Abstract
BackgroundWomen are described as experiencing unmet need for contraception if they are fecund, sexually active and wish to postpone or limit childbearing but fail to use contraception to do so. The consequences of unmet need include unwanted pregnancy, induced abortions, school dropout due to pregnancy and premature maternal deaths. Global efforts aimed at addressing the adverse effects of unmet need abound. In Kenya, one in every four married women in the reproductive age bracket (15–49 years) has unmet need for contraception. Regional differences exist but the reasons behind these differences remain poorly understood. The purpose of this study was to examine the extent to which regional differentials in unmet need for contraception exists and to explain the regional differences in unmet need for contraception in Kenya.MethodsThe paper used the Kenya Demographic and Health Survey (2008/09) data. Unmet need for contraception was measured based on the revised estimates contained in the survey. Summary statistics were used to show the percentage differences in the values of selected covariates across the high and low unmet need zones. The dependent variable had three categories: no unmet need, unmet need for spacing and unmet need for limiting births. The categorical nature of this dependent variable which is not ordered in any way lends itself to the use of multinomial logistic regression. The paper applied the seemingly unrelated estimation (suest) test to ascertain whether the covariate coefficients between the high and low unmet need zones were different. Stata Version 13.0 was used for analysis.ResultsThe percentage values of the selected covariates of unmet need for contraception were much higher in the high unmet need zone as compared to those observed in the low unmet need zones. On the overall, 15.4 % of women in the high unmet need zone had unmet need to space their next birth as compared to 8.6 % of their counterparts. Likewise, the percentage of women who wanted to limit further births stood at 14.1 % among women residing in high unmet need zones while those in low unmet need zones had 10.5 %. Further analysis based on seemingly unrelated estimation found that in general, a comparison of the coefficients been the high and low unmet need regions were significantly different (p < 0.05).ConclusionEvidence from the nationally representative KDHS 2008/09 shows that regional differentials in the covariates of unmet need for contraception exist. There is need to address religious inhibitions that stymie contraceptive uptake especially in the high unmet need regions. Efforts should promote maternal education and economically empower women in order to reinforce individual and contextual attitudes towards the benefits of contraception. The government should also establish social franchise programs to increase access to costly long acting and permanent methods of contraception to poor women.
Highlights
Women are described as experiencing unmet need for contraception if they are fecund, sexually active and wish to postpone or limit childbearing but fail to use contraception to do so
Zones with high unmet need for contraception had generally higher percentage points of unmet need for spacing and limiting as compared to the rates observed in low unmet need zones
In both the high and low unmet need zones, unmet need for spacing births decreased with increasing age while unmet need to limit further births increased with age
Summary
Women are described as experiencing unmet need for contraception if they are fecund, sexually active and wish to postpone or limit childbearing but fail to use contraception to do so. In Kenya, one in every four married women in the reproductive age bracket (15–49 years) has unmet need for contraception. Women are described as experiencing unmet need for contraception if they are fecund, sexually active and wish to postpone or limit further childbearing but fail to use contraception for one reason or another [2, 3]. Unmet need for contraception denies women the economic and social benefits of family planning and violates their reproductive health right on the number and timing of childbirths. In Kenya, a quarter of the married women in the reproductive age group (15–49 years) have unmet need for contraception [4]. Investments aimed at promoting voluntary family planning initiatives can mob up the huge gap in unmet need by increasing access [3]
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