- Injectables are the most widely used contraception in Kenya, followed by implants, and the pill, according to the Economic Survey 2022 data.
- Sixty three per cent of them blamed family planning failure, seven per cent thought it was their own mistake and about 34 per cent could not explain why they conceived.
Image: FILE
Most women reporting unintended pregnancies in Nairobi are already using contraception pills and injections, raising concern there is a high failure of these methods or they are being used incorrectly, medics say.
A majority of the women with unwanted pregnancies are between 18 and 25 years and are unmarried but say they were already on some contraception when they conceived.
Researchers from the Jomo Kenyatta University of Agriculture and Technology sampled 227 women attending antenatal clinics at the Kenyatta National Hospital and 29 per cent of them said their pregnancies were unintended.
This means the pregnancies were mistimed, unplanned, or unwanted at the time of conception.
“Women who used contraceptives had an eight-fold risk of unplanned pregnancies,” the researchers found out.
Injectables are the most widely used contraception in Kenya, followed by implants and the pill, according to the Economic Survey 2022 data.
The women reporting unintended pregnancies at the KNH revealed they mostly used short-term pills and injectables.
Sixty three per cent of them blamed family planning failure, seven per cent thought it was their own mistake and about 34 per cent could not explain why they conceived.
They also revealed they did not necessarily procure the contraception from established health facilities.
“This could also be supported by the fact that those who reported unintended pregnancies thought the health talks in the clinics were not meeting their need regarding family planning. This attitude could impact on their healthcare-seeking behaviour,” the authors said.
The authors – Rose Ojuok, Dr Daniel Nyamongo and Dr Joseph Mutai, all of JKUAT – have published their findings in the F1000 Research journal.
Their article is titled Determinants of unintended pregnancy among women attending antenatal clinic at Kenyatta National Hospital.
Globally, unintended pregnancies mostly arise as a result of non-use or incorrect use of contraceptives, or a noticeable contraceptive failure.
Ojuok and her colleagues further noted unintended pregnancies are not common among married people in Kenya, despite the risk.
They are also rare among women aged 35 and above, married or unmarried.
“This may be because the younger women were more exposed to frequent sexual intercourse with lower utilisation [of contraception] or higher failure rates of contraceptives,” Ojuok and her colleagues said.
Studies in Malaysia and South Africa have also reported that unintended pregnancies are higher in women who were not married, the authors said.
Another factor women end up with unintended pregnancy is when a man is not involved in planning the pregnancy.
The study found that the relationships in which the woman was the sole decision-maker regarding conception had a four-fold risk of unintended pregnancy.
“This could be attributed to the lack of a common goal within the relationship hence conflicting intentions,” the authors said.
This is also comparable to the findings of a study that was carried out in Bangladesh in 2011 where women who discussed their intent of using contraceptives with their sexual partners showed less prevalence of unintended pregnancy likened to those who did not discuss it at all.
Ojuok advised Kenya should promote long-acting methods such as implants.
“Kenya family planning programmes in collaboration with Ministry of Health and other reproductive health stakeholders need to continue with the family planning 2020 campaigns on the scaling up of long-term reversible methods of family planning,” she said.
In September during the world Contraception Day, Dr Andrew Mulwa, the head directorate of preventive and promotive services, advised women to stop using short-term family planning methods.
He questioned why one would use injectables every one or three months, for three years while reversible methods like implants could serve them better, with zero failure rate.
“If you want to stay a longer time without getting pregnant, use the long-term family planning methods instead of using short term methods repeatedly,” Dr Mulwa said.
More than 60 per cent of unintended pregnancies end in abortion, according to the UNFPA’s flagship State of World Population 2022 report, released earlier this year.
The report notes unintended pregnancies are actually a global concern.
It says nearly half of all pregnancies, totalling 121 million each year worldwide, are unintended.
UNFPA says a range of factors also contribute to unintended pregnancies, including a lack of sexual and reproductive healthcare; contraceptive that does not suit women's circumstances; harmful norms surrounding women controlling their own bodies; sexual violence and reproductive coercion; and shaming in health services.