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Why don't young Kenyan women use modern contraception?

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Young women in Kenya knew about modern contraceptives, but myths about infertility and side effects spread by friends, family and partners kept many from using them.

Source

Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study

Ochako R, Mbondo M, Aloo S, et al. · BMC public health · 2015

doi.org/10.1186/s12889-015-1483-1Read the full paper ↗239 citationscc by

Study at a glance

Design
Qualitative / archival — In-depth one-to-one interviews with a semi-structured discussion guide, analysed with thematic coding using pre-set and emergent codes.
N
N=34 · 34 young women interviewed in Kisumu, Thika and Mombasa; 58.8% of recruits were contraceptive users.
Population
Sexually active women aged 15 to 24 from lower socioeconomic groups in urban and peri-urban areas of three Kenyan regions.
Outcome
Themes describing perceived barriers to, and beliefs about, modern contraceptive methods.

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

A family-planning organisation interviewed 34 sexually active women aged 15 to 24 from low-income urban and peri-urban areas in three Kenyan regions with high, average and low contraceptive use. Households were approached using a random-walk method and interviews were held one-to-one in English or Kiswahili, then transcribed, translated and coded for themes about barriers and drivers of contraceptive use.

What they found

All the women had heard of modern methods such as pills, injectables, implants, the coil and condoms, but many held mistaken beliefs, most often that contraception causes permanent or temporary infertility, especially injectables. Other fears included birth defects, cancer, 'dirty blood' building up when periods stop, weight change, heavy bleeding and loss of sexual desire. Some women who used condoms did not count themselves as contraceptive users because they saw condoms as protection against disease rather than pregnancy. Information came mainly from peers, relatives and partners rather than health workers, and male partners often linked contraception with promiscuity or opposed it.

The limits

What it doesn't show

With 34 women from selected districts, the findings describe the range of beliefs but cannot say how common each barrier is or how strongly it predicts use. Only young women were interviewed, so men's views are reported second-hand even though partners were a key influence. The study was run by the organisation planning a communication campaign, and the interview guide was built partly around marketing concepts, which may have shaped the themes. It measures beliefs, not whether correcting myths increases contraceptive uptake.

Key terms

Modern contraceptive methods
Clinically developed methods such as pills, injectables, implants, intrauterine devices (the coil) and condoms.
Dual protection
Protection against both pregnancy and sexually transmitted infections, which condoms provide.
Qualitative in-depth interview
A one-to-one open conversation guided by topics rather than fixed questions, used to explore beliefs and experiences in participants' own words.
Thematic analysis
Coding interview transcripts and grouping the codes into recurring themes to describe patterns across participants.
Social network influence
The way people's decisions are shaped by information and norms from peers, family and partners around them.

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What type of data did this study collect?

Common questions

If women know about contraception, why don't they use it?

This study suggests knowledge is not enough: beliefs that methods cause infertility, birth defects or other harm, and disapproval from partners and community, can outweigh awareness.

Can these results tell us what percentage of Kenyan women hold these myths?

No. Qualitative interviews with a small purposive sample reveal what beliefs exist and why, but a large representative survey is needed to estimate how common they are.

What did the organisation do with the findings?

It developed a national 'C-word' media campaign and community activities targeting the specific myths identified, such as contraceptives causing infertility, weight gain or cancer.

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