Client-related factors influencing contraception uptake among postpartum women in Kitui County, Kenya

Background/Aims Low postpartum contraception uptake is a major public health concern, as it contributes to the rising incidence of unintended pregnancies among postpartum women. This results in increased maternal and infant morbidity and mortality rates. This study's aim was to assess the influence of client-related factors on the uptake of postpartum contraception among postpartum women. Methods This mixed-methods study was carried out in two purposively selected health facilities in Kitui County, Kenya. For quantitative data, 228 randomly sampled postpartum women completed semi-structured questionnaires and responses were analysed using Chi-squared and Fisher's exact tests to establish factors related to postpartum contraceptive uptake. For qualitative data, four focus group discussions were held with 40 postpartum women and key informant interviews were carried out with department in-charges at the two health facilities, exploring perceptions of factors influencing postpartum contraceptive uptake. The qualitative data were analysed thematically. Results There was a significant association between uptake of postpartum contraception and multiple factors, including: age (P=0.004), ethnicity (P=0.036), religion (P=0.027), education (P=0.013), residence (P<0.001) and employment (P<0.001). The qualitative findings highlighted individual and sociocultural factors that influenced uptake of postpartum contraception, including previous use of contraception, cultural beliefs and women's age, religion and education. Conclusions There were multiple predictors of postpartum contraception uptake among women, including employment, parity, age, ethnicity, religion, residence and education. These constitute useful targets for interventions to improve postpartum contraception use. Implications for practice It is important to educate women on contraception during postnatal, immunisation and wellbeing visits by providing information on the effectiveness and side effects of different methods. Efforts to encourage postpartum contraception use should also target partner and religious leader engagement to address misconceptions and support women in rural areas or those with lower education levels to overcome barriers to uptake. Tailored strategies are needed, possibly incorporating mobile reminders to support women in Kitui County and similar settings in their choice to use contraception.