Saturday, June 22, 2024

Understanding Contraceptive Choices of Kenyan Adolescent Girls and Young Women

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In Kisumu County, Kenya, the preferences and priorities of adolescent girls and young women (AGYW) regarding contraceptive methods and service delivery characteristics have been under-researched. A recent study delves deeply into the factors influencing their choices, aiming to tailor family planning services to better meet this demographic’s unique needs. This research is crucial for developing effective reproductive health strategies that resonate with the specific concerns and priorities of AGYW.

Methodology and Data Collection

The study utilized a comprehensive four-stage approach encompassing data collection, data reduction, elimination of unsuitable attributes, and optimization of wording. Conducted between June and October 2021, the researchers carried out in-depth interviews with 30 sexually-active AGYW aged 15-24 in Kisumu County. These participants, who were non-pregnant and wished to delay pregnancy, shared their preferences and how they balanced different contraceptive attributes.

Interviews were meticulously translated and analyzed using a constant comparative method to uncover core themes. To ensure clarity and relevance, the research team developed and repeatedly refined a list of attributes and levels, which were then tested through cognitive interviews with an additional 15 AGYW.

Key Findings

The study participants, with a median age of 18, identified six primary themes influencing their contraceptive choices: side effects, effectiveness, user control, privacy, source of services, and cost. Notably, bleeding patterns emerged as a major concern, with many considering amenorrhea an unacceptable side effect. Privacy often took precedence over effectiveness, although some participants prioritized the duration of use and the likelihood of preventing pregnancy.

Most AGYW favored accessing contraceptives in a clinic setting due to the availability of professional counseling, although pharmacies were preferred for their privacy benefits. The study successfully selected and pre-tested seven discrete choice experiment (DCE) attributes, each categorized into 2-4 levels.

Concrete Inferences for Service Improvement

– Emphasize privacy in contraceptive service delivery to align with AGYW preferences.
– Address concerns about bleeding patterns in contraceptive counseling.
– Provide multiple access points, including clinics and pharmacies, to cater to diverse preferences.
– Incorporate user control and cost considerations into family planning programs.
– Tailor contraceptive effectiveness information to individual preferences.

In conclusion, understanding the contraceptive preferences of AGYW is vital for crafting innovative and effective reproductive health interventions. The insights gained from this study can guide the development of customized counseling and service delivery models, ensuring that the specific needs of AGYW are met.

Original Article: Front Reprod Health. 2024 May 7;6:1360390. doi: 10.3389/frph.2024.1360390. eCollection 2024.

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