Family planning utilization and correlates; perspective of women aged 15-49 years from Mandera County of North Eastern Kenya

Background: Unmet need for modern family planning methods is an important health issue for women. The purpose of this study was to evaluate family planning awareness, utilization and associated factors among women aged 15-49 years from Mandera County, an arid part of North Eastern Kenya. Methods: This cross sectional study randomly enrolled 117 eligible women from April to September 2015. Data was collected using structured questionnaire, key informant interviews (KII) and focused group discussions (FGD) guides. Up to 36 FDGs were conducted among women in health, leadership, education and religious sectors. 12 KIIs among influential and knowledgeable members of the county were also conducted to gather qualitative data. STATA version 11 was used for qualitative data analysis. The thematic content analysis was used to analyze qualitative data. Results: The mean age of the 117 women who responded was 29.9 (SD± 9.8) years. About 79.5% of these 117 women were aware of contraceptive and family planning methods mainly through family and friends (52.1%). Of the 41.9% who reported using family planning (FP) methods, 26.5% used condoms. In multivariate analysis, women who were from either the Northern (OR 4.3, 95% CI 1.1 to 18.2), Southern (OR 7.5, 95% CI 1.7 to 33.4) or Eastern of Madera County (OR 4.7, 95% CI 1.1 to 20.8); had either secondary (OR 11.1, 95% CI 2.7 to 46.1) or tertiary (OR 11.9, 95% CI 2.6 to 55.9) level of education; were employed (OR 4.3, 95% CI 1.2 to 19.1); used either condoms (OR 5.7, 95% CI 1.3 to 24.5) or hormonal family planning methods (OR 5.8, 95% CI 1.4 to 25.2) were independently associated with utilization of FP. The FGD and KII confirms the low level of utilization of FP. These discussions identified location of origin, awareness, income, employment, religion and cultural practices as some of the factors limiting the utilization of FP. Conclusion: Remarkably, a high proportion of women from Mandera County; an arid, region in the North Eastern Kenya, were aware and embraced FP. If deterrents such as socio-cultural, lack of education and awareness are tackled, this region is poised to record one of the highest up take of modern family planning methods in Kenya. Keywords: Family Planning, Utilization, Women of Reproductive Age

High content of long-chain n-3 polyunsaturated fatty acids in red blood cells of Kenyan Maasai despite low dietary intake

<p>Abstract</p> <p>Background</p> <p>Increasing land restrictions and a reduced livestock-to-human ratio during the 20th century led the Maasai to lead a more sedentary, market-orientated lifestyle. Although plant-derived food nowadays contributes substantially to their diet, dairy products being high in saturated fatty acids (SFA) and low in polyunsaturated fatty acids (PUFA) still are an important energy source. Since reliable data regarding the Maasai diet date back to the 1980s, the study objective was to document current diet practices in a Kenyan Maasai community and to investigate the fatty acid distribution in diet and red blood cells.</p> <p>Methods</p> <p>A cross-sectional study was conducted among 26 Maasai (20 women, 6 men) from Loodokilani, Kajiado District, Kenya. Food intake was described by the subjects via 24-h recall, and both food and blood samples were analysed.</p> <p>Results</p> <p>Two main foods - milk and <it>ugali </it>- constituted the Maasai diet in this region. A total of 0.9 L of milk and 0.6 kg of <it>ugali </it>were consumed per person and day to yield an energy intake of 7.6 MJ/d per person. A major proportion of ingested food contributing 58.3% to the total dietary energy (en%) was plant-derived, followed by dairy products representing 41.1 en%. Fat consumed (30.5 en%) was high in SFA (63.8%) and low in PUFA (9.2%). Long-chain n-3 PUFA (EPA, DPA and DHA) made up only 0.15% of the ingested fatty acids, but 5.9% of red blood cell fatty acids.</p> <p>Conclusion</p> <p>The study indicates the Maasai diet is rich in SFA and low in PUFA. Nevertheless, red blood cells are composed of comparable proportions of long-chain n-3 PUFA to populations consuming higher amounts of this fatty acid group.</p