| dc.description.abstract | Strengthening health systems calls for attention on focus on the six health systems building
blocks. The focus of this study was on medicines, vaccines and technologies, with an
emphasis on access to contraceptives. In July 2013, the Kenyan government introduced the
Free Maternal Service (FMS) policy. Implementing the FMS policy resulted in more usage
of maternity services in Kenya however, personnel and physical resources were not
enhanced to match the increasing demand. The challenges pointing to implementation of the
FMS policy may be implied to lead to low access of maternal health services, including
family planning services hence resulting in multiple health problems including unsafe
abortions, unwanted births and unplanned pregnancies. Identifying the enabling and
inhibiting elements before the execution of the interventions is likely to overcome these
unmet needs. This study thus will seek to establish the factors influencing access to
contraceptives by women of reproductive age within public health facilities in Kajiado
County. The aim of the study was to determine how client factors, human resource factors,
organizational factors and health communication influence access to contraceptives by
women of reproductive age within Kajiado Central Sub-County, which has the highest
average household size of 4.3 in Kajiado County. A cross-sectional descriptive research
design was used in this study. The study targeted about 500 family planning clients visiting
five public primary care health facilities in the sub-County. A sample of 217 drawn using
systematic sampling. A structured questionnaire was used to collect data from 197
respondents. The majority of the respondents were between 25-35 years 112 (57%), were
married 169 (86%), and majority 88 (45%) were on an injectable contraceptive method
referred to as Depo Provera. The majority had one to four children 158 (80%), 93 (47%) had
a college education, they were self-employed 81 (41%), and 61 (31%) were earning between
KShs11,000-20,000. Results obtained from logistics regression analysis indicated that
clients’ factors (p <0.001, OR=12.655, 95% CI [4.701-34.067]), and organizational factors
(p <0.05, OR=2.541, 95% CI [1.079-5.985]), had a significant association with access to
contraceptives. This study recommends that clients should be educated to demystify the
cultural beliefs, myths and misconceptions surrounding contraceptive access. The county
government should ensure the supply chain is well managed to ensure a constant supply of
contraceptives, adopt automated systems and reduce human interventions. The county
government should also improve the health provider infrastructure, as this is likely to lead
to the delivery of quality services, client satisfaction and reduced maternal mortality. The
health workers counsel clients before giving contraceptives, they also are friendly and listen
to clients. This practice should continue being encouraged and natured, through in-service
training. | en_US |
