An examination of postpartum family planning in western Kenya: “I want to use contraception but I have not been told how to do so”

Violet Naanyu, Joyce Baliddawa, Emily Peca, Julie Karfakis, Nancy Nyagoha, Beatrice Koech

Abstract

Postpartum family planning (FP) in Kenya is low due to inadequate sensitization and awareness among women, particularly in rural areas. This paper identifies most widely used types of FP, intent and unmet needs among women, FP counseling and barriers to FP uptake. Focus group discussions with providers, traditional birth attendants (TBAs) and mothers, as well as indepth interviews identify key themes including preferred postpartum FP, limits to existing FP counseling and barriers to FP uptake. Postpartum FP is common including injectable contraceptives, oral contraceptives, coils, condoms, and calendar methods. FP counseling is provided by peers, friends, TBAs and formal health providers. FP practices are associated with family support, literacy, access to FP information, side effects, costs and religion. In conclusion, changes in service provision and education could encourage increase in postpartum FP use in Kenya. (Afr J Reprod Health 2013; 17[3]: 44-53).

 

Résumé

La planification familiale du post-partum (PF) au Kenya est faible en raison de la sensibilisation insuffisante et la sensibilisation des femmes, en particulier dans les zones rurales. Ce document identifie les types les plus répandus de la PF, l'intention et les besoins non satisfaits chez les femmes, la consultation de la PF  et les obstacles à l'adoption de la PF. Des  discussions à groupe cible avec les prestataires de services, les accoucheuses traditionnelles (AT) et des mères, ainsi que des entrevues en profondeur dégagent les principaux thèmes, y compris la PF du post-partum préféré, les limites de la consultation de la  PF en cours et les obstacles à l'adoption de la PF.  La PF du Post-partum  est commune, y compris les contraceptifs injectables, les contraceptifs oraux, les bobines, les préservatifs et les méthodes de calendrier.  La consultation de la PF est prodiguée par des pairs, les amis, les accoucheuses traditionnelles et les prestataires officiels de santé. Les pratiques de la PF sont associées avec le soutien de la famille, l'alphabétisation, l'accès à l'information sur la PF, les effets secondaires, les coûts et la religion. En conclusion, les changements dans la prestation de services et de l'éducation pourraient encourager  la hausse de l’utilisation de la PF du postpartum au Kenya. (Afr J Reprod Health 2013; 17[3]: 44-53).

 

Keywords: Kenya; Postpartum family planning; Family planning counseling; Family planning barriers; Traditional birth 

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References

http://www.un.org [Internet]. United Nations, Millennium Development Goals [cited 2012 Sept 6]. Available from: http://www.un.org/millenniumgoals/

Perkins M, Brazier E, Themmen E, Bassane B, Diallo D, Mutunga A, et al. Out-of-pocket costs for facility-7(3): Naanyu et al.

based maternity care in three African countries. Health Policy and Plann 2009; 24(4): 289–300.

Ministry of Health. Safe Motherhood Demonstration Project - Repositioning postpartum care in Kenya. Safe Motherhood Policy Alert, Kenya. Ministry of Health: University of Nairobi and Population Council; 2005.

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A and Innis J. Family planning: the unfinished agenda. Lancet 2006; 368(9549): 1810–1827.

Kaler A, Alibhai A, Kipp W, Konde-Lule J and Rubaale T. Enough children: Reproduction, risk and “unmet need” among people receiving antiretroviral treatment in western Uganda. AJRH 2012; 16(1): p. 133-144

Access-FP & USAID. Postpartum contraception: Family planning methods and birth spacing after childbirth. Family planning initiative addressing unmet need for postpartum family planning. USAID: Washington, DC; 2008.

Ojakaa D. Trends and determinants of unmet need for family planning in Kenya. Calverton, MD: Macro International; 2008.

Ndegwa S, Onduso P and Casey L. Reproductive health and family planning in Kenya: The Pathfinder International experience. Pathfinder International: Nairobi. 2008.

Kenya National Bureau of Statistics. Kenya Demographic and Health Survey 2008-9, Government of Kenya: Nairobi; 2010.

Mwangi A, Warren C, Koskei N and Blanchard H. Strengthening postnatal care services including postpartum family planning in Kenya. Frontiers in Reproductive Health, ACCESS-FP Jhpiego,

Population Council, USAID: Washington, DC; 2008.

Mathe JK, Kasonia KK, and Maliro AK. Barriers to adoption of family planning among women in eastern Democratic Republic of Congo. AJRH 2011; 15: 69-77.

Burke HM and Ambasa-Shisanya C. Qualitative study of reasons for discontinuation of injectable contraceptives among users and salient reference groups in Kenya. AJRH 2011; 15(2): 67-78.

Malarcher S, Family planning success stories in SubSaharan Africa. Global Health Technical Briefs, USAID: Washington, DC; 2007

Berhane A, Biadgilign S, Amberbir A, Morankar S, Berhane A, and Deribe K. Men’s knowledge and spousal communication about modern family planning methods in Ethiopia. AJRH 2011; 15(4): 24-32.

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