Women’s Decision-Making regarding Birth Planning in a Rural Site in Kenya and Its Implications for Family Planning Programs

Francis Obare, Population Council
George Odwe, Population Council
John G. Cleland, London School of Hygiene and Tropical Medicine (LSHTM)

This paper explores women’s decision-making regarding contraceptive uptake, switching and discontinuation and their implications for family planning programs. Data are from in-depth interviews conducted in 2018 with 42 women who participated in a longitudinal research project implemented in Homa Bay County of Kenya, and who discontinued use between the first and second rounds of data collection. Uptake of contraception was largely driven by concerns about the effect of frequent childbirth on individual health and household socio-economic well-being. Most women discontinued methods they were dissatisfied with and tried other methods instead of abandoning contraception altogether. However, some women had challenges identifying an appropriate method after experiencing side effects, contraceptive failure or stock-out of their current method as well as securing their partners’ cooperation. The findings suggest the need for strategies to enhance partner support for contraception besides expanding the method mix, ensuring commodity security, and improving quality of care.