Kenya DHS Shows Large Fertility Decline Since 1980s, Rise in Method Use

Abstract

7540 women aged 15-49 and 2336 men aged 20-54 were surveyed in the 1993 Kenya Demographic and Health Survey (DHS). Total fertility (TFR) for the three years prior to the 1993 survey was 5.4 lifetime births per woman a sharp decline from the TFR of 8.1 births per woman registered during the mid-1970s. A 20% decline in fertility occurred between the 1989 Kenya DHS and the 1993 survey mainly in the Central and Western provinces and in Nairobi. Rural and urban TFRs are 5.8 and 3.4 births per woman respectively. The increasing median age at marriage now at 19.5 among Kenyan women aged 25-29 has probably helped to bring about this decline in fertility. 61% of female respondents were currently married or living with a man with 20% of the currently married women in a polygynous union. 63% of women aged 20-49 reported having had sexual intercourse by age 18 with 16.8 years being the median age at sexual intercourse two years younger than the overall median age at marriage. An increased prevalence of contraception use has also affected the change in TFR. Almost all men and 97% of married Kenyan women know of at least one method of family planning. 55% of all currently married women have used a contraceptive method with modern methods having been used by 43%. Less than 33% of women in 1977-78 had ever used a method. 27% of married Kenyan women were currently using modern methods of family planning while 6% were using traditional methods. This level of current use compares to 17% overall in 1984. The pill is the most popular method among current users followed by injectables female sterilization the IUD and rhythm. Less than 1% of women use condoms vaginal methods the implant natural family planning withdrawal or other traditional methods. Current use of any method increases with age among married respondents peaking at 40% among women aged 30-34 and declining thereafter. Urban women are more likely than rural women to be currently using a method. Current use is highest in the Central Province at 56% and lowest in the Coast at 20% and more common among highly educated women than among those with no education. Regarding condom use almost one-third of men reported having had two or more sex partners in the past six months although only 20% reported using condoms during that time. Finally child mortality levels have not improved despite high use of prenatal care; 10% of Kenyan children die before reaching five years of age.