Improving Access to Quality Family Planning Services in Kenya by Addressing Contraceptive Discontinuation

Susan Ontiri

    Research output: ThesisThesis fully internal (DIV)

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    Contraception has a significant impact on pregnancy-related risks, maternal and child survival. Kenya a low middle-income country in sub-Saharan Africa has a high contraceptive use of over 60% among women of reproductive age. However, one out of three women discontinue the use of a method by 12 months. High discontinuation rates result in women having an unmet need for modern contraceptives, meaning, they want to avoid a pregnancy but are not using a modern method thus negating the gains made. For instance, more than a third of pregnancies in Kenya are unintended, contributing to the high rates of maternal mortality. This thesis used qualitative and quantitative research methodology to explore contraceptive discontinuation, specifically the trends, reasons, and quality of care offered to women seeking contraception in Kenya.
    Findings presented in this thesis, indicate that majority of women in Kenya who currently use a contraceptive method are on a short-term method specifically injectables, which have been documented to have higher discontinuation rates compared to other long-acting methods. Side effects and costs are among the leading causes of discontinuation. The health system has not adequately supported women’s reproductive health needs by ensuring that they receive adequate information regarding their chosen contraception at initiation. Moreover, the burden of use of contraception continues to be with women, with some being covert users due to lack of spousal support. Family planning programs need to focus on the reproductive needs of women who have initiated contraceptive use to ensure their fertility desires are met.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    • Stekelenburg, Jelle, Supervisor
    • Biesma-Blanco, Regien, Co-supervisor
    • Kabue, Mark, Co-supervisor, External person
    Award date22-Dec-2021
    Place of Publication[Groningen]
    Publication statusPublished - 2021

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