Inequities in unmet need for contraception among married women: Evidence from the PMA2020/ Kenya survey

Abstract

Abstract Unintended pregnancy is a common global public health problem associated with significant health risks and social costs with 85 M occurring in 2012. Innumerable health surveys have shown increased contraceptive use and access, despite not meeting demand leading to unmet need for contraception. This paper scrutinizes inequity in unmet need among married women of reproductive age using PMA2020/Kenya survey data. Cross-sectional design with multi-stage cluster random sampling technique involving random selection of nine Counties, 120 enumeration areas and 42 households was adopted. Face-to-face interviews using digital platform was done in seven survey rounds from 2014 to 2018 generating 35,185 interviews. Strongly balanced panel data with 2,154 respondents per wave was analyzed using Stata® Ver 14.2. Unmet need was high amongst pubescents (23.2%), higher parity (22.6%), rural residency (22.6%), informal education (36.0%) and poorest (24.8%). Concentration index was negative (−0.11, SE = 0.01), implying poor households have unmet need unlike rich households. Unadjusted and adjusted odds ratio was estimated to rise by 0.44 (95%CL = 0.35–0.57, p-value < 0.05) and 0.69 times (95%CL = 0.34–1.42, p-value > 0.05) with increased poverty levels. Creating contraceptive uptake demand must reciprocate unfailing supply of inexpensive methods targeting adolescents, higher parity, less educated and poorest. Consider involving spouses when discussing contraceptive methods, associated side effects and individual health concerns.