ArticleBMC public health2025
Socioeconomic inequality and its drivers in unmet needs for family planning in Kenya.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFamily planning has both health and social benefits for women. A lack of access can lead to unwanted pregnancies, unsafe abortion, high maternal and infant mortality, and loss of economic opportunities. The global unmet need for family planning was 15.6% in 2019, while the unmet need for modern family planning among women aged 15-49 years in low- and middle-income countries was unacceptably high at 24%. In Kenya, it was 20% in 2022 despite SDG target 3.7.1 guaranteeing universal coverage.
methodsMost studies on unmet needs focus on the prevalence and factors associated with the uptake of family planning, but assessments of socioeconomic inequality within low-utilization groups are rarely given much attention. This is despite socioeconomic inequality being a central theme in achieving the SDGs. This study assessed socioeconomic inequality in the unmet need for family planning measured by the household wealth index and used putative determinants to explain the inequality. The study used data from the KDHS (2022). Associations between individual factors and unmet needs for family planning were determined using logistic regression models, whereas socioeconomic inequality was assessed using concentration curves and concentration indices.
resultsThe prevalence rate of unmet needs was 14%; 7.6% for spacing and 6.4% for limiting. And among the poorest women was 21.6% compared to 10.1% among the richest. Being poor (OR: 1.788, 95% CI: 1.324-2.414), young (OR: 1.569, 95% CI: 1.212-2.030), having more than one living child (OR: 1.393, 95% CI: 1.157-1.676), not employed (OR: 1.561, 95% CI: 1.375-1.772), having no education (OR: 1.456, 95% CI: 1.022-2.074) and lacking media exposure (OR: 1.249, 95% CI: 1.027-1.519) increased the odds of unmet needs. The socioeconomic inequality in unmet needs was pro-poor (CIX < 0) and was substantially high (CIX<-0.4) among women with more than three children (CIX=-0.41), with no education (CIX=-0.46) or partners have no education (CIX=-0.68) or lack media exposure (CIX=-0.49).
conclusionThe study recommends youth friendly - highly subsidized family planning services and commodities, and family planning information and education for women of low socioeconomic status.
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