Determinants of Contraceptive Use Among Postpartum Adolescents in Western Kenya: A Qualitative Analysis

Abstract

Objective: To examine influences of contraceptive access and use pre- and postpartum among a group of postpartum adolescents. Design/Setting/Participants: This qualitative study utilizing focus group discussions (FGDs) was conducted between October and November 2013 at 2 public sector hospitals in western Kenya. Participants were postpartum adolescents attending infant immunization clinics (n=26) and health care providers (n=28). Emergent themes related to contraceptive knowledge, access, use, and social relationships were analyzed. Methods: 4 FGDs with postpartum adolescents were stratified by study site and age (14-18 and 19-21). 2 provider FGDs were stratified by site. Transcripts were analyzed using a grounded theory approach. Results: Influences on adolescent contraceptive decision-making and use were shaped by social norms of adolescent sexual behavior, the transition to motherhood, misinformation and knowledge sources, method preferences, and provider and health system capacity to offer services to adolescents. Conclusion: Given the increased risk of pregnancy-related morbidity and mortality among adolescents and postpartum women, increasing and improving targeted, effective services is critical to better understanding the influences for contraceptive access and use among postpartum adolescents. Keywords: postpartum, adolescents, contraception, family planning, Kenya, focus groups