Determinants of modern contraceptive use among sexually active men in Kenya

Background: Research in Kenya has focussed on family planning from women’s perspectives, with the aim of helping reduce the burden of unintended pregnancies. As such, the determinants of modern contraceptive use among sexually active women are well documented. However, the perspectives of men should be considered not only as women’s partners, but also as individuals with distinct reproductive histories and desires of their own. This study seeks to understand the determinants of modern contraceptive use among sexually active men, by exploring factors that are correlated with modern contraceptive use. Methods: The data source is the nationally representative 2014 Kenya Demographic and Health Survey (DHS) of men aged 15–54 years. The analysis is restricted to 9,514 men who reported being sexually active in the past 12 months prior to the survey, as they were likely to report either doing something or not to avoid or delay pregnancy. We use bivariate and multinomial logistic regression to assess factors that influence modern contraceptive use among sexually active men. Results: Findings from the bivariate and multinomial logistic regression indicate that region of residence, marital status, religion, wealth, interaction with a health care provider, fertility preference, number of sexual partners and access to media were all significantly associated with modern contraceptive use among sexually active men. Conclusion: Provider-client interaction as well as dissemination of information through mass media has the potential to increase knowledge and uptake of modern contraceptives. Similar efforts targeting segments of the population where contraceptive uptake is low are recommended

Evaluating the impact of social franchising on family planning use in Kenya

Background: In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya\u2019s largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. Methods: A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Results: Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18\u201324 and 41\u201349 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. Conclusions: This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya

Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study

Background: Young women in Kenya experience a higher risk of mistimed and unwanted pregnancy compared to older women. However, contraceptive use among youth remains low. Known barriers to uptake include side effects, access to commodities and partner approval. Methods: To inform a youth focussed behaviour change communication campaign, Population Services Kenya developed a qualitative study to better understand these barriers among young women. The study was carried out in Nyanza, Coast, and Central regions. Within these regions, urban or peri-urban districts were purposively selected based on having contraceptive prevalence rate close to the regional average and having a population with low socioeconomic profiles. In depth interviews were conducted with a sample of sexually active women aged 15–24, both users and non-users, that were drawn from randomly selected households. Results: All the respondents in the study were familiar with modern methods of contraception and most could describe their general mechanisms of action. Condoms were not considered as contraception by many users. Contraception was also associated with promiscuity and straying. Fear of side effects and adverse reactions were a major barrier to use. The biggest fear was that a particular method would cause infertility. Many fears were based on myths and misconceptions. Young women learn about both true side effects and myths from their social networks. Conclusion: Findings from this research confirm that awareness and knowledge of contraception do not necessarily translate to use. The main barriers to modern contraceptive uptake among young women are myths and misconceptions. The findings stress the influence of social network approval on the use of family planning, beyond the individual’s beliefs. In such settings, family planning programming should engage with the wider community through mass and peer campaign strategies. As an outcome from this study, Population Services Kenya developed a mass media campaign to address key myths and misconceptions among youth

Kenya (2016): Tunza Client Exit Interview monitoring the quality of Tunza service delivery.

The purpose of the annual Tunza Client Exit Interview (CEI) Survey is to gather information from the clients that attend the franchise that will aide in improving their interaction with the providers and franchise as a whole. The surveys collate data on quality of care indicators and the equity of access to Tunza Services. Survey results are used by PS Kenya managers to map out performance gaps, thus, guiding formulation of more targeted and evidence-based programmatic decisions

Kenya (2014): Malaria TRaC Study among Populations Living in Malarial Zones in Kenya

In the last decade, the Government of Kenya (GoK) has emphasized malaria programming with a bid at reducing the infant mortality, and malaria related maternal mortality. PS Kenya has developed an evidence-based programmes aimed at enhancing use of insecticide treated mosquito nets through support of routine net distribution, mass media campaign, and interpersonal campaigns. In order to inform this campaign, PS Kenya, with funding from the DfID plans to implement a national household survey among residents of malarial zones in Kenya. This study design highlights the objectives of the survey, the methodological approach, the ethical consideration, and the data collection tools proposed for the study. We aim in this study to provide national level monitoring data on net ownership, and net usage. Specifically this survey will determine the factors associated with net ownership and use among the target populations, the trends in uptake of nets compared to other national level surveys, the association of exposure to mass media and interpersonal communication with ownership of LLINs with use of LLINs. The investigators propose a cross sectional study design that adopts quantitative approaches to data collection. The investigators propose to implement the study between May and June 2014. The study will include a national sample of 6002 households distributed based on the square root allocation method to the different malarial zones. The investigators will get an additional sample in IPC implementation areas to bring the sample for this area to 2320 to enable conclusion around IPC intervention. The survey proposes a two-stage cluster sampling design. The study will use a sampling frame based on the NASSEP V developed by the Kenya National Bureau of Statistics. Using 298 enumeration areas (EA), the interviewers will include, without replacement, 28 households per. The investigators propose the inclusion of respondents aged 18-49 years who give written, informed, and voluntary consent to participate in the survey. The interviewers will collect data using mobile phones through the open data kit system. The investigators anticipate that an interview will take between 30 -45 minutes with the interviewers conducting an average of seven interviews per day. SPSS version 21 will aid the analysis for this study. Net use defined as sleeping under an insecticide treated net the night preceding the survey, will be determined through frequencies and proportions, segmented by the malarial zones, age, and gender categories. The study considers net ownership at two levels: ownership of at least one net in a household and universal coverage (owner ship of 1 net for every 2 people in the household). The behavioral factors, based on Leikert Scales, will be assessed using Analysis of Variance to determine possible association to the behavior. The evaluation of the IPC’s association with behavior will be determined using coarsened exact matching to increase comparison accuracy. The influence will then be assessed based on analysis of variance. The investigators will present the findings from this survey in PS Kenya’s dashboard and study specific report. The investigators will share the report with the donor, the GoK through the MCU, and other stakeholders in malaria prevention. Insights from the report will inform malaria programming in Kenya