Determinants of unintended pregnancy among women attending Kenyatta National Hospital Antenatal Care Clinic

Published: 24 August 2021| Version 2 | DOI: 10.17632/bg26ctff7f.2
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Background. Unintended pregnancy is a public health problem that cuts across all the countries in the world due to its negative health and socio-economic outcomes to the mother, family, and society in general. It predisposes women of child-bearing age to risk factors like unsafe abortion, maternal deaths, malnutrition, mental illness because of stress, and vertical transmission of HIV. There is no representative information on its prevalence and correlates among women attending antenatal clinics in Nairobi, Kenya, hence the need for this study. Method. In a cross-sectional study design, data was collected using a structured, pretested and interviewer guided questionnaire from a sample size of 227 pregnant women attending the antenatal clinic at the Kenyatta National Hospital, Nairobi. The prevalence of unintended pregnancies was calculated, and logit regression models were fitted to predict the correlates of unintended pregnancies. Results. In this study, a third (29.9%) of the pregnant women reported that their current pregnancy was unintended. Individual factors such as age less than 25 years [AOR 8.1 (95% CI 1.4-48.6)), p=0.001], use of contraceptive method [AOR 7.9 (95% CI 2.5-25.0), p<0.001] and the woman being the sole decision-maker on when to get pregnant [AOR 3.8 (95% CI 1.3-11.2), p=0.014] were independent predictors of unintended pregnancy. Conclusion. The study finding strongly highlights the need for reinforcing targeted contraceptive counselling during antenatal and postnatal clinics. Raise awareness on the benefits of Contraceptive to all mothers delivering in government health facilities to reduce unintended pregnancy.

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This was a cross sectional study that was conducted at the Antenatal care clinic (known as clinic 18) at Kenyatta National Hospital. At least 1200 expectant mothers visit every month for their antenatal care services. Kenyatta National Hospital is the biggest teaching and referral hospital located in Nairobi, Kenya. The study population was pregnant women attending antenatal clinic at Kenyatta National Hospital. Inclusion criteria i. 18-49-year-old ii. Willing to participate in the study iii. Pregnant women with a gestation period of up to at least 36 weeks Exclusion criteria i. In labor or had complications that could not allow her to be interviewed ii. Declined to consent. iii. Those who were unable to communicate (pregnant women who cannot hear speak or mentally challenged). The sample frame was all pregnant women attending antenatal clinic at Kenyatta National Hospital and had been registered on the ANC registration book (patients going for subsequent visits and new patients) at the ANC clinic. The following formula was used to calculate the sample size: n = (Z2 p q) ÷d2 The study population comprised of 1200 pregnant women attending antenatal clinic at Kenyatta National Hospital. The sample frame of all pregnant women attending antenatal clinic at Kenyatta National Hospital and had been registered on the ANC registration book (patients going for subsequent visits and new patients) at the ANC clinic. A sample n= 227 was selected using systematic sampling technique and data collected using a pretested interviewer-administered questionnaire. Quantitative data was entered in Microsoft Office excel 2010 data sheet. Thereafter coding and analysis was done using Statistical Package for Social Sciences (SPSS) version 21. The study population was described by summarizing socio-demographic characteristics into percentages and means/medians for categorical and continuous variables, respectively. Prevalence of unintended pregnancies was calculated and presented as a percentage of all the women studied. Factors associated with unintended pregnancies were determined using chi square test of associations. Odds ratios were calculated to estimate the relative risks associated with each independent factor. Multiple logistic regressions were used to adjust for confounding effects in the variables associated with unintended pregnancies. Statistical significance was interpreted at 5% level (p value less or equal to 0.05). Results In this study, a third (29.9%) of the pregnant women reported that their current pregnancy was unintended. Individual factors such as age less than 25 years [AOR 8.1 (95% CI 1.4-48.6)), p=0.001], use of contraceptive method [AOR 7.9 (95% CI 2.5-25.0), p<0.001] and the woman being the sole decision-maker on when to get pregnant [AOR 3.8 (95% CI 1.3-11.2), p=0.014] were independent predictors of unintended pregnancy..