Determinants of modern contraceptive prevalence and unplanned pregnancies in Migori County, Kenya: results of a cross-sectional household survey

Troy D. Moon, Vincent Okoth, Joseph R. Starnes, Elisha Opiyo, Daniele J. Ressler, Julius Mbeya, Ash Rogers


Family planning and contraceptive utilization can have significant effects in reducing unplanned pregnancies and improving maternal and child health indicators.  We conducted a retrospective cross-sectional study analyzing survey response data within six sub-locations of Migori County, Kenya in 2018 and 2019. We utilize this survey data to estimate both the prevalence of contraceptive uptake and unwanted pregnancies in the study populations, and to examine the potential role that different factors play in meeting related family planning targets. Descriptive statistics were calculated, and multivariable logistic regression was used to model determinants of contraceptive use and reported unplanned pregnancy. A total of 3,642 female heads of household were included. 63% of respondents reported that they currently use some form of contraception, and the prevalence of unplanned pregnancy was 36.7%.  Our findings reflect the need for family planning programs to focus interventions on those at highest risk. There is a need for additional research and investigation into community and individual beliefs surrounding family planning in order to ensure that interventions are culturally sensitive and locally responsive. (Afr J Reprod Health 2021; 25[1]: 29-40).

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Amo-Adjei J, Mutua M, Athero S, Izugbara C and 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(1):498.

Starbird E, Norton M and Marcus R. Investing in Family

Planning: Key to Achieving the Sustainable Development Goals. Glob Health Sci Pract. 2016;4(2):191-210.

Mochache V, Lakhani A, El-Busaidy H, Temmerman M

and 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(1):10.

United Nations Population Fund. Family planning. Accessed 25 June 2020.

Ameyaw EK, Budu E, Sambah F, Baatiema L, Appiah F,

Seidu A-A and Ahinkorah BO. Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys. PloS One. 2019;14(8): e0220970.

Family Planning and the 2030 Agenda for Sustainable

Development (Data Booklet). Accessed 25 June 2020.

Dasgupta ANZ, Wheldon M, Kantorova V and Ueffing P.

Progress in Family Planning: Did the Millennium Development Goals Make a Difference? Accessed 25 June 2020.

Ba DM, Ssentongo P, Agbese E and Kjerulff KH.

Prevalence and predictors of contraceptive use among women of reproductive age in 17 sub-Saharan African countries: A large population-based study. Sex Reprod Healthc Off J Swed Assoc Midwives. 2019; 21:26-32.

Tsui AO, Brown W and Li Q. Contraceptive Practice in

sub-Saharan Africa. Popul Dev Rev. 2017;43(S1):166-191.

Prata N, Weidert K, Fraser A and Gessessew A. Meeting

rural demand: a case for combining community-based distribution and social marketing of injectable contraceptives in Tigray, Ethiopia. PloS One. 2013;8(7): e68794.

Sileo KM, Wanyenze RK, Lule H and Kiene SM.

Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda. Int J Public Health. 2015;60(8):987-997.

Niemeyer Hultstrand J, Tydén T, Jonsson M and

Målqvist M. Contraception use and unplanned pregnancies in a peri-urban area of eSwatini (Swaziland). Sex Reprod Healthc. 2019; 20:1-6.

Abdi B, Okal J, Serour G and Temmerman M. “Children

are a blessing from God” – a qualitative study exploring the socio-cultural factors influencing contraceptive use in two Muslim communities in Kenya. Reprod Health. 2020;17.

Family Planning 2020 - Kenya. Accessed 25 June 2020.

Demographic and Health Survey-Kenya (2014). Accessed 25 June 2020.

Abubakar A, Van Baar A, Fischer R, Bomu G, Gona JK

and Newton CR. Socio-cultural determinants of health-seeking behaviour on the Kenyan coast: a qualitative study. PloS One. 2013;8(11):e71998.

Emina JBO, Chirwa T and Kandala N-B. Trend in the use

of modern contraception in sub-Saharan Africa: Does women’s education matter? Contraception. 2014;90(2):154-161.

Haider TL and Sharma M. Barriers to family planning

and contraception uptake in sub-Saharan Africa: a systematic review. Int Q Community Health Educ. 2012;33(4):403-413.

Blackstone SR, Nwaozuru U and Iwelunmor J. Factors

Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review. Int Q Community Health Educ. 2017;37(2):79-91.

Chen Y, Begnel E, Muthigani W Achwoka D, Mcgrath

CJ, Singa B, Gondi J, Ng’ang’a L, Langat A, John-Stewart G, Kinuthia J and Drake AL. Higher contraceptive uptake in HIV treatment centers offering integrated family planning services: A national survey in Kenya. Contraception. 2020;102(1):39-45.

MEASURE Evaluation. Migori County Family Planning:

January to June 2016. Accessed 25 June 2020.

Demographic and Health Survey-Zambia (2018). Accessed 25 June 2020.

Demographic and Health Survey-Ethiopia (2016). Accessed 25 June 2020.

Lasong J, Zhang Y, Gebremedhin SA, Opoku S, Abaidoo

CS, Mkandawire T, Zhao K and Zhang H. Determinants of modern contraceptive use among married women of reproductive age: a cross-sectional study in rural Zambia. BMJ Open. 2020;10(3): e030980.

Tiruneh FN, Chuang K-Y, Ntenda PAM and Chuang Y-

C. Factors associated with contraceptive use and intention to use contraceptives among married women in Ethiopia. Women Health. 2016;56(1): 1-22.

Wamoyi J, Mshana G, Mongi A, Neke N, Kapiga S and

Changalucha J. A review of interventions addressing structural drivers of adolescents’ sexual and reproductive health vulnerability in sub-Saharan Africa: implications for sexual health programming. Reprod Health. 2014; 11:88.

Yakubu I and Salisu WJ. Determinants of adolescent

pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2018;15(1):15.

Lunani LL, Abaasa A and Omosa-Manyonyi G.

Prevalence and Factors Associated with Contraceptive Use Among Kenyan Women Aged 15-49 Years. AIDS Behav. 2018;22(Suppl 1): 125-130.

Tekelab T, Melka AS and Wirtu D. Predictors of modern

contraceptive methods use among married women of reproductive age groups in Western Ethiopia: a community based cross-sectional study. BMC Womens Health. 2015; 15:52.

Rossier C and Corker J. Contemporary Use of Traditional

Contraception in sub-Saharan Africa. Popul Dev Rev. 2017;43(Suppl 1):192-215.


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