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Pattern and determinants of contraceptive usage among women of reproductive age from the Digo community residing in Kwale, Kenya : results from a cross-sectional household survey

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Abstract
Background: Contraceptive usage has been associated with improved maternal and child health (MCH) outcomes. Despite significant resources being allocated to programs, there has been sub-optimal uptake of contraception, especially in the developing world. It is important therefore, to granulate factors that determine uptake and utilization of contraceptive services so as to inform effective programming. Methods: Between March and December 2015, we conducted a cross-sectional survey among women of reproductive age (WRA) from the Digo community residing in Kwale County, Kenya. The study aimed to describe the pattern and determinants of contraceptive usage in this population. Respondents were selected using stratified, systematic sampling and completed a household sexual and reproductive health (SRH) questionnaire. Results: We interviewed 745 respondents from 15 villages in 2 out of 4 sub-counties of Kwale. Their median (interquartile range, IQR) age was 29 (23-37) years. 568 (76%) reported being currently in a marital union. Among these, 308 (54%) were using a contraceptive method. The total unmet need, unmet need for spacing and for limiting was 16%, 8% and 8%, respectively. Determinants of contraceptive usage were education [adjusted Odds Ratio, aOR = 2.1, 95% confidence interval, CI: 1.4-3.4, P = 0.001]; having children [aOR = 5.0, 95% CI: 1.7-15.0, P = 0.004]; having attended antenatal care (ANC) at last delivery [aOR = 4.0, 95% CI: 1.1-14.8, P = 0.04] as well as intention to stop or delay future birth [aOR = 6.7, 95% CI: 3.3-13.8, P < 0.0001]. Conclusions: We found high levels of contraceptive usage among WRA from the Digo community residing in Kwale. To further improve uptake and utilization of contraception in this setting, programs should address demand-side factors including ensuring female educational attainment as well as promotion of ANC and skilled birth attendance.
Keywords
SUB-SAHARAN AFRICA, COUNTRIES, CONTEXT, HEALTH, CARE, Contraception, Uptake, Utilization, Unmet need, Determinants, Demand-side, Kwale, Digo, Kenya

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Chicago
Mochache, Vernon, Amyn Lakhani, Hajara El-Busaidy, Marleen Temmerman, and Peter Gichangi. 2018. “Pattern and Determinants of Contraceptive Usage Among Women of Reproductive Age from the Digo Community Residing in Kwale, Kenya : Results from a Cross-sectional Household Survey.” Bmc Womens Health 18.
APA
Mochache, V., Lakhani, A., El-Busaidy, H., Temmerman, M., & Gichangi, P. (2018). Pattern and determinants of contraceptive usage among women of reproductive age from the Digo community residing in Kwale, Kenya : results from a cross-sectional household survey. BMC WOMENS HEALTH, 18.
Vancouver
1.
Mochache V, Lakhani A, El-Busaidy H, Temmerman M, Gichangi P. Pattern and determinants of contraceptive usage among women of reproductive age from the Digo community residing in Kwale, Kenya : results from a cross-sectional household survey. BMC WOMENS HEALTH. 2018;18.
MLA
Mochache, Vernon, Amyn Lakhani, Hajara El-Busaidy, et al. “Pattern and Determinants of Contraceptive Usage Among Women of Reproductive Age from the Digo Community Residing in Kwale, Kenya : Results from a Cross-sectional Household Survey.” BMC WOMENS HEALTH 18 (2018): n. pag. Print.
@article{8550535,
  abstract     = {Background: Contraceptive usage has been associated with improved maternal and child health (MCH) outcomes. Despite significant resources being allocated to programs, there has been sub-optimal uptake of contraception, especially in the developing world. It is important therefore, to granulate factors that determine uptake and utilization of contraceptive services so as to inform effective programming. 
Methods: Between March and December 2015, we conducted a cross-sectional survey among women of reproductive age (WRA) from the Digo community residing in Kwale County, Kenya. The study aimed to describe the pattern and determinants of contraceptive usage in this population. Respondents were selected using stratified, systematic sampling and completed a household sexual and reproductive health (SRH) questionnaire. 
Results: We interviewed 745 respondents from 15 villages in 2 out of 4 sub-counties of Kwale. Their median (interquartile range, IQR) age was 29 (23-37) years. 568 (76\%) reported being currently in a marital union. Among these, 308 (54\%) were using a contraceptive method. The total unmet need, unmet need for spacing and for limiting was 16\%, 8\% and 8\%, respectively. Determinants of contraceptive usage were education [adjusted Odds Ratio, aOR = 2.1, 95\% confidence interval, CI: 1.4-3.4, P = 0.001]; having children [aOR = 5.0, 95\% CI: 1.7-15.0, P = 0.004]; having attended antenatal care (ANC) at last delivery [aOR = 4.0, 95\% CI: 1.1-14.8, P = 0.04] as well as intention to stop or delay future birth [aOR = 6.7, 95\% CI: 3.3-13.8, P {\textlangle} 0.0001]. 
Conclusions: We found high levels of contraceptive usage among WRA from the Digo community residing in Kwale. To further improve uptake and utilization of contraception in this setting, programs should address demand-side factors including ensuring female educational attainment as well as promotion of ANC and skilled birth attendance.},
  articleno    = {10},
  author       = {Mochache, Vernon and Lakhani, Amyn and El-Busaidy, Hajara and Temmerman, Marleen and Gichangi, Peter},
  issn         = {1472-6874},
  journal      = {BMC WOMENS HEALTH},
  keyword      = {SUB-SAHARAN AFRICA,COUNTRIES,CONTEXT,HEALTH,CARE,Contraception,Uptake,Utilization,Unmet need,Determinants,Demand-side,Kwale,Digo,Kenya},
  language     = {eng},
  pages        = {11},
  title        = {Pattern and determinants of contraceptive usage among women of reproductive age from the Digo community residing in Kwale, Kenya : results from a cross-sectional household survey},
  url          = {http://dx.doi.org/10.1186/s12905-017-0497-5},
  volume       = {18},
  year         = {2018},
}

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