Jhpiego Corporation, An Affiliate of Johns Hopkins University, Nairobi 00800, Kenya.
Jhpiego Corporation, An Affiliate of Johns Hopkins University, Baltimore, MD 21231, USA.
Int J Environ Res Public Health. 2019 May 1;16(9):1543. doi: 10.3390/ijerph16091543.
In the last two decades, the use of short-acting methods of contraception has driven the increase of contraceptive use in Kenya. We assessed the factors associated with uptake of long-acting reversible contraception by women seeking family planning services in public health facilities in Kakamega County, Kenya. A mixed methods cross-sectional study through client exit surveys among 423 women seeking family planning services was done at 12 public health facilities in Kakamega County. Twelve in-depth interviews with health care providers from the study facilities further explored practices in provision of long-acting reversible contraception (LARC). Among women initiating contraceptive use, LARC method utilization was 20.6%. Women's tertiary education level, Protestant Christian religion, age at first birth, and having no desire for more children were significantly associated with utilization of LARC. Structural factors including shortage of human resource, provider bias and lack of adequate skills on provision of services were identified as key barriers to uptake of long-acting reversible contraception services.
在过去的二十年中,短效避孕方法的使用推动了肯尼亚避孕措施使用率的上升。我们评估了在肯尼亚卡卡梅加县的公共卫生设施中寻求计划生育服务的女性中,与长效可逆避孕措施的使用相关的因素。通过在卡卡梅加县的 12 个公共卫生设施中对 423 名寻求计划生育服务的妇女进行客户退出调查,进行了一项混合方法的横断面研究。还对来自研究设施的 12 名医疗保健提供者进行了 12 次深入访谈,进一步探讨了提供长效可逆避孕(LARC)的实践情况。在开始使用避孕措施的妇女中,LARC 方法的使用率为 20.6%。妇女的第三级教育水平、新教基督教信仰、首次生育年龄和没有生育更多孩子的愿望与 LARC 的使用显著相关。结构因素,包括人力资源短缺、提供者偏见以及提供服务的技能不足,被确定为长效可逆避孕措施服务使用率的主要障碍。