Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar;97(3):227-235.
doi: 10.1016/j.contraception.2017.10.001. Epub 2017 Oct 12.

Uptake and correlates of contraception among postpartum women in Kenya: results from a national cross-sectional survey

Dunstan Achwoka  1 , Jillian Pintye  2 , Christine J McGrath  3 , John Kinuthia  4 , Jennifer A Unger  5 , Norah Obudho  6 , Agnes Langat  7 , Grace John-Stewart  8 , Alison L Drake  9 ; Collaborative HIV Impact on MCH Evaluation (CHIME) Study Team
Affiliations

Uptake and correlates of contraception among postpartum women in Kenya: results from a national cross-sectional survey

Dunstan Achwoka et al. Contraception. 2018 Mar.

Abstract

Objective: The objective was to characterize uptake and correlates of effective contraceptive use postpartum.

Study design: We analyzed data from a national, cross-sectional evaluation of prevention of mother-to-child HIV transmission programs that enrolled women attending 6-week or 9-month infant immunization visits at 120 Kenyan maternal and child health clinics. We classified women who resumed sexual activity postpartum and did not desire a child within 2 years as having a need for family planning (FP).

Results: We included 955 (94%) of 1012 women 8-10 months postpartum in the analysis. Mean age was 25.8 years and 36% were primigravidas. By 9 months postpartum, 62% of all women used contraception and 59% used effective contraception [injectables, implants, intrauterine devices [IUDs], oral contraceptives [OCs] and tubal ligations]. Most contraceptive users (61%) used injectables, followed by implants (10%), OCs (6%), IUDs (4%) and condoms alone (2%). The majority (n=733, 77%) had a need for FP, and 67% of 733 women with FP need used effective contraception. Among women with a need for FP, effective contraception use was higher among those who discussed FP in postnatal care (PNC) than who did not discuss FP in PNC [prevalence ratio (PR) for PNC alone: 1.35, 95% confidence interval (CI): 1.16-1.58; PR for PNC and antenatal care (ANC): 1.42, 95% CI: 1.21-1.67; p=.001 for both].

Conclusions: Two thirds of postpartum women with a need for FP used effective contraception at 9 months postpartum, and use was associated with discussing FP during PNC.

Implications: Integrating FP counseling in ANC/PNC could be an effective strategy to increase effective contraception use.

Keywords: Child health; Contraception; Kenya; Maternal health; Postpartum.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURE OF INTERESTS

Conflicts of interest: There are no conflicts of interest.

Figures

Figure 1
Figure 1. Study locations (n=120) and regional uptake of effective contraceptive methods among Kenyan postpartum women attending maternal and child health clinics, 2013
Percentages are weighted
Figure 2
Figure 2. Study flowchart for Kenyan postpartum women attending maternal and child health clinics, 2013
*Not mutually exclusive. PMTCT=prevention of mother-to-child HIV transmission; MCH=maternal and child health Modern contraception included condoms, injectables, implants, intrauterine devices, oral contraceptives, and tubal ligations; effective contraception included all modern contraception except condoms. Women with unmet need reported resuming sexual activity after delivery and not desiring children within the next two years. Percentages are weighted.
Figure 3
Figure 3. Contraceptive methods used among Kenyan postpartum women attending maternal and child health clinics, 2013
IUD= intrauterine device; OC = oral contraceptives; TL=tubal ligation. Dual methods include condoms and another effective method (injectables, implants, IUDs, OCs, and TL). Percentages are weighted. Percentages rounded up or down to nearest integer if >1%, which results in total exceeding 100%. Women with a need for FP had resumed sexual activity by 9 months postpartum and did not desire more children in the next 2 years.
Figure 4
Figure 4. Frequency of contraceptive use, by type and HIV status, among Kenyan postpartum women attending maternal and child health clinics, 2013
Women with unmet need reported resuming sexual activity after delivery and not desiring children within the next two years.
See this image and copyright information in PMC

References

    1. United Nations. Transforming our world: the 2030 Agenda for Sustainable Development. 2015
    1. Brown W, Druce N, Bunting J, et al. Developing the “120 by 20” goal for the Global FP2020 Initiative. Stud Fam Plann. 2014;45:73–84. - PubMed
    1. DaVanzo J, Hale L, Razzaque A, Rahman M. Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG. 2007;114:1079–87. - PMC - PubMed
    1. Rutstein S. Further evidence of the effects of preceding intervals on neonatal, infant, and under-five mortality and nutritional status in developing countries: evidence from the Demographic and Health Surveys, DHS Working Papers, Calverton, MD, USA. Macro International. 2008;(41) - PubMed
    1. Moore Z, Pfitzer A, Gubin R, Charurat E, Elliott L, Croft T. Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and bottom-income countries. Contraception. 2015;92:31–9. - PubMed

Publication types

MeSH terms