Introduction:

Contraceptive allows people to attaintheir desired number of children and determine the spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility. Reproductive health addresses the reproductive processes functions and system at all stages of life WHO 2010. Reproductive health therefore implies that people are able to have responsible satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if when and how often to do so. The attention drawn to the issue of contraception by international bodies like theWorld health organization and United Nations fund for population agency cannot be over-emphasized. This is due to the socio economic implications and health hazards that high population growth rate have increasingly manifested in the economies of developing countries. Inadequate family planning strategies have continuously exacerbated the vulnerability of developing countries culminating into high maternal and infant mortality increasing hard core poverty disintegration of the extended family system and high incidence of STI/HIV/AIDS. At least 25 of all maternal deaths can be prevented by family planning. One in 4 infants deaths in developing countries can be prevented by spacing birthsat least two years apart Isifeet al.2012.There are several contraceptive methods used in Kenya they include intrauterine pelvic device IUD Implants injectables pills female and male sterilization and male and female condoms KDHS 2014. Evidence suggests that women who have more than 4 children are at increased risk of maternal mortality. Reducing rates of unintended pregnanciesfamily planning reduces the need for unsafe abortion. Reducing infant mortality family planning can prevent closely spaced and ill-timed pregnancies and births which contribute to worlds highest infant mortality. Infants of mothers who die as a result of giving birth are at greater risk to die of poor health. Having smaller families allow parents to invest more in each child. Children with few siblings tend to stay in school longer than those with many siblings. Slowing population growth as a result of family planning is critical to slowing unsustainable population growth and resulting to negative impacts on the economy environment national and regional development efforts Moreland and Talbird 2006.The World Health Organization estimated the unmet need for contraceptives worldwide to be at 215 million women of child bearing age 15-49 years. About 200 million couples still have unmet need for contraceptives 64 million are still using traditional methods of family planning and 29 of them are women in developing countries.Contraceptive use enables people to make their informed choices about their sexual andreproductive health especially for benefit of women and childrens healthin the community WHO 2009-10.According to Moreland and Talbird 2006 when access to family planning services is increased the unmet need for family planning could be met therebyslowing population growth rate and reducing the costs of meeting Millennium development goals MDGs in terms of universal primary education. Many African economies are characterized by rapid population growth that is partly attributed to high fertility rate high birth rates accompanied by steady declines in death rates low contraceptive prevalence rate and high but declining mortality rate Oyedokun 2007. The USAID/HPI 2007 found that in Sub-Saharan Africa the rate of population growth was one of the highest in the world 2.8 compared to the rest of the world. This is likely to be an impediment towards reduction of child mortality improvement of maternal health achievement of universal primary education environmental sustainability and combating HIV/AIDS malaria and other diseases as part of Millennium Development Goals. In a study it was estimated that over half of Kenyans rapid rate of population growth is attributed to unwanted and mistimed birth. In Kenya the population growth rate is increasing at the same rate as the 2009 gross domestic product 2.6 per annum meaning that the real economic growth is virtually stagnant. A population growth rate above 2 per year makes it difficult for a countrys institutions and technologies to keep upwith the population pressures on all sectors of the economy World Bank 2009.Kenya is located in East Africa and has a population of 50 million people World population Review 2018. Kenya was one of the first countries in Africa to adopt a population policy to reduce the population growth rate just four years after gaining independence in 1963 Chimbwete 2003 Commonwealth 2018. According to WHO 2010 the Kenya Government is committed to improve the quality of life and to satisfy the wellbeing of her people. The unmet contraceptive need in Kenya is highest among women who are 15-49 years and declines thereafter. Kenya Demographic Health Survey 2014 revealed that 18 of married women have unmet needs for family planning. Sexually active unmarried women reported a higher demand for FP and a higher unmet need than currently married women. The total demand was 92 while the level of unmet need was 27. According to KDHS 2014 injectables are the widely used method of contraception at 26. The report has also shown that 28 of married women with no education have an unmet need for family planning. Millset al. 2010observed that unmet need is often described as a problem of access and interpreted as women do not use contraceptives because they cannot find or afford them. While access is an issue many other reasons have been cited by women for not using contraceptives including lack of knowledge culture personal religious and fear of side effects. Therefore just making contraceptives accessible does not guarantee that women will use them.

Objectives:

determine the utilization of contraceptives among women aged 25 44years attending Ngong sub-county hospital in Kajiado Kenya

Methodology:

This study was conducted at the maternal child health family planning/outpatient clinicat Ngongsub-county hospital.Thestudy adopted across-sectional study design. The study population waswomen aged between 25-44years.A sample size of 380 was realized and had questionnaires administered to them.Quantitative data was analyzed using SPSS version 20 and presented in frequencies percentages and pie-charts.Chi square was used to determine association between various variables. Data from FGDs inform of notes was manually codedusing themes generated from responses was analyzed andresultspresented in verbatim form. The study was submitted to KNH/UoN Ethical review committee for ethical approval.

Findings:

Results:

The study findings indicate that majority of women were between age 35-39 years. The proportion of women utilizing contraceptives was 80. Agreater proportion of women 65 preferred Depo-provera injection as a method of contraception. Educationand occupation greatlyinfluenced utilization of contraceptive p value 0.05.It was noted that the pointof access for contraceptiveshada significant associationwith utilization of contraceptives chi-square 0.033 df 2 P 0.05.Culture effects werenoted onage occupation and education and hence a further significance with utilization of contraceptives

Conclusion:

Aproportion of 80 of women using contraceptives most women have seen the need to space theirbirths and therefore areconscious of their health and that of their babies. However there are women who are still not in any method which is an indication of exposing themselves to unintended/ unplanned pregnancy and abortions.For the success of family planning programs male involvement is critical as they play an important role in the decision making process and use of contraceptives.Thereis need to encourage the community and their leaders to promote formal education so that the girl childcan be empowered through education. This will boost her self-esteem and is able to make informed choices overreproductive issues.rnThis study concluded that the proportionofwomen using contraceptivewas at 80.Most women have seen the need to space their births and therefore are conscious of their health and that of their babies. However there are women who are still not in any method which is an indication of exposing themselves to unintended/ unplanned pregnancy and abortions.The study findings showed that there was a positive and significant relationship between education and utilization of contraceptives. The more the women were educated the more likely they were using a contraceptive method.There is a strong need to improve the girl childeducation status andtheneed to empowerthe women which directlyinfluence their decision making on reproductive issues and inturn can reduce the family pressure and opposition. It may also enable the remaining 20 not using contraceptives change their mind. The study showedthat in spiteof high level of awareness of contraceptive methods the utilization was affected by various misconceptions especially inlong acting family planning methods. Women in the area did not embrace IUCD and Norplant contraceptive method as the percentage use was 8 and 15 respectively. Thereforethere is needto create more awareness on the methods and to train more health care providers as the methods areeffective and less expensive.

Author(s):

Focus County(s):

Kajiado County

Programme Area(s):

Biotechnology

Research Priority Area(s):

Disease Domain(s):

maternal and child health

Publication Date: 01.Jan.1970

Conference Title:

Venue: