Akoth, C., Oguta, J.O. orcid.org/0000-0002-2401-9895 and Gatimu, S.M. (2021) Prevalence and factors associated with covert contraceptive use in Kenya: a cross-sectional study. BMC Public Health, 21 (1). 1316. ISSN 1471-2458
Abstract
Background: Family planning (FP) is a key intervention for preventing unplanned pregnancies, unsafe abortions,
and maternal death. Involvement of both women and their partners promotes contraceptive acceptance, uptake
and continuation, couple communication and gender-equitable attitude. Partner involvement is a key strategy for
addressing about 17.5% of the unmet needs in FP in Kenya. This study assessed the prevalence and factors
associated with covert contraceptive use (CCU) in Kenya.
Methods: We used data from the sixth and seventh rounds of the performance monitoring for accountability
surveys. We defined CCU as “the use of contraceptives without a partner’s knowledge”. We used frequencies and
percentages to describe the sample characteristics and the prevalence of CCU and assessed the associated factors
using bivariate and multivariable logistic regressions.
Results: The prevalence of CCU was 12.2% (95% CI: 10.4–14.2%); highest among uneducated (22.3%) poorest
(18.2%) and 35–49 years-old (12.8%) women. Injectables (53.3%) and implants (34.6%) were the commonest
methods among women who practice CCU. In the bivariate analysis, Siaya county, rural residence, education,
wealth, and age at sexual debut were associated with CCU. On adjusting for covariates, the odds of CCU were
increased among uneducated women (aOR 3.79, 95% CI 1.73–8.31), women with primary education (aOR 1.86, 95%
CI 1.06–3.29) and those from the poorest (aOR 2.67, 95% CI 1.61–4.45), poorer (aOR 1.79, 95% CI 1.05–3.04), and
middle (aOR 2.40, 95% CI 1.52–3.78) household wealth quintiles and were reduced among those with 2–3 (aOR
0.49, 95% CI 0.33–0.72) and ≥ 4 children (aOR 0.62, 95% CI 0.40–0.96). Age at sexual debut (aOR 0.94, 95% CI 0.89–
0.99) reduced the odds of CCU.
Conclusion: About one in 10 married women in Kenya use contraceptives covertly, with injectables and implants
being the preferred methods. Our study highlights a gap in partner involvement in FP and calls for efforts to
strengthen their involvement to increase contraceptive use in Kenya while acknowledging women’s right to make
independent choices.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
Keywords: | Kenya; Covert contraceptive use; Family planning; Autonomy; Secret use; Male involvement; injectaAles; PMA survey; Decision making |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 02 Nov 2022 16:37 |
Last Modified: | 02 Nov 2022 16:37 |
Status: | Published |
Publisher: | BMC |
Refereed: | Yes |
Identification Number: | 10.1186/s12889-021-11375-7 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:192560 |