Thesis:

Utilization of contraceptives among sexually active girls aged 15 to 19 years in Kuria west subcounty, Migori county, Kenya

Inadequate contraceptive use among young women aged 15 to 25 has resulted in unintended pregnancies, unsafe abortions, complications such as fistula, infant mortality, and a high incidence of teenage pregnancies. In Kenya, many adolescent girls become sexually active before the age of 15, which contributes to the country's elevated teen pregnancy rates. This study aimed to examine the factors influencing contraceptive use among girls aged 15 to 19 in Kuria West Sub-County, Migori County, Kenya. A cross-sectional, analytical research design was employed, utilizing a mixed-methods approach to collect both quantitative and qualitative data through surveys and interviews with key informants. The sample was selected using a multistage sampling technique, and data were gathered via structured questionnaires and interview schedules. Quantitative data were analyzed using SPSS version 26, with the Chi-square test applied to assess relationships between categorical variables. The findings showed that 114 (27.4%) were 18 years, 321 (77.0%) never married, 324 (77.8%) were living with parents/guardian, 143 (34.3%) had secondary level of education, and 402 (96.4%) had heard of contraceptive during the study period. Slightly less than two thirds 361 (86.6%) of respondents had engaged in sexual activities with 140 (38.7%) had been pregnant of which 87 (62.0%) had been pregnant once and 14 (9.8%) thrice. More than two third 249 (69.0%) of respondents had utilized contraceptives such as condoms (33.3%), injection (25.3%), implants (22.9%), and pills (15.7%), the uptake of contraceptive increased with increase in age up to age 18 years from 57.9% at age 15 years to 76.8% at 18 years, 11(78.6%) who were separated from marital union had utilized contraceptives followed by married respondents 38(73.1%). Respondents comfortably discussing contraceptive with relatives 40(75.5%), parents 7(75.0%), and healthcare workers 62(72.9%) utilized the contraceptives, further, respondents agreed culture prohibits the use of contraceptives 168(68.3%), discuss contraceptive methods with family 54(73.0%), and had difficult to engage in sexual discussions with their parents/guardian 209(69.9%) utilized the contraceptives. Respondents sought reproductive health services 174(75.7%), discussed the use of a contraceptive with healthcare workers 151(76.3%), and get contraceptive methods when required 162(74.3%) had higher rates of contraceptive uptake. Secondary dropout (OR=7.307; 95% CI=1.746-30.581; p= 0.006), living with caregiver (OR= 3.198, 95% CI=1.293-7.908, p=0.012), formally employed parents/guardian (OR=0.350, 95% CI=0.165-0.741, p=0.006), self-employed parents/guardian (OR=0.489, 95% CI=0.266-0.901, p=0.022), heard contraceptives (OR=5.813, 95% CI=1.466-23.894, p= 0.012), and engaging in sexual intercourse (OR=5.813; 95% CI=3.309-10.210; p= 0.0001) influenced uptake of contraceptives. Further, religious affiliation, sorting reproductive health services, discussing the use of a contraceptive with healthcare workers, distance to nearest health facility, getting contraceptive methods when required, and duration taken to be offered a contraceptive service were significantly associated with uptake of contraceptives. The national, county government, health team, and stakeholders should collaborate to increase contraceptive service utilization by mass campaigns, age-specific sexual and reproductive health information. Have regular medical camps in areas far from health facilities on contraceptives services to adolescents.