN MFANGANO ISLAND, HOMABAY COUNTY, KENYA

Abstract

Family Planning (FP) is voluntary prevention of pregnancy and it entails the interruption of a chain of events that leads to conception. Family planning is important because it helps reduce the Total Fertility Rate (TFR), maternal deaths and morbidity as well as improving the health of the child. In Kenya, only 58 % of women of reproductive age currently use family planning services, the uptake is even lower in Homabay County (56.4 %). The study explored the potential barriers to utilization of family planning services among women of reproductive ages (18-45 years) in Mfangano Island, Homabay County, Kenya. A facility based cross-sectional study was conducted from January 2 to February 28, 2015 among women aged 18-45 years in Mfangano Island Homabay County. Simple random sampling technique was used to select five (5) health facilities out of the seven (7). The participants were selected through convenience sampling whereby a total of 396 participants were recruited from those who came to seek care in the facility and met the inclusion criteria. A pre-tested questionnaire was used for data collection. Barriers to uptake of FP were identified using logistic regression analysis. Of the total sample of (396 participants) 183 (46 %) were using family planning methods. Knowledge level on the methods of family planning was high, with 87.3 % of the participants reporting knowledge of at least three methods. The study examined the challenges the clients experienced in seeking family planning services in the clinics. Results show that participants were not satisfied with the information offered by health care providers on FP. Clinics were closed on some days and sometimes the FP methods were out of stock for at least three months. In the multivariable regression model, secondary education level Adjusted Odds Ratio (AOR) 4.72 (95% CI 2.70 to 8.26) and above secondary education level (AOR 14.45 (95% CI 5.18 to 40.29) were associated vi with higher odds of FP uptake compared to primary or no education. Being unemployed (AOR 0.36 (95% CI 0.20 to 0.64) and having at least eight children (AOR 0.23 (95% CI 0.06 to 0.84) were associated with lower odds of FP uptake after the adjustment. Utilization of family planning services in Mfangano Island, Homabay County was lower (46%) compared to the national average of 58%. Although knowledge level on the methods of family planning was high, the uptake of family planning services was reported to be low. Lack of spousal consent was the main barrier hence, Program planners should put strategies geared towards education and involvement of men on family planning. Further longitudinal studies on uptake of family planning should be carried out to enhance generalizability of the