Determinants Of Contraceptive Use And Fertilty Preference Among Women Ofreproductive Age In Kakamega County, Kenya

ABSTRACT

This cross-sectional study was conducted to find out the determinants of contraceptive use and fertility preference among women of reproductive age in Kakamega County, Kenya. The study utilized a descriptive survey design comprising quantitative and qualitative approaches. The target population was 444,350 women in the childbearing age in Kakamega County. To obtain the sample population size, the formula for finite population was used. The sample size consisted of 384 women in the reproductive age. A structured questionnaire, a focus group discussion guide and an interview schedule were used as research tools. The data was analyzed using descriptive and inferential statistics. Descriptive statistics included frequency distribution tables, means and percentages while inferential statistics comprised correlations, Chi-square and the ANOVA test. The KDHS (2014)report shows that the fertility in Kakamega County was high at 5 per woman in spite of a decline at the national level from , 4.6 to 3.9 from 2008 to 2014 respectively. Kenya has experienced relatively high incidences of mistimed (26%) and unwanted (17%) pregnancies among all women of childbearing age, with young women (15-24 years) recording higher mistimed (32% versus 30%) and unwanted (15% versus 10%) pregnancies compared to women in other age groups. Annually, about 13,000 Kenyan girls drop out of school due to accidental pregnancies and 103 out of every 1000 births in Kenya are delivered to girls aged (15-19) (NCPD & UNFPA, 2013). This study, therefore, sought to find out the determinants of contraceptives and fertility preference in Kakamega County that contribute to high fertility. Low utilization of contraceptives has been generally associated with unwanted and mistimed pregnancies resulting to high parity. This has impacted negatively on the socioeconomic development of the county. The study’s general objective was to identify the determinants of contraceptive use and desired family size amongst women of reproductive age in Kakamega County, Kenya. The specific objectives were threefold: to identify levels and determinants of contraceptive use among women of reproductive age in Kakamega County, to determine the role of socio-cultural factors on fertility preference among women of child bearing age in Kakamega County; and to identify the role of demographic factors in determining fertility preference among women of childbearing age in Kakamega County. The results showed that increase in family planning use corresponds with the desire to have fewer children while the desire to have an increased number of children is influenced by low use of family planning. The advancement in education level and increase in age at first marriage showed a reduction in the desire to have many of children. Women residing in urban areas were found to have fewer children than their counterparts in rural areas. Further, women with low income were found to have more children compared to those who had high income. The study also found out that the perceived mean number of children translates to long fertility duration as adolescence start giving birth at an early age hence; age factor and sexual behavior were established to be predictors of fertility preferences. The study recommends that the government develops good plans and policies to encourage maximum utilization and access to health care services for effective implementation of family planning use to all women particularly those in rural areas, in an equitable, indiscriminate and socially sensitive way. The government also needs to adequately train and facilitate community health workers to enable them take reproductive information and supplies directly to peoples’ homes. Further, efforts to increase girls’ education must address the problem of pregnancies among young girls aged 18 years and below so that they do not become mothers before adulthood. To lower school drop-outs among girls, the Ministry of Education Science and Technology ought to work closely with stakeholders in ensuring that the back-to-school policy is being fully implemented to end early marriages.