FACTORS INFLUENCING THE UTILIZATION IMPLANTABLE

CONTRACEPTIVE METHODS AMONG WOMEN OF REPRODUCTIVE

AGE IN KAHAWA WEST, NAIROBI COUNTY.

MWANGI WANJIRU

Q20/6486/2020

DEPARTMENT OF FAMILY MEDICINE, COMMUNITY HEALTH AND

EPIDEMIOLOGY.

KAHAWA WEST, KENYATTA UNIVERSITY

JUNE, 2024.
DECLARATION
I declare that this project is my original work, the best of my knowledge and has not been
presented for a degree in any other University.

Signature………………………………. Date………………….
Name…………………………………… Reg………………….

Supervisor’s section

Name: JUSTUS OSERO

Signature………………….
Date
TABLE OF CONTENTS
DECLARATION.....................................................................................................................................2
ABBREVIATIONS...........................................................................................................................................5
ABSTRACT................................................................................................................................................6
CHAPTER ONE: INTRODUCTION...............................................................................................................7
1.1problem statement.............................................................................................................................7
1.2justification of the study.....................................................................................................................8
1.3research question...................................................................................................................................8
1.4 hypothesis.........................................................................................................................................9
1.5 objectives...........................................................................................................................................9
1.6 significance of the study..................................................................................................................10
1.7 limitations........................................................................................................................................10
1.8 conceptual framework.....................................................................................................................11
CHAPTER TWO: LITERATURE REVIEW........................................................................................................12
2.1 Theoretical literature review............................................................................................................12
2.2 background of the study...................................................................................................................15
2.3 overview of the study.......................................................................................................................15
2.4 Accessibility and Availability of Services........................................................................................16
2.5 Education level................................................................................................................................17
2.6 Awareness campaigns......................................................................................................................17
2.7 Satisfaction Levels...........................................................................................................................18
2.8 Partner support and involvement.....................................................................................................19
2.9 cultural and religious beliefs............................................................................................................19
2.1.0 conclusion.....................................................................................................................................20
CHAPTER THREE: Methods and materials..................................................................................................21
3.1 Study design....................................................................................................................................21
3.2 The independent and the dependent variables..................................................................................21
3.3 Study location..................................................................................................................................21
3.4 Study population..............................................................................................................................21
3.5 sampling techniques........................................................................................................................21
3.6 Determining the sample size............................................................................................................22
3.7 Construction of instruments.............................................................................................................22
3.8 Pretesting and Piloting.....................................................................................................................23
3.9 Validity of the instruments...............................................................................................................24
3.9 Data collection techniques...............................................................................................................24
3.9.0 Data analysis techniques...........................................................................................................25
3.9.1 Logistical and ethical considerations issues.............................................................................25
Chapter 4: FINDINGS...........................................................................................................................26
4.1 Introduction.....................................................................................................................................26
4.2 Sociodemographic factors................................................................................................................26
4.2.1 Age...............................................................................................................................................27
4.2.2 Educational background...............................................................................................................27
4.2.3 Marital status................................................................................................................................28
4.2.4 Number of children.......................................................................................................................28
4.3 Utilization of implantable methods..................................................................................................29
4.3.1 Usage of implantable contraceptive..............................................................................................29
4.3.2 Influence to use implantable methods...........................................................................................30
4.3.2.1 Recommendation from healthcare provider...............................................................................30
4.3.2.2 Dissatisfaction with other methods............................................................................................31
4.3.3 Reason for not using implantable methods...................................................................................31
4.4 Satisfaction with implantable methods............................................................................................31
4.4.1 Level of satisfaction in pregnancy prevention..............................................................................32
4.4.2 Level of satisfaction with side effects...........................................................................................32
4.4.3 Overall satisfaction with implantable methods.............................................................................32
4.5 Access to healthcare and family planning services..........................................................................33
4.5.1 Distance from health facility.........................................................................................................33
4.5.2 Challenges in accessing implantable contraceptive methods........................................................33
4.6 Cultural influence and partner involvement.....................................................................................34
4.6.1 Cultural and religious influence....................................................................................................34
4.6.2 Extent of partner involvement......................................................................................................35
CHAPTER 5: DISCUSSION.................................................................................................................36
5.1 Introduction.....................................................................................................................................36
5.2 Discussion.......................................................................................................................................36
5.2.1 Utilization of implantable methods...............................................................................................37
5.2.2 Satisfaction with implantable methods.........................................................................................38
 5.2.3 Access to healthcare and family planning services.......................................................................38
5.2.4 Cultural influence and partner involvement..................................................................................39
5.3 Conclusion.......................................................................................................................................40
5.4 Recommendation.............................................................................................................................40
5.4.1 Recommendation from results..........................................................................................................40
REFERENCES..........................................................................................................................................44
Appendices............................................................................................................................................44
5.5 QUESTIONARRE...........................................................................................................................45

ABBREVIATIONS

IUDs: Intrauterine Devices

FP: Family Planning
SDGs: Sustainable Development Goals
FP/RH: Family Planning/Reproductive Health
SRHR: Sexual and Reproductive Health and Rights
NCDs: Non-Communicable Diseases
STIs: Sexually Transmitted Infections
ABSTRACT

Family planning is crucial for empowering women and promoting their reproductive health. In

Kahawa West, Nairobi, where access to healthcare and information on contraception may vary,

understanding the factors influencing women's contraceptive choices is essential. This research

aims to investigate the utilization and satisfaction levels of implantable contraceptives,

specifically Implanon and Jadelle, among women of reproductive age in Kahawa West. A mixed-

methods approach including surveys, interviews, and focus group discussions will explore

demographic characteristics, access to healthcare, and socio-cultural factors impacting

contraceptive decision-making. The study seeks to identify barriers and facilitators to the

adoption of implantable contraceptives and provide insights for tailored interventions to improve

family planning services in the area. By promoting informed decision-making and addressing the

unique needs of women in Kahawa West, this research aims to contribute to the enhancement of

reproductive autonomy and overall well-being within the community.

CHAPTER ONE: INTRODUCTION

Family planning is crucial for the well-being of women and families, ensuring they can make

informed choices about their reproductive health. In Kahawa West, Nairobi, many women of

reproductive age face decisions about contraception, including the use of implantable methods

like Implanon and Jadelle. However, there is limited understanding of how factors such as

education, access to healthcare, and cultural beliefs influence their choices. This research aims to

fill this gap by investigating the utilization and satisfaction levels of implantable contraceptives

among women in Kahawa West. By examining demographic characteristics, healthcare access,

and socio-cultural influences, the study seeks to provide insights that can inform tailored

interventions to improve family planning services in the area. Understanding the barriers and

facilitators to contraceptive use among this population is essential for promoting reproductive

autonomy and improving the overall health and well-being of women and families in Kahawa

West, Nairobi.

1.1problem statement
Despite the availability of implantable contraceptives like Implanon and Jadelle in Kahawa west,

soweto area area, there remains a gap in understanding the factors that influence their utilization

and satisfaction among women of reproductive age. Limited research exists on the nuanced

interplay of demographic variables and geographic disparities affecting the adoption of these
methods. Consequently, there is a need to explore these factors comprehensively to optimize

family planning programs and improve reproductive health outcomes for women across various

demographic groups and geographic regions in Kahawa west, soweto area

1.2justification of the study

Understanding the utilization and satisfaction levels of implantable contraceptives among women

of reproductive age in Kahawa west, soweto area is crucial for enhancing family planning

initiatives and improving reproductive health outcomes. By identifying the factors influencing

the adoption of methods like Implanon and Jadelle, this study can inform the development of

targeted interventions and healthcare policies tailored to the diverse needs of different

demographic groups and geographic regions within Kahawa west. Moreover, addressing the gaps

in knowledge regarding the barriers and facilitators to contraceptive use can contribute to the

promotion of informed decision-making, thereby empowering women to make choices that align

with their reproductive goals and preferences. Ultimately, the findings of this study have the

potential to enhance access to effective contraception, reduce unintended pregnancies, and

promote women's reproductive autonomy and well-being in Kahawa west.

1.3research question

i. What is the utilization rate of Implanon and Jadelle implants among women of

reproductive age in Kahawa west?

 ii. How satisfied are women with Implanon and Jadelle implants in terms of efficacy, side

effects, and overall experience?

iii. What are the barriers to adopting implantable contraceptives among certain demographic

groups or geographic regions within Kahawa West?

iv. What are the primary factors influencing the initial adoption of implantable

contraceptives (Implanon or Jadelle) among women of reproductive age in Kahawa

West?

1.4 hypothesis
There is no significant relationship between demographic factors, access to healthcare services,

cultural beliefs, partner involvement, and satisfaction levels, and the utilization of implantable

contraceptive methods (Implanon or Jadelle) among women of reproductive age in Kahawa

West, Nairobi County.

1.5 objectives

a) To determine the utilization rate of Implanon and Jadelle implants among women of

reproductive age in Kahawa west, soweto area through a population-based survey or analysis of

health facility data.

b) To assess the satisfaction levels of women with Implanon and Jadelle implants in Kahawa

west, soweto area by conducting structured interviews or surveys to gather feedback on efficacy,

side effects, and overall experience.

c) To identify the barriers to the adoption of implantable contraceptives among specific

demographic groups or geographic regions within Kahawa west, soweto area through qualitative

interviews or focus group discussions.

d) To investigate the primary factors influencing the initial adoption of implantable

contraceptives (Implanon or Jadelle) among women of reproductive age in Kahawa west, soweto

area through quantitative surveys or interviews aimed at understanding decision-making

processes and motivations.

1.6 significance of the study

This study holds significant importance as it sheds light on the usage and satisfaction levels of

implantable contraceptives among women in Kahawa West. By addressing key research

questions and objectives, it offers evidence-based guidance for policymakers, healthcare

providers, and family planning programs, aiming to enhance reproductive health outcomes and

access to contraception. Insights into utilization patterns, satisfaction, barriers, and influencing

factors can tailor interventions to meet diverse needs across different demographics and regions.

Ultimately, the findings can empower women with informed decision-making, foster effective

family planning practices, and contribute to reducing unintended pregnancies while improving

women's reproductive autonomy and well-being in Kahawa west.

1.7 limitations
Possible limitations of this study include sampling bias, as the research may not capture the

perspectives of women who do not have access to healthcare services or who choose not to

utilize implantable contraceptives. There may also be challenges in accessing remote or rural

areas for data collection, potentially leading to underrepresentation of these populations

1.8 conceptual framework

Independent variables Dependent variables

• Demographic Variables: • Utilization of Implantable
Age
Education Level Contraceptives:
Marital Status
Utilization Rate of Implanon and Jadelle
Parity (Number of Children)
• Access to Healthcare: Implants
Availability of Trained Healthcare Providers
Proximity to Contraceptive Services • Satisfaction with Implantable
Urban/Rural Residence
• Socio-Cultural Factors: Contraceptives:
Societal Norms
Satisfaction Levels with Efficacy
Religious Beliefs
Partner Involvement Satisfaction Levels with Side Effects
• Awareness and Knowledge:
Familiarity with Implanon and Jadelle Implants Overall Experience Satisfaction
Understanding of Contraceptive Options
CHAPTER TWO: LITERATURE REVIEW
2.1 Theoretical literature review

Family planning plays a pivotal role in reproductive health, empowering women to make

informed decisions about their fertility and overall well-being. In Kahawa west, like many

developing countries, access to and utilization of contraception remains a critical issue,

particularly among women of reproductive age in urban areas such as Kahawa West, Nairobi.

Utilization of Contraceptives in Kahawa west:

Studies have highlighted the diverse landscape of contraceptive utilization in Kahawa west. The

2014 Kahawa west, soweto area Demographic and Health Survey (KDHS) reported a national

contraceptive prevalence rate of 58%, with significant variations across regions and demographic

groups (National Council for Population and Development, 2014). While traditional methods

like condoms and pills remain popular, long-acting reversible contraceptives (LARCs) such as

implants have gained traction due to their efficacy and convenience (Manda-Taylor et al., 2020).

Factors Influencing Contraceptive Utilization:

Various factors influence contraceptive decision-making among women in Kahawa west.

Education level, socio-economic status, and parity have been identified as significant

determinants of contraceptive use, with higher-educated women and those of higher socio-

economic status more likely to adopt modern methods (Kabagenyi et al., 2014). Accessibility and
affordability of contraceptive services, including the availability of trained healthcare providers

and proximity to clinics, also play crucial roles in utilization rates, particularly in urban settings

(Mutumba et al., 2017).

Cultural and Societal Influences:

Sociocultural factors, including religious beliefs, societal norms, and partner dynamics, heavily

influence contraceptive behavior among Kahawa west, soweto area n women. Cultural taboos

surrounding discussions about contraception and reproductive health may hinder women's ability

to access and utilize contraceptive services (Mbizvo et al., 2017). Partner approval and

involvement in contraceptive decision-making are often cited as key influencers of women's

contraceptive choices, highlighting the importance of engaging men in family planning

initiatives (Kim et al., 2019).

Satisfaction with Contraceptive Methods

Women's satisfaction with contraceptive methods significantly impacts their continuation and

adherence. Studies have shown that dissatisfaction with side effects, perceived efficacy, and

overall experience can lead to discontinuation and method switching (Polis et al., 2016).

Implants, known for their high efficacy and long-acting nature, have generally been associated

with high levels of satisfaction among users (White et al., 2018).

Research Gap and Justification:

While existing literature provides valuable insights into contraceptive behaviour and utilization

patterns in Kahawa West, Soweto area , there remains a gap in understanding the specific factors

influencing the utilization and satisfaction levels of implantable contraceptives among women in

urban areas like Kahawa West, Nairobi. By focusing on this understudied population, this

research aims to address this gap and provide evidence-based recommendations for improving

family planning services and reproductive health outcomes in the area.

Conclusion:

In conclusion, the literature review highlights the complex interplay of factors shaping

contraceptive behaviour among women in Kahawa West, Soweto area. By synthesizing existing

research, this study aims to contribute to the growing body of knowledge on family planning in

urban settings, with a particular focus on the utilization and satisfaction levels of implantable

contraceptives among women of reproductive age in Kahawa West, Nairobi. Through an in-depth

exploration of demographic, socio-cultural, and healthcare-related factors, this research seeks to

inform targeted interventions and policies aimed at enhancing reproductive autonomy and overall

well-being within the community.

2.2 background of the study

The background of this study revolves around the importance of family planning in empowering

women and promoting reproductive health, particularly in urban areas like Kahawa West,

Nairobi, Kahawa West, and the Soweto area. Despite national efforts to increase contraceptive

prevalence rates, challenges persist in ensuring equitable access and utilization of contraceptive

methods, including implants like Implanon and Jadelle. Kahawa west, soweto area represents a

dynamic urban community where access to healthcare services, socio-cultural norms, and

individual decision-making processes intersect to influence contraceptive behaviour among

women of reproductive age. Understanding the specific factors shaping contraceptive utilization

and satisfaction levels with implantable contraceptives in this context is crucial for informing

targeted interventions and policies to improve family planning services and reproductive health

outcomes in the area, ultimately contributing to the overall well-being of women and families in

Kahawa West, Soweto area and similar urban settings across Kahawa West, Soweto area.

2.3 overview of the study

The proposed research aims to explore the factors influencing the utilization and satisfaction of

implantable contraceptive methods, specifically Implanon or Jadelle, among women of

reproductive age in Kahawa West, Nairobi County. Despite efforts to increase access to family

planning services in Kahawa west, soweto area , disparities persist in contraceptive utilization,

particularly in urban areas like Kahawa West. Limited research has focused on understanding the
unique challenges and facilitators associated with the adoption of implantable contraceptives in

this specific context. Therefore, this study seeks to address this gap by investigating the

multifaceted factors influencing women's decisions to utilize and their satisfaction with Implanon

or Jadelle implants. By identifying these factors, the research aims to provide insights that can

inform targeted interventions and policies to improve family planning services and reproductive

health outcomes in Kahawa west, soweto area and similar urban settings in Nairobi County.

2.4 Accessibility and Availability of Services

Accessibility and proximity to healthcare facilities offering implant insertion and removal

services are critical factors influencing the utilization of Implanon and Jadelle implants among

women in Kahawa West. Women who have easy access to healthcare facilities within their

community are more likely to seek contraceptive services and initiate the use of implantable

contraceptives. Conversely, women facing barriers such as long travel distances, transportation

costs, or limited clinic hours may experience difficulties in accessing these services, leading to

lower utilization rates. Improving access to healthcare facilities, particularly in underserved areas

of Kahawa West, can enhance contraceptive uptake and satisfaction among women of

reproductive age. Also the availability of trained healthcare providers who can counsel women

on contraceptive options, insert and remove implants safely, and address any concerns or side

effects is essential for ensuring positive contraceptive experiences. In Kahawa West, the shortage

of skilled healthcare personnel or inadequate training in contraceptive counseling and procedures

may limit women's access to quality contraceptive services. Women may hesitate to seek

implantable contraceptives if they perceive a lack of expertise or trust in the healthcare providers

available in their community.

2.5 Education level

Women's education level can significantly influence their knowledge about contraceptive

options, including implantable contraceptives, and their ability to make informed decisions

regarding family planning. Higher education levels are often associated with increased awareness

of contraceptive methods, better understanding of their benefits and potential side effects, and

enhanced ability to navigate healthcare systems to access contraceptive services. Women with

higher education levels may be more likely to utilize implantable contraceptives due to their

familiarity with modern contraceptive methods and their ability to critically assess their

reproductive health needs. Additionally, educated women may have greater confidence in

communicating their contraceptive preferences to healthcare providers, leading to higher

satisfaction levels with the chosen method.

2.6 Awareness campaigns

Effective awareness campaigns about contraceptive methods, including implantable

contraceptives, can play a crucial role in promoting their utilization among women in Kahawa

West. Awareness campaigns can provide accurate information about the benefits, efficacy, and
safety of Implanon and Jadelle implants, dispel myths and misconceptions, and increase women's

confidence in their contraceptive choices. By raising awareness about the availability of

implantable contraceptives and the importance of family planning, these campaigns can

empower women to make informed decisions about their reproductive health and encourage

them to seek contraceptive services from healthcare facilities in Kahawa West.

2.7 Satisfaction Levels

Women's satisfaction with implantable contraceptives, including Implanon and Jadelle, is

influenced by various factors, including efficacy, side effects, convenience, and overall user

experience. High satisfaction levels are associated with positive experiences, minimal side

effects, and perceived effectiveness of the chosen contraceptive method. Women who are

satisfied with their implantable contraceptives are more likely to continue using them and may

also recommend them to others, thereby contributing to higher utilization rates. Conversely,

dissatisfaction with implantable contraceptives due to side effects, discomfort, or perceived

ineffectiveness can lead to discontinuation or method switching, resulting in lower utilization

rates. Ensuring women's satisfaction with implantable contraceptives requires addressing their

individual preferences, providing comprehensive counseling and support services, and

addressing any concerns or issues that may arise during contraceptive use.
2.8 Partner support and involvement

The support and involvement of partners in contraceptive decision-making can significantly

influence women's utilization and satisfaction with implantable contraceptives in Kahawa West.

Women who have supportive partners may feel more empowered to discuss family planning

options, including the use of Implanon and Jadelle implants, and make joint decisions about

contraceptive methods. Conversely, women facing resistance or lack of support from their

partners may experience barriers to accessing contraceptive services or may feel hesitant to use

implantable contraceptives. Partner involvement in counseling sessions and contraceptive

education programs can enhance communication between couples, promote shared decision-

making, and improve contraceptive uptake and satisfaction levels among women in Kahawa

West.

2.9 cultural and religious beliefs

Cultural and religious beliefs can profoundly impact women's attitudes towards contraceptive

use, including implantable contraceptives, in Kahawa West. Some cultural and religious beliefs

may promote large family sizes or discourage the use of modern contraceptive methods, leading

to resistance or reluctance among women to adopt implantable contraceptives. Misconceptions

about the safety and morality of contraception may also prevail in certain cultural contexts,

influencing women's decision-making processes. Addressing cultural and religious beliefs

through culturally sensitive and context-specific health education initiatives can help dispel
myths and misconceptions, foster positive attitudes towards contraceptive use, and promote the

acceptance and utilization of implantable contraceptives among women in Kahawa West.

2.1.0 conclusion

In conclusion, the utilization and satisfaction of implantable contraceptives, Implanon and

Jadelle, among women of reproductive age in Kahawa West, Nairobi County, are influenced by a

myriad of interconnected factors. Education level significantly impacts women's contraceptive

knowledge and decision-making abilities, while effective awareness campaigns play a crucial

role in promoting contraceptive uptake and dispelling myths and misconceptions. Access to

healthcare facilities offering implant insertion and removal services is essential for ensuring

contraceptive access and utilization, while cultural and religious beliefs shape women's attitudes

towards contraceptive use. Partner support and involvement can enhance communication and

decision-making around contraceptive choices, ultimately impacting utilization and satisfaction

levels. Moreover, women's satisfaction with implantable contraceptives, influenced by factors

such as efficacy and side effects, directly affects continuation rates and overall contraceptive

outcomes. By addressing these factors comprehensively and implementing targeted

interventions, stakeholders can enhance contraceptive uptake and satisfaction levels among

women in Kahawa West, ultimately improving reproductive health outcomes and empowering

women to make informed choices about their reproductive health.

CHAPTER THREE: Methods and materials
3.1 Study design
I used an observational cross-sectional study. It was appropriate since the research is for a short

period of time. The study design allowed me to use the appropriate group of members

concerning factors influencing the utilization and satisfaction of implantable contraceptive

methods (Implanon or Jadelle) among women of child bearing age in Kahawa west, soweto area

in Nairobi County.

3.2 The independent and the dependent variables.

In the context of factors influencing the utilization and satisfaction of implantable contraceptive

methods (Implanon or Jadelle) among women of childbearing age in Kahawa west, the

dependent variable is utilization of implantable family planning methods while the independent

variable includes proximity to Contraceptive Service, Socio-Cultural Factors, Societal Norms,

Religious Beliefs, Partner Involvement and Awareness and Knowledge.

3.3 Study location

My study location was in Kahawa west, soweto area in Nairobi County.

3.4 Study population

The study population will be the residents of Kahawa west, soweto area Soweto area, especially

the women of childbearing age.

3.5 sampling techniques

This involves the methods that I will use to select the most appropriate sample. I will use

stratified random sampling technique. Firstly, formation of categories will be in form of

identifying the factors that influence the usage of implantable family planning methods.
The next sampling technique after categorizing will be systematic random sampling, an

appropriate interval among the categories will be used to obtain the final representative of the

final study population.

3.6 Determining the sample size

This involves finding the exact representatives of the study population. I will first ask myself a

question like what do I need? There are a number of factors that influence my requirements;

these are the purpose of the study, population size, the risk of selecting a ‘’ bad’’ sample. And the

allowable sampling error.

Three criteria will need to be specified to determine the appropriate sample size:

 The level of precision

 The level of confidence risk

 The degree of variability in the attributes being measured.

The formulae of determining the sample size is:

n = N/ 1+ N (e) 2

30= 150/1+150(0.4)2

where n is the study population

N is the whole population

e is the level of precision

3.7 Construction of instruments

In this I will considers factors such as:
  Reviewing the literature on what to be used in such kind of study

 Deciding what information will be sought

 Knowing the respondents

 Construction of questionnaire items.

 Re-examination and revision of the questions

 Editing the questionnaire and specifying procedure for use. Example constructing a

questionnaire item;

 Each item on the questionnaire must be developed to measure a specific aspect of

objectives or hypothesis.

 I must be able as a researcher to explain in detail why a certain question is being asked

and how the responses will be analyzed.

3.8 Pretesting and Piloting

In pretesting, 20-30 people from my target group carried out the actual pretesting of the

questionnaire.

I asked them to complete the survey while thinking out loud.

I observed how they completed it.

Making improvements based on results. After reviewing the results of the pretesting, I repeated it

using a different group of testers if need be.

In piloting, I selected a pilot sample.

Implementing all the steps from start to finishing. For example, through starting training of data

collectors. I made improvements of the same.

3.9 Validity of the instruments

I ensured both internal and external validity was established. Also, conclusive and constructive

validity. I used the sources of validity evidence such as content, response process, internal

structure, relation to other variables and consequences.

Reliability of the research instrument. Reliability refers to the extent that the instrument yields

the same results over multiple trials.

The types of reliability that I established well and used them are;

Test re-test that involves the same test over time.

Interrater, the same test conducted by different people.

Parallel forms, that different versions of a test which are designed to be equivalent. And internal

consistency reliability.

3.9 Data collection techniques

The research used both quantitative and qualitative methods of data collection.

The quantitative methods are questionnaires, surveys, documents and the institutional records.

Concerning mental health problems among students.

The qualitative methods to use are interviews of some selected group of students and even some

staff members, focus groups discussion and also observations.

3.9.0 Data analysis techniques

I employed both quantitative and qualitative techniques for analyzing the results of my study.

The quantitative techniques include descriptive and inferential statistics. I followed the stages of

data analysis such as describing, diagnosing, predicting and prescribing.

3.9.1 Logistical and ethical considerations issues.

I trained my team well for ethical considerations while in the filed collecting data.

Some of the ethical and logistical issues to make clear are; obtaining consent of the study

participants, explaining everything concerning my study and making them understand it clearly.

Providing consent forms for them sign, those who are willing to participate.
Chapter 4: FINDINGS
4.1 Introduction

The following section presents the key findings from a questionnaire given to thirty individuals

to explore factors influencing the utilization of implantable contraceptive methods, specifically

Implanon or Jadelle, among women of reproductive age in Kahawa West, Nairobi County.

Through this questionnaire, I sought to understand demographic characteristics, access to

healthcare services, cultural beliefs, partner involvement, and satisfaction levels among

participants regarding the use of implantable contraceptives. By analyzing the responses

gathered, I aimed to provide insights into the complex interplay of factors shaping contraceptive

behavior in this urban community, offering valuable implications for improving family planning

services and reproductive health outcomes in Kahawa west, soweto area and similar settings.

4.2 Sociodemographic factors

In Kahawa West, understanding the influence of these sociodemographic factors is essential for

designing effective family planning programs. Tailoring interventions to address the specific

needs and barriers faced by different demographic groups can enhance the utilization of

implantable contraceptives and improve reproductive health outcomes for women in the

community.
4.2.1 Age

The majority of users of implantable contraceptives fall within the 25-34 age group, suggesting

that women in this age range may have the highest demand or preference for long-term

contraceptive solutions. This could be due to several factors, including being in the prime

childbearing years, seeking to space out or limit the number of children they have, or having

established family planning goals. The lower usage among the 18-24 and 35-44 age groups may

reflect different reproductive health priorities or access issues. The absence of users above 45

years is expected, as women in this age group are likely nearing the end of their reproductive

years.

4.2.2 Educational background

Women with secondary education constitute the largest group using implantable contraceptives,

indicating that a moderate level of education is associated with higher contraceptive use. This

might be due to increased health awareness and better access to information compared to those

with only primary education. Women with tertiary or college education also show significant use,

highlighting the role of higher education in empowering women to make informed reproductive

health decisions. The low number of users with only primary education suggests a need for

targeted educational and outreach efforts to increase contraceptive use among less-educated

women.
4.2.3 Marital status

Married women are the predominant users of implantable contraceptives, which is consistent

with the likelihood of higher contraceptive needs for family planning within marriage. Single

women also show notable usage, possibly reflecting a desire for effective long-term

contraception without the daily hassle of other methods. The low number of divorced women

using implants might indicate either a smaller representation in the sample or different

contraceptive preferences or needs among divorced women.

4.2.4 Number of children

Women with one or two children are the most frequent users of implantable contraceptives. This

suggests that these women are likely using implants to space their pregnancies or limit the

number of children. Women with three children also show some usage, reflecting continued

contraceptive needs. The very low number of users with more than four children may indicate
that women with larger families might either stop using contraception due to completion of

family size or might prefer other contraceptive methods.

4.3 Utilization of implantable methods

To determine the number of women using implantable family planning contraceptives, I

administered the questionnaires to thirty women of reproductive area in Kahawa west.

4.3.1 Usage of implantable contraceptive

usage of implantable methods

7%
utilization of implantable
methods yes
utilization of implantable
methods no

93%

The overwhelming majority (28 out of 30) of women reported using implantable contraceptives,

indicating a high level of acceptance and utilization of these methods within the study sample.

Only one woman preferred not to use implantable contraceptives, suggesting that other factors

might influence contraceptive choices for a small minority.

4.3.2 Influence to use implantable methods

Recommendations from healthcare providers play a significant role in the decision to use

implantable contraceptives for the majority of the women (19 out of 30 users). This highlights

the trust and reliance on professional medical advice. Dissatisfaction with other contraceptive

methods is also a notable influence, with 11 women switching to implants due to negative

experiences with other methods. Only one woman preferred other methods over implants,

indicating a general preference for implants among the sample.

4.3.2.1 Recommendation from healthcare provider

Most women upon deciding to use family planning ask for advice from their health providers.

They have a big impact on what method women choose to use since they give them all the

information they need on the side effects, effectiveness of methods and advantages of using the

contraceptive method.
4.3.2.2 Dissatisfaction with other methods

Implantable contraceptive is not always the number one choice of family planning by women.

Some are influenced to use these methods due to being dissatisfied by their initial methods and

end up settling for implantations such as Implanon which is for three years and Jadelle for five

years.

4.3.3 Reason for not using implantable methods

Two of the thirty women from my sample size, when asked they said they do not use neither

Jadelle nor Implanon as a form of family planning. This is because they prefer using other

methods which in our case was intrauterine device which is a non-hormonal method. They also

said that they opted for other methods since the side effects were too severe for her body.

4.4 Satisfaction with implantable methods

4.4.1 Level of satisfaction in pregnancy prevention

From the sample size, all the women claimed that the implantable contraceptives are very

effective in pregnancy prevention. Most of them go back to the method because they work well

for them in terms of planning for children.

4.4.2 Level of satisfaction with side effects

Implantable methods are hormonal methods thus they have different side effects on the body.

Some women tend to experience side effects such as weight gain or loss, irregular flows and

many others. From our sample size, all the women said that they are able to handle the side

effect.

4.4.3 Overall satisfaction with implantable methods

The overall satisfaction with implantable contraceptives among this sample of women is high,

particularly in terms of effectiveness and manageable side effects. While the majority of users

are very satisfied, continued support and information from healthcare providers can further

enhance the experience for those who are only somewhat satisfied. This positive feedback

suggests that implantable contraceptives are a reliable and acceptable option for many women

seeking long-term contraception.

4.5 Access to healthcare and family planning services

4.5.1 Distance from health facility

Women who live closer to healthcare facilities, particularly those within 1-5 kilometers, may

find it easier to access contraceptive services. The convenience of being near a facility reduces

barriers to seeking and obtaining implantable contraceptives. On the other hand, women living

farther away, especially those beyond 10 kilometers, may face challenges accessing healthcare

services. Longer travel distances increase the time, effort, and possibly cost associated with

reaching the facility, potentially acting as a deterrent to seeking contraceptive services.

4.5.2 Challenges in accessing implantable contraceptive methods

Twenty eight out of the thirty women said they did not face any challenge in accessing

implantable contraceptive method thus influencing their continuous use of the methods.

Challenges in accessing implantable contraceptive methods influence their utilization by creating

barriers that impede women's ability to obtain and use these contraceptives effectively. When

women face challenges such as delays in services such as implant insertion or removal they tend

to change the method to the ones that services are available.

4.6 Cultural influence and partner involvement

4.6.1 Cultural and religious influence

From the answers in the questionnaire, cultural and religious influences have a varied impact on

the utilization of implantable contraceptive methods among the surveyed women. While the

majority (22 out of 30) reported that their cultural or religious beliefs do not influence their

choice of contraception, a minority of women indicated some degree of influence. Two woman

stated that religion strongly influenced their contraceptive choice, and six women reported some

level of influence. This indicates that for a small subset of women, cultural or religious beliefs

play a role in shaping their contraceptive decisions. However, the overall prevalence of this
influence appears to be low within the sample. This suggests that while cultural and religious

factors may impact contraceptive decision-making for some women, the majority are able to

make choices based on personal preferences, healthcare provider recommendations, and

satisfaction with the method's effectiveness and side effects, rather than solely on cultural or

religious considerations.

4.6.2 Extent of partner involvement

The findings indicate that partner involvement has a notable but varied impact on the utilization

of implantable contraceptive methods among the surveyed women. While a minority (3 out of

30) reported that their partners are fully involved in contraceptive decisions and one woman

mentioned partial involvement, the majority (26 out of 30) stated that their partners are not

involved. This suggests that for a subset of women, partner involvement plays a significant role

in contraceptive decision-making, potentially influencing the choice to use implantable methods.

However, the prevalence of partner involvement appears to be relatively low within the sample,

indicating that many women make contraceptive decisions independently. This suggests that

while partner involvement may impact contraceptive choices for some women, a substantial

proportion of users are able to make decisions based on individual preferences, healthcare

provider recommendations, and satisfaction with the method's effectiveness and side effects,

without significant input from their partners.

CHAPTER 5: DISCUSSION

5.1 Introduction

The utilization of contraceptive methods is a critical component of reproductive health

management for women worldwide. Understanding the factors influencing contraceptive choice

and utilization is essential for designing effective healthcare interventions and promoting access

to contraception. This research project investigates the utilization of implantable contraceptive

methods among a sample of 30 women, focusing on various factors that may influence their

decision-making process. Through a comprehensive analysis of survey data, this study explores

the impact of healthcare provider recommendations, satisfaction with the method, access to

healthcare services, cultural and religious influences, and partner involvement on the utilization

of implantable contraceptives. By examining these factors, this research aims to provide valuable

insights into the complexities surrounding contraceptive decision-making and contribute to the

development of targeted interventions aimed at improving access to and uptake of implantable

contraceptive methods.

5.2 Discussion

This study in comparison with the study done by Ilegbusi, P. H. (2022) on contraceptive Implants

in studies in family planning Intechopen, investigated the utilization of implantable contraceptive

methods among 30 women, revealing that the majority opted for these methods based on

healthcare provider recommendations, expressing high satisfaction with their effectiveness and
side effects. While most didn't face significant challenges accessing services, distance from

healthcare facilities posed barriers for some. Cultural and religious influences had minimal

impact, with only a few women citing them as factors. Similarly, partner involvement varied,

with most women making contraceptive decisions independently. The findings underscore the

importance of provider guidance, addressing access barriers, and recognizing individual

autonomy in contraceptive decision-making to enhance utilization and support reproductive

health outcomes.

5.2.1 Utilization of implantable methods

There are various factors influencing the utilization of implantable contraceptive methods among

the sampled women. Firstly, the overwhelming majority of women (28 out of 30) reported

utilizing implantable contraceptives, highlighting the significance of this contraceptive option

within the sample population. Healthcare provider recommendations emerged as a primary driver

of utilization, with nine women indicating that they chose implantable methods based on

healthcare provider advice. This underscores the crucial role of healthcare professionals in

guiding contraceptive decisions and emphasizes the importance of effective communication

between providers and patients regarding contraceptive options.

5.2.2 Satisfaction with implantable methods

Satisfaction with implantable contraceptives was another prominent theme in the findings. All

women using implantable methods expressed satisfaction with their effectiveness in preventing

pregnancies, demonstrating high confidence in the method's ability to meet their contraceptive

needs. Additionally, the majority of users reported being very satisfied with the side effects

associated with implantable contraceptives, indicating that these methods are generally well-

tolerated among the sampled population. However, it is noteworthy that a small proportion of

women (18 out of 30) expressed only partial satisfaction with side effects, suggesting that there

may be room for improvement in addressing individual concerns and preferences regarding

method-related discomfort or inconvenience.

5.2.3 Access to healthcare and family planning services

Access to healthcare services emerged as a multifaceted factor influencing contraceptive

utilization. While the majority of women did not face significant challenges in accessing

services, a significant number reporting no obstacles, a notable subset encountered difficulties

related to access, such as delays in removal services. Distance from healthcare facilities also

played a role, with women living farther away potentially experiencing greater barriers to

accessing contraceptive services. These findings underscore the importance of ensuring equitable
access to contraceptive care, particularly in remote or underserved areas, to minimize barriers

and facilitate consistent utilization of contraceptive methods.

5.2.4 Cultural influence and partner involvement

Cultural and religious influences were found to have a limited impact on contraceptive decision-

making within the sample population. While a small number of women reported that their

cultural or religious beliefs influenced their choice of contraception to some extent, the majority

indicated that these factors did not play a significant role in their decision-making process. This

suggests that, while cultural and religious considerations may influence contraceptive choices for

some individuals, they are not predominant factors for the majority of women sampled in this

study.

Partner involvement in contraceptive decision-making varied among the surveyed women, with a

minority reporting significant partner involvement. While some women indicated that their

partners were fully or partially involved in contraceptive decisions, the majority reported making

decisions independently. This highlights the importance of considering individual autonomy and

agency in contraceptive decision-making processes, while also recognizing the potential benefits

of partner involvement in supporting informed and collaborative decision-making.

5.3 Conclusion

In conclusion, the findings of this study highlight the significant role of healthcare provider

recommendations in driving the utilization of implantable contraceptive methods among women.

High levels of satisfaction with the effectiveness and side effects of these methods underscore

their importance in meeting women's contraceptive needs. However, challenges related to access

to healthcare services, particularly for women living farther from facilities, indicate the need for

interventions to improve access and reduce barriers. While cultural and religious influences and

partner involvement varied among the sampled women, individual autonomy emerged as a

predominant factor in contraceptive decision-making. Moving forward, efforts to enhance

patient-provider communication, address access barriers, and support informed decision-making

will be essential in promoting equitable access to contraceptive care and supporting reproductive

health outcomes for women worldwide.

5.4 Recommendation

5.4.1 Recommendation from results

Based on the findings of this study, several recommendations can be made to improve the

utilization of implantable contraceptive methods and support reproductive health outcomes

By implementing these recommendations, healthcare systems can better support women in

accessing and utilizing implantable contraceptive methods, ultimately improving reproductive

health outcomes and empowering individuals to make informed choices about their reproductive

future

i. Enhance Provider Education and Counseling: Healthcare providers should receive

comprehensive training on contraceptive methods, including implantable contraceptives,

to effectively counsel patients on their options. Providers should be equipped to discuss

the benefits, side effects, and efficacy of implantable methods and address any concerns

or misconceptions patients may have.

ii. Improve Access to Contraceptive Services: Efforts should be made to reduce barriers to

accessing contraceptive services, particularly for women living in remote or underserved

areas. This may include expanding the availability of contraceptive services in rural

areas, increasing clinic hours to accommodate working individuals, and providing

transportation assistance for those facing logistical challenges.

iii. Promote Patient Education and Awareness: Public health campaigns should aim to

increase awareness and knowledge about contraceptive options, including implantable

 methods, among women of reproductive age. Education initiatives should address

common myths and misconceptions surrounding contraception and empower women to

make informed choices about their reproductive health.

iv. Address Cultural and Religious Considerations: Healthcare providers should be sensitive

to cultural and religious beliefs that may influence contraceptive decision-making and

tailor counseling and support accordingly. Collaborative approaches that respect

individual autonomy while acknowledging cultural and religious values can help ensure

that women receive culturally competent care.

v. Support Partner Involvement: While the majority of women in this study made

contraceptive decisions independently, efforts should be made to engage partners in

discussions about family planning when appropriate. Couples counseling and educational

interventions that involve partners can promote shared decision-making and support

couples in achieving their reproductive goals.

Research and Innovation: Continued research into contraceptive methods, including the

development of new technologies and formulations, can expand contraceptive options and

improve user satisfaction. Innovation in service delivery models, such as telemedicine and

community-based outreach programs, can also help overcome access barriers and reach

underserved populations
REFERENCES
Ilegbusi, P. H. (2022). Contraceptive Implants. In Studies in Family Planning. IntechOpen.

Rouncivell, L. (2020). Knowledge, attitudes and perceptions of long acting reversible

contraceptive (LARC) methods among healthcare workers in sub-Saharan Africa: A systematic

review and meta-analysis. PQDT-Global.

Chekole, M. S., Zikie, D. T., Wogie Fitie, G., Taye, B. T., Kibiret, D. M., Silesh Zerihun, M., ...

& Lemma Demisse, T. (2023). Determinants of Implanon discontinuation among women who

use Implanon at Debre Berhan town public health institutions in Northeast Ethiopia: a case–

control study. Frontiers in Global Women's Health, 4, 961364.

Appendices

Appendix1: writing letters for support

Appendix2: mapping of the study location

Appendix 3: Budgeting for all the activities

Appendix 4: selection and training of the personnels to do the actual work

Appendix 5: preparations of questionnaires and other tools to be used in collection of data.

5.5 QUESTIONARRE

FACTORS INFLUENCING THE UTILIZATION OF IMPLANTABLE

CONTRACEPTIVE METHODS AMONG WOMEN OF REPRODUCTIVE AGE IN
KAHAWA WEST (soweto area), NAIROBI COUNTY.

Note: Please answer all questions to the best of your ability. Your responses will remain
confidential and will be used for research purposes only.

Section 1: Demographic Information

1. What is your age?

o 18-24

o 25-34

o 35-44

o 45 and above

2. What is your highest level of education?

o Primary education or below

o Secondary education

o Tertiary education (college/university)

o Postgraduate education

3. What is your marital status?

o Single

o Married

o Divorced

o Widowed

4. How many children do you currently have?

Section 2: Utilization of Implantable Contraceptives

5. Have you ever used Implanon or Jadelle implants for contraception?

o Yes

o No

6. If yes, what influenced your decision to use implantable contraceptives? (Select all that
apply)

o Recommendation from healthcare provider

o Awareness campaigns or educational materials

o Partner support and involvement

o Previous dissatisfaction with other contraceptive methods

o Other (please specify): ___________

7. If no, what factors have influenced your decision not to use implantable contraceptives?
(Select all that apply)

o Concerns about side effects

o Lack of awareness or knowledge about implants

o Cultural or religious beliefs

o Partner opposition

o Preference for other contraceptive methods

o Other (please specify): ___________

Section 3: Satisfaction with Implantable Contraceptives

8. If you have used Implanon or Jadelle implants, how satisfied are you with the method in
terms of efficacy (effectiveness in preventing pregnancy)?

o Very satisfied
o Somewhat satisfied

o Neither satisfied nor dissatisfied

o Somewhat dissatisfied

o Very dissatisfied

9. How satisfied are you with the side effects experienced while using Implanon or Jadelle
implants?

o Very satisfied

o Somewhat satisfied

o Neither satisfied nor dissatisfied

o Somewhat dissatisfied

o Very dissatisfied

10. Overall, how satisfied are you with your experience using Implanon or Jadelle implants?

o Very satisfied

o Somewhat satisfied

o Neither satisfied nor dissatisfied

o Somewhat dissatisfied

o Very dissatisfied

Section 4: Access to Healthcare and Services

11. How far is the nearest healthcare facility offering contraceptive services from your
residence?

o Less than 1 kilometer

o 1-5 kilometers

o 6-10 kilometers
o More than 10 kilometers

12. Have you encountered any challenges in accessing contraceptive services, including
implant insertion and removal, at healthcare facilities?

o Yes

o No

o If yes, please specify the challenges: ___________

Section 5: Cultural and Partner Influences

13. How do cultural or religious beliefs influence your decision-making regarding

contraceptive use?

o Strongly influences

o Somewhat influence

o Do not influence

14. To what extent is your partner involved in decisions regarding contraceptive use?

o Fully involved

o Somewhat involved

o Not involved

Section 6: Additional Comments

15. Is there anything else you would like to share about your experiences or thoughts
regarding the use of Implanon or Jadelle implants for contraception?
Thank you for participating in this study! Your feedback is valuable in helping us understand
the factors influencing contraceptive utilization and satisfaction among women in Kahawa
West, Nairobi County.