Contraceptive Uptake and Its Determinants among Women in West Pokot, Kenya: Implications for Reproductive Health in Marginalised Pastoralist Settings

Abstract

Background: One of the main targets to reach Sustainable Development Goals 3.7 and 5.6 is to promote family planning uptake. However, the uptake in the pastoralist communities has been recorded to be very low compared to the global and national uptake. Purpose of the study: To determine contraceptive uptake and assess individual-level factors that influence Family Planning uptake in the pastoral community of West Pokot County, Kenya. Methodology: A community-based Cross-sectional descriptive study design was conducted among women of reproductive age. Two sub-counties were selected by a multistage sampling technique. Forty community health units were randomly selected from the sub-counties. Households were randomly selected. A structured questionnaire was used to collect socio-demographic characteristics, contraceptive prevalence rate and the factors influencing family planning uptake. Data was analysed using STATA software version 16.0, and logistic regression methods were employed to investigate the association among the variables. Results: 59.2% of the respondents were aged between 14-29 years, a majority (86.3%) were married. 60.7% of the respondents were aware of family planning methods, and 52.9% cited hospital workers as their source of information. The proportion of participants using modern contraceptive methods was 20.4%. Those currently on a method, nearly half (49.2%) were on implant, 41.8% were on injectables, and very few (1.6%) were using IUCD. Strong links were found between obtaining a formal education, working as a herder, being familiar with family planning choices and being aware of at least one long-lasting and reversible contraceptive method, and individuals who accepted family planning (AOR=16.03; 95% CI: 9.14-28.10), (AOR=1.69; 95% CI: 0.83-3.47), (AOR=7.30; 95% CI: 2.83-18.87), (AOR=2.65; 95% CI: 0.97-7.73), with a p-value of less than 0.001. Conclusions and recommendations: The contraceptive prevalence rate in the study area was low. Spousal disapproval, fear of side effects and cultural beliefs were identified to be the barriers to Family Planning uptake. Formally educated women were predominantly the users of contraceptives. The awareness level also contributes to a greater use of contraception. The study recommends the design of programs that involve men in Family Planning decision-making and address cultural and religious misconceptions about contemporary contraception.