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Contraceptive Use in Kenya (Socio-cultural Factors (Strong taboos against…
Contraceptive Use in Kenya
Awareness
Lack of knowledge of where to get contraceptives amongst adolescents
Lack of adequate sexual education
Myths and rumours regarding the effects of contraception
Lack of information regarding how contraceptives work
Lack of family planning information
Socio-cultural Factors
Strong taboos against sex outside marriage
High value placed on fertility and children seen as wealth of the father
Opposition to contraceptives from religious groups
The status of women is linked to the number of children they have. Women often travel secretly to family planning centres to get contraceptives.
Lack of parental approval for adolescents
Unwanted pregnancy disrupt education for adolescent girls
Rape, poverty and alcoholism continue to be common in the countryside and slums
Sex- based customs like claiming a home, celebration of harvest, etc. which require young men to find a girl to have sex with.
Influence of social networks on decision making – the extended family as the basis of the social structure.
Increasing number of teenage pregnancies
Many women considered married just by virtue of living with a man
Ancestors are greatly respected and naming a baby after them is a common form of offering.
Husband and wife may not necessarily share a place of residence.
Stakeholders
Secondary
Family
Partners
Teachers
Employers
Co-workers
Spiritual Leaders
Community Health Workers
Family Planning Services
Self Help Groups
Tertiary
Family Planning/ Health Agencies
Ministry of Health
UFPA Country Offices
Community Healthcare Centres
Contraceptive Manufacturers/ Marketers
Last mile supply chains
Women Empowerment Groups
Primary Users
Majority of 16-19 year olds
Mainly users of SARC
Small subset of non-users
Small subset of users of traditional methods
Majority of 20- 24 year olds
Users of SARC
Users of LARC
Small subset of users of traditional methods
Users who have recently changed methods
From SARC to LARC
From LARC to SARC
From traditional to modern
From modern to traditional
Users who are about to get a LARC
25-34 yrs
Users of SARC
Users of LARC
Small subset of non-users
Users of traditional methods
Users of Irreversible methods
Users who have changed methods
From SARC to LARC
From traditional to modern
Users who are about to get a LARC
Subset of 35- 50 year olds
Users of SARC
Users of LARC
Users of Irreversible methods
Users of traditional methods
Small subset of users who have changed methods
From SARC to LARC
From traditional to modern
Cultural metaphors
"Harambee" means 'to pull together'. It symbolises mutual effort, assistance, responsibility and community self reliance – the Kenyan way of life.
Gifts are appreciated – specially practical gifts, or those one cannot afford themselves.
Numerous children as a sign of virility for men and status symbol for women.
Non-Use + Discontinuation
Concerns about side-effects and health risks
Suspicion that outsiders (westerners) aim to control
Reliance on traditional methods which provide greater privacy
Contraceptive failures of method related problems
Concerns about future fertility due to its link social status
Partners attitude towards the use of contraception
Unfavourable treatment of adolescent girls by healthcare practitioners due to taboos against premarital sex
Common to miss follow-up appointments causing discontinuity
Lack of adequate infrastructure to support LARC usage + inability to undertake regular visits to a provider for SARC usage
Affordability is often a major constraint in accessing the latest technologies
Locations
Areas with high contraception use
Chogoria
Central Province
Areas with very low contraceptive use
Tribes
Kikuyp
Luo
Highest teen pregnancies
Kilifi County
Murang'a
High islamic population / density
Mombasa
Lamu
Malindi
Urban Super slums
Mathare, Nairobi
Kibera, Nairobi
Enablers
Career driven
Spousal / Family Support
access to healthcare
access to info / sex ed