Determinants of unmet family planning needs among women of reproductive age between 15 and 49 years in Siaya County, Kenya.

Introduction: unmet need for family planning is still a major public health issue, impacting maternal and child health outcomes. In Kenya, 14% of women desire to avoid or delay a pregnancy but are not using contraceptives. Unmet need differs across counties, with Siaya having a high unmet need at 21% despite the target to eliminate unmet need for family planning. This study sought to establish determinants of unmet family planning needs among Women of Reproductive Age (WRA) between 15 and 49 years in Siaya County, Kenya. Specifically, the study sought to address three specific objectives: to determine the level of unmet needs among WRA, socio-demographic characteristics of WRA, assess the level of knowledge on family planning and to determine attitudes towards family planning among WRA. Methods: the study presents findings from the baseline phase of a larger quasi-experimental study design. It utilized a mixed research design. The study adopted the World Health Organization's 30 by 30 2-stage cluster sampling method. The FANTA sample size formula was applied to arrive at 724 respondents. A total of 728 women of reproductive age participated in the study. The study included sexually active WRA, married women, or women in a companion. The study targeted over 67,023 women already in such unions and sexually active, which served as the sampling frame for the study. The current study, being a baseline study, results after the health education intervention will be presented in another study. Results were presented in tables and figures. Ethical guidelines and procedures upheld during the study included informed consent, voluntary participation of participants, confidentiality, data security measures, assent for the minors, and usage of research licenses and approval from the ethics from the school. Data analysis was done using IBM SPSS version 28.0. The statistical analysis was undertaken in two steps: bivariate analysis and multivariate analysis. Results: a total of 728 women of reproductive age participated in the study. The majority (45.2%) of the women were aged 25 to 34 years. Results showed that most (64.0%) of the women demonstrated a high level of knowledge, scoring 80% or above. However, only 2.7% had a low level of knowledge, with aggregate scores below 50%. The majority (75.5%) of the women had a positive attitude, with 24.5% having a negative attitude. The prevalence of unmet need was 52.7%. The proportion of unmet need was significantly more (COR = 1.61; 95%CI = 1.19 - 2.19; p = 0.002) among women with a low or moderate level of knowledge on family planning compared to those women with a high level of knowledge. Women aged 15 to 24 years were 3.43 times more likely to have unmet need for family planning compared to those aged 35 to 49 years (COR = 3.43; 95%CI = 2.23 - 5.26; p <0.001). Women with a negative attitude towards family planning had a significantly higher unmet need for family planning (COR = 1.53; 95%CI = 1.09 - 2.16; p = 0.015) compared to those women with a positive attitude. Conclusion: the study concludes that social-demographic factors such as education, age, or economic activity significantly influenced the unmet needs for family planning. Knowledge significantly influenced the unmet needs for family planning, where WRA with lesser knowledge were more likely to experience unmet needs. Lastly, Attitudes such as perceived harm of using contraceptives and stigmatization from their use significantly increased the odds of unmet family planning needs.