Julia Velonjara1, Bonnie Crouthamel2, Gabrielle O'Malley3, Mona Wiggins4, Daniel Matemo5, Grace John-Stewart6, Jennifer A Unger7, John Kinuthia8, Alison L Drake9. 1. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States. Electronic address: juliavelonjara@aya.yale.edu. 2. Department of Obstetrics and Gynecology, University of Washington, 1959 NE Pacific St, Box 356460, Seattle, WA 98195, United States. Electronic address: bcroutha@gmail.com. 3. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States. Electronic address: gomalley@uw.edu. 4. School of Nursing, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States. Electronic address: monaesther@gmail.com. 5. Research and Programs, Kenyatta National Hospital, Box 259000202, Nairobi, KE 00202, United States. Electronic address: daniel.matemo@gmail.com. 6. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States. Electronic address: gjohn@uw.edu. 7. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States. Electronic address: junger@uw.edu. 8. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States; Research and Programs, Kenyatta National Hospital, Box 259000202, Nairobi, KE 00202, United States; Department of Global Health, University of Washington, Seattle, WA 98104, United States. Electronic address: kinuthia@uw.edu. 9. Department of Global Health, University of Washington, 325 9th Ave, Box 359909, Seattle, WA 98104, United States. Electronic address: adrake2@uw.edu.
Abstract
OBJECTIVE: Adolescent fertility rates are high in Kenya, and increase the risks of unintended repeat pregnancies and maternal and infant morbidity and mortality. Our objective was to examine knowledge, practices, and influences surrounding contraceptive access and use among Kenyan postpartum adolescents. STUDY DESIGN: We conducted a mixed methods study (surveys and focus group discussions) with postpartum adolescents and family planning (FP) providers at two maternal and child health clinics in Kenya. MAIN OUTCOME MEASURES: Four focus group discussions (FGDs) were conducted with postpartum adolescents (stratified by age and site), and two FGDs were conducted with FP providers (stratified by site). Transcripts were analyzed for prevalent themes. The participants also completed individual surveys that were analyzed for contraceptive knowledge. RESULTS: Adolescent contraceptive decision-making and use were shaped by social norms of adolescent sexual behaviour. Lack of FP knowledge, community misinformation, and insufficient counselling and time with providers all contributed to adolescent concerns about FP. However, as adolescents transitioned to motherhood, they felt more encouraged to use FP and had increased awareness of FP benefits. CONCLUSION: Both postpartum adolescents and providers felt delivery of FP services could be improved if providers had better training and counselling tools.
OBJECTIVE: Adolescent fertility rates are high in Kenya, and increase the risks of unintended repeat pregnancies and maternal and infant morbidity and mortality. Our objective was to examine knowledge, practices, and influences surrounding contraceptive access and use among Kenyan postpartum adolescents. STUDY DESIGN: We conducted a mixed methods study (surveys and focus group discussions) with postpartum adolescents and family planning (FP) providers at two maternal and child health clinics in Kenya. MAIN OUTCOME MEASURES: Four focus group discussions (FGDs) were conducted with postpartum adolescents (stratified by age and site), and two FGDs were conducted with FP providers (stratified by site). Transcripts were analyzed for prevalent themes. The participants also completed individual surveys that were analyzed for contraceptive knowledge. RESULTS: Adolescent contraceptive decision-making and use were shaped by social norms of adolescent sexual behaviour. Lack of FP knowledge, community misinformation, and insufficient counselling and time with providers all contributed to adolescent concerns about FP. However, as adolescents transitioned to motherhood, they felt more encouraged to use FP and had increased awareness of FP benefits. CONCLUSION: Both postpartum adolescents and providers felt delivery of FP services could be improved if providers had better training and counselling tools.
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