Overcoming Barriers to Contraceptive Uptake among Adolescents: The Case of Kiambu County, Kenya

Abstract

Despite high sexual activity among adolescent girls in Kenya, contraceptive uptake is very low with only about 26 percent sexually active adolescent girls currently using a contraceptive method. This exposes them to HIV infections and unplanned preg- nancies which consequently lead to school dropouts, unsafe abortions, and lack of employment opportunities. This cross-sectional study aimed at assessing the utiliza- tion of contraceptives among secondary school adolescent girls in Karuri Town Council, Kiambu County. Overall, 421 girls aged between 13.0 to 19.0 years took part in the study. Findings showed that despite majority (77.5%) of the adolescent girls having had sexual debut by the age of 15 years, contraceptive utilization was very low at 43%. The results revealed that age of the adolescent, knowledge of contraceptives options, perception and accessibility of the contraceptives had positive significant ef- fect on contraceptive utilization. Adolescents aged 18 years and above were more likely to utilize contraceptives as compared to those of a lesser age (p ≤ 0.001; OR: 9.870 (95% CI: 3.781 - 25.763)). Those with knowledge on contraceptives were OR 3.2 times more likely to use contraceptives (p = 0.025), similarly, accessibility was significantly associated with increased contraceptive utilization (p = 0.34, 95% CI: 1.054 - 4.187). Adolescents who perceived use of contraceptives as wise were more likely to use a contraceptive than those of a divergent opinion (OR: 2.053 (95% CI: 1.024 - 4.115), p = 0.041). This revealed that high level of knowledge on contracep- tives did not always amount to practice. There is therefore a need to develop age specific reproductive health messages to guide school education curriculum as well as parent or guardian-child communication.