Technical University of Mombasa, Mombasa, Kenya.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
PLoS One. 2021 Apr 9;16(4):e0248393. doi: 10.1371/journal.pone.0248393. eCollection 2021.
Demand for family planning met/satisfied with modern contraceptive methods (mDFPS) has been proposed to track progress in Family Planning (FP) programs for Sustainable Development Goals. This study measured mDFPS among married women of reproductive age (MWRA) in Kenya to identify which groups were not being reached by FP programs.
Performance, Monitoring and Accountability 2020 (PMA2020) survey data from 2014-2018 was used. PMA2020 surveys are cross-sectional including women 15-49 years. PMA2020 used a 2-stage cluster design with urban/rural regions as strata with random selection of households. Univariate and multivariate analysis was done using stata V15.
Of the 34,832 respondents interviewed from 2014 to 2018, 60.2% were MWRA. There was a significant decrease in demand for FP from 2014 to 2018, p = 0.012. Lowest demand was among 15-19 and 45-49 years old women. Overall, modern contraceptive prevalence rate increased significantly from 54.6% to 60.8%, p = 0.004, being higher for women from urban areas, home visits by health care worker (HCW), educated, wealthy, visited health facilities and exposed to mass media. Unmet need for FP decreased from 23.0-13.8% over the 5-years, p<0.001. Married adolescent 15-19 had the highest unmet need and those from rural areas, poor, uneducated and not exposed to mass media. mDFPS increased significantly from 69.7-79.4% over the 5-years, p<0.001, with increase in long acting reversible contraception/permanent methods from 19.9-37.2% and decrease in short acting methods from 49.9-42.2%. Significant determinants of mDFPS were age, rural/urban residence, education, wealth, health facility visitation, exposure to FP messages via mass media in the last 12 months, year of study and county of residence.
Results show a good progress in key FP indicators. However, not all MWRA are being reached and should be reached if Kenya is to achieve the desired universal health coverage as well as Sustainable Development Goals. Targeted home visits by HCW as well increase in mass media coverage could be viable interventions.
为了跟踪可持续发展目标下计划生育项目的进展，提出了已婚育龄妇女（MWRA）对计划生育的现代避孕方法的需求（mDFPS）。本研究旨在衡量肯尼亚 MWRA 对现代避孕方法的需求，以确定哪些群体未被计划生育项目覆盖。
使用 2014-2018 年期间的绩效、监测和问责制 2020（PMA2020）调查数据。PMA2020 是一项横断面研究，包括 15-49 岁的女性。PMA2020 采用两阶段聚类设计，城乡区域为分层，家庭随机选择。使用 stata V15 进行单变量和多变量分析。
在 2014 年至 2018 年期间接受采访的 34832 名受访者中，60.2%是 MWRA。从 2014 年到 2018 年，对计划生育的需求呈显著下降趋势，p=0.012。需求最低的是 15-19 岁和 45-49 岁的女性。总体而言，现代避孕方法的普及率从 54.6%显著上升至 60.8%，p=0.004，城市地区、医护人员家访、教育程度高、富有、经常去卫生机构和接触大众媒体的女性普及率更高。5 年内计划生育未满足需求从 23.0%降至 13.8%，p<0.001。15-19 岁的已婚青少年未满足需求最高，农村地区、贫困、未受教育和未接触大众媒体的人群未满足需求最高。5 年内 mDFPS 从 69.7%显著上升至 79.4%，p<0.001，长效可逆避孕/永久性方法的比例从 19.9%上升至 37.2%，短期方法的比例从 49.9%下降至 42.2%。mDFPS 的显著决定因素是年龄、城乡居住、教育、财富、卫生机构就诊、过去 12 个月内接触计划生育信息、研究年份和居住县。
结果表明，计划生育的主要指标取得了良好进展。然而，如果肯尼亚要实现全民健康覆盖以及可持续发展目标，仍有部分 MWRA 未被覆盖。医护人员有针对性的家访以及增加大众媒体报道可能是可行的干预措施。
