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Published in: BMC Women's Health 1/2019

Open Access 01-12-2019 | Fertility | Research article

Fertility intentions and the adoption of long-acting and permanent contraception (LAPM) among women: evidence from Western Kenya

Authors: Joshua Amo-Adjei, Michael Mutua, Carol Mukiira, Namuunda Mutombo, Sherine Athero, Alex Ezeh, Chimaraoke Izugbara

Published in: BMC Women's Health | Issue 1/2019

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Abstract

Background

The use of long-acting and permanent method (LAPM) for family planning (FP) is of importance to the FP movement. A better understanding of how fertility-related intentions shape the usage of LAPM is important for programming. This paper explored the interaction of fertility intentions with LAPM use in rural western Kenya.

Methods

We draw on monitoring data from 28,515 women aged 15–49 years who received FP services between 2013 and 2015 as part of a community-based FP project. We assessed the association between the use of LAPM and fertility intentions, adjusting for age, parity, education, service delivery model, FP counseling and year of data collection.

Results

Of the 28,515 women who accessed FP services during the period (2013–2015), about two-thirds (57%) reported using LAPM, much higher than the national rates, and around 46% wanted another child within or after two years. In a multivariable regression model, women who desired no more children tended to use LAPM more than those wanting a child within or after some years as well as those uncertain about their future intentions.

Conclusion

The significant rates of utilization of LAPM between both women who desired no more children and the fair proportion of use among women spacing births underscore the benefits of sustained community level interventions that address both the demand and supply barriers of contraceptive adoption and use.
Literature
1.
go back to reference Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya National Bureau of Statistics (KNBS). Calverton: ICF Macro; 2015. Co-published by KNBS, 2015 Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya National Bureau of Statistics (KNBS). Calverton: ICF Macro; 2015. Co-published by KNBS, 2015
2.
go back to reference National Coordinating Agency for Population and Development (NCAPD), Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya Service Provision Assessment Survey 2010. Nairobi, Kenya 2011. National Coordinating Agency for Population and Development (NCAPD), Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya Service Provision Assessment Survey 2010. Nairobi, Kenya 2011.
3.
go back to reference Fabic MS, Choi Y, Bongaarts J, Darroch JE, Ross JA, Stover J, et al. Meeting demand for family planning within a generation: the post-2015 agenda. Lancet. 2015;385(9981):1928.CrossRef Fabic MS, Choi Y, Bongaarts J, Darroch JE, Ross JA, Stover J, et al. Meeting demand for family planning within a generation: the post-2015 agenda. Lancet. 2015;385(9981):1928.CrossRef
7.
go back to reference Ochako R, Mbondo M, Aloo S, Kaimenyi S, Thompson R, Temmerman M, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15(1):118.CrossRef Ochako R, Mbondo M, Aloo S, Kaimenyi S, Thompson R, Temmerman M, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15(1):118.CrossRef
8.
go back to reference Tumlinson K, Pence BW, Curtis SL, Marshall SW, Speizer IS. Quality of care and contraceptive use in urban Kenya. Int Perspect Sex Reprod Health. 2015;41(2):69.CrossRef Tumlinson K, Pence BW, Curtis SL, Marshall SW, Speizer IS. Quality of care and contraceptive use in urban Kenya. Int Perspect Sex Reprod Health. 2015;41(2):69.CrossRef
9.
go back to reference Finer LB, Jerman J, Kavanaugh ML. Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertil Steril. 2012;98(4):893–7.CrossRef Finer LB, Jerman J, Kavanaugh ML. Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertil Steril. 2012;98(4):893–7.CrossRef
10.
go back to reference Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception. 2007;76(4):267–72.CrossRef Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception. 2007;76(4):267–72.CrossRef
11.
go back to reference Trussell J, Henry N, Hassan F, Prezioso A, Law A, Filonenko A. Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception. Contraception. 2013;87(2):154–61.CrossRef Trussell J, Henry N, Hassan F, Prezioso A, Law A, Filonenko A. Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception. Contraception. 2013;87(2):154–61.CrossRef
12.
go back to reference Ghana Statistical Service, ICF Macro, Ghana Health Service. Ghana Demographic and Health Survey 2014. Accra: Statistical Service; 2015. Ghana Statistical Service, ICF Macro, Ghana Health Service. Ghana Demographic and Health Survey 2014. Accra: Statistical Service; 2015.
13.
go back to reference Wambui T, Ek AC, Alehagen S. Perceptions of family planning among low-income men in Western Kenya. Int Nurs Rev. 2009;56(3):340–5.CrossRef Wambui T, Ek AC, Alehagen S. Perceptions of family planning among low-income men in Western Kenya. Int Nurs Rev. 2009;56(3):340–5.CrossRef
14.
go back to reference Lucke JC, Herbert DL. Higher uptake of long-acting reversible and permanent methods of contraception by Australian women living in rural and remote areas. Aust N Z J Public Health. 2014;38(2):112–6.CrossRef Lucke JC, Herbert DL. Higher uptake of long-acting reversible and permanent methods of contraception by Australian women living in rural and remote areas. Aust N Z J Public Health. 2014;38(2):112–6.CrossRef
15.
go back to reference Baldwin MK, Rodriguez MI, Edelman AB. Lack of insurance and parity influence choice between long-acting reversible contraception and sterilization in women postpregnancy. Contraception. 2012;86(1):42–7.CrossRef Baldwin MK, Rodriguez MI, Edelman AB. Lack of insurance and parity influence choice between long-acting reversible contraception and sterilization in women postpregnancy. Contraception. 2012;86(1):42–7.CrossRef
16.
go back to reference Tang JH, Dominik R, Re S, Brody S, Stuart GS. Characteristics associated with interest in long-acting reversible contraception in a postpartum population. Contraception. 2013;88(1):52–7.CrossRef Tang JH, Dominik R, Re S, Brody S, Stuart GS. Characteristics associated with interest in long-acting reversible contraception in a postpartum population. Contraception. 2013;88(1):52–7.CrossRef
17.
go back to reference Kane R, Irving G, Brown S, Parkes N, Walling M, Killick S. Long-acting, reversible and permanent methods of contraception: insight into women's choice of method. Qual Prim Care. 2009;17(2):107–14.PubMed Kane R, Irving G, Brown S, Parkes N, Walling M, Killick S. Long-acting, reversible and permanent methods of contraception: insight into women's choice of method. Qual Prim Care. 2009;17(2):107–14.PubMed
18.
go back to reference Cremer ML, Holland E, Monterroza M, Duran S, Singh R, Terbell H, et al. Exploring factors in the decision to choose sterilization vs alternatives in rural El Salvador. The Medscape Journal of Medicine. 2008;10(8):183.PubMedPubMedCentral Cremer ML, Holland E, Monterroza M, Duran S, Singh R, Terbell H, et al. Exploring factors in the decision to choose sterilization vs alternatives in rural El Salvador. The Medscape Journal of Medicine. 2008;10(8):183.PubMedPubMedCentral
19.
go back to reference Shattuck D, Wesson J, Nsengiyumva T, Kagabo L, Bristow H, Zan T, et al. Who chooses vasectomy in Rwanda? Survey data from couples who chose vasectomy, 2010-2012. Contraception. 2014;89(6):564–71.CrossRef Shattuck D, Wesson J, Nsengiyumva T, Kagabo L, Bristow H, Zan T, et al. Who chooses vasectomy in Rwanda? Survey data from couples who chose vasectomy, 2010-2012. Contraception. 2014;89(6):564–71.CrossRef
20.
go back to reference Neukom J, Chilambwe J, Mkandawire J, Mbewe RK, Hubacher D. Dedicated providers of long-acting reversible contraception: new approach in Zambia. Contraception. 2011;83(5):447–52.CrossRef Neukom J, Chilambwe J, Mkandawire J, Mbewe RK, Hubacher D. Dedicated providers of long-acting reversible contraception: new approach in Zambia. Contraception. 2011;83(5):447–52.CrossRef
21.
go back to reference Bratton M, Kimenyi MS. Voting in Kenya: putting ethnicity in perspective. Journal of Eastern African Studies. 2008;2(2):272–89.CrossRef Bratton M, Kimenyi MS. Voting in Kenya: putting ethnicity in perspective. Journal of Eastern African Studies. 2008;2(2):272–89.CrossRef
22.
go back to reference Were GS. A History of the Abaluyia of Western Kenya: c. 1500-1930. Nairobi: East African Publishing House; 1967. Were GS. A History of the Abaluyia of Western Kenya: c. 1500-1930. Nairobi: East African Publishing House; 1967.
23.
go back to reference Ochieng WR. People round the Lake. London: Evans Brothers, Limited; 1979. Ochieng WR. People round the Lake. London: Evans Brothers, Limited; 1979.
24.
go back to reference Fedders A, Salvadori C. Peoples and cultures of Kenya. Nairobi: Transafrica; 1979. Fedders A, Salvadori C. Peoples and cultures of Kenya. Nairobi: Transafrica; 1979.
25.
go back to reference Ayot HO. A History of the Luo-Abasuba of western Kenya: from AD 1760-1940. Nairobi: Kenya Literature Bureau; 1979. Ayot HO. A History of the Luo-Abasuba of western Kenya: from AD 1760-1940. Nairobi: Kenya Literature Bureau; 1979.
26.
go back to reference Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya demographic and health survey 2008-09. Calverton: ICF Macro; 2010. Co-published by KNBS, 2009 Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya demographic and health survey 2008-09. Calverton: ICF Macro; 2010. Co-published by KNBS, 2009
27.
go back to reference Amo-Adjei J, Mutua M, Athero S, Izugbara C, Ezeh A. Improving family planning services delivery and uptake: experiences from the “reversing the stall in fertility decline in Western Kenya project”. BMC Res Notes. 2017;10(498). Amo-Adjei J, Mutua M, Athero S, Izugbara C, Ezeh A. Improving family planning services delivery and uptake: experiences from the “reversing the stall in fertility decline in Western Kenya project”. BMC Res Notes. 2017;10(498).
28.
go back to reference Ajzen I, Klobas J. Fertility intentions: An approach based on the theory of planned behavior. Demogr Res. 2013;29:203-32. Ajzen I, Klobas J. Fertility intentions: An approach based on the theory of planned behavior. Demogr Res. 2013;29:203-32.
29.
go back to reference Philipov D. Theories on fertility intentions: a demographer's perspective. Vienna Yearbook of Population Research. 2011;9:37–45.CrossRef Philipov D. Theories on fertility intentions: a demographer's perspective. Vienna Yearbook of Population Research. 2011;9:37–45.CrossRef
30.
go back to reference Mutombo N, Bakibinga P, Mukiira C, Kamande E. Benefits of family planning: an assessment of women's knowledge in rural Western Kenya. BMJ Open. 2014;4(3):e004643.CrossRef Mutombo N, Bakibinga P, Mukiira C, Kamande E. Benefits of family planning: an assessment of women's knowledge in rural Western Kenya. BMJ Open. 2014;4(3):e004643.CrossRef
31.
go back to reference Gebremariam A, Addissie A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reproductive health. 2014;11(24):1–9. Gebremariam A, Addissie A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reproductive health. 2014;11(24):1–9.
32.
go back to reference Bulto GA, Zewdie TA, Beyen TK. Demand for long acting and permanent contraceptive methods and associated factors among married women of reproductive age group in Debre Markos Town, North West Ethiopia. BMC Women's Health. 2014;14(46). Bulto GA, Zewdie TA, Beyen TK. Demand for long acting and permanent contraceptive methods and associated factors among married women of reproductive age group in Debre Markos Town, North West Ethiopia. BMC Women's Health. 2014;14(46).
33.
go back to reference Moreau C, Hall K, Trussell J, Barber J. Effect of prospectively measured pregnancy intentions on the consistency of contraceptive use among young women in Michigan. Hum Reprod. 2013;28(3):642–50.CrossRef Moreau C, Hall K, Trussell J, Barber J. Effect of prospectively measured pregnancy intentions on the consistency of contraceptive use among young women in Michigan. Hum Reprod. 2013;28(3):642–50.CrossRef
34.
go back to reference Gutin SA, Mlobeli R, Moss M, Buga G, Morroni C. Survey of knowledge, attitudes and practices surrounding the intrauterine device in South Africa. Contraception. 2011;83(2):145–50.CrossRef Gutin SA, Mlobeli R, Moss M, Buga G, Morroni C. Survey of knowledge, attitudes and practices surrounding the intrauterine device in South Africa. Contraception. 2011;83(2):145–50.CrossRef
35.
go back to reference Alemayehu M, Belachew T, Tilahun T. Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, North Ethiopia. BMC Pregnancy and Childbirth. 2012;12(6). Alemayehu M, Belachew T, Tilahun T. Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, North Ethiopia. BMC Pregnancy and Childbirth. 2012;12(6).
36.
go back to reference Tanfer K, Wierzbicki S, Payn B. Why are US women not using long-acting contraceptives? Fam Plan Perspect. 2000;32(4):176–91. Tanfer K, Wierzbicki S, Payn B. Why are US women not using long-acting contraceptives? Fam Plan Perspect. 2000;32(4):176–91.
37.
go back to reference Glasier A, Scorer J, Bigrigg A. Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods. Journal of Family Planning and Reproductive Health Care. 2008;34(4):213–7.CrossRef Glasier A, Scorer J, Bigrigg A. Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods. Journal of Family Planning and Reproductive Health Care. 2008;34(4):213–7.CrossRef
38.
go back to reference Takele A, Degu G, Yitayal M. Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia. Reproductive health. 2012;9(1):26.CrossRef Takele A, Degu G, Yitayal M. Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia. Reproductive health. 2012;9(1):26.CrossRef
39.
go back to reference Kasarda JD, Billy JO, West K. Status enhancement and fertility: Reproductive responses to social mobility and educational opportunity. Orlando: Elsevier; 2013. Kasarda JD, Billy JO, West K. Status enhancement and fertility: Reproductive responses to social mobility and educational opportunity. Orlando: Elsevier; 2013.
40.
go back to reference Rindfuss RR, Morgan SP, Offutt K. Education and the changing age pattern of American fertility: 1963–1989. Demography. 1996;33(3):277–90.CrossRef Rindfuss RR, Morgan SP, Offutt K. Education and the changing age pattern of American fertility: 1963–1989. Demography. 1996;33(3):277–90.CrossRef
41.
go back to reference Machiyama K, Marston C, Termini LaChance N, AddaBalinia T, Placide T. “How are educated women in Ghana regulating fertility without high levels of modern contraceptive use?” STEP UP Evidence Summary, June 2018. Accra: LSHTM & Population Council. Machiyama K, Marston C, Termini LaChance N, AddaBalinia T, Placide T. “How are educated women in Ghana regulating fertility without high levels of modern contraceptive use?” STEP UP Evidence Summary, June 2018. Accra: LSHTM & Population Council.
Metadata
Title
Fertility intentions and the adoption of long-acting and permanent contraception (LAPM) among women: evidence from Western Kenya
Authors
Joshua Amo-Adjei
Michael Mutua
Carol Mukiira
Namuunda Mutombo
Sherine Athero
Alex Ezeh
Chimaraoke Izugbara
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2019
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-019-0716-3

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