KNOWLEDGE, ATTITUDE AND PRACTICE OF CONTRACEPTION AMONG

UNDERGRADUATE STUDENTS IN THE SCHOOL OF EDUCATION IN MOUNT

KENYA UNIVERSITY

FLAVIA KHASOA

BSCN\34705\2015

A RESEARCH PROJECT SUBMITTED TO THE MOUNT KENYA UNIVERSITY

SCHOOL OF NURSING IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR
THE AWARD OF THE DEGREE OF SCIENCE IN NURSING

SEPTEMBER 2020

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DECLARATION

This Research Project is my original work and has not been presented before in any other
institution of higher learning for purposes of academic accreditation

Sign …………………………. Date……………………….

FLAVIA KHASOA

BSCN/34705/2015

This Project has been submitted for examination with my approval as a university supervisor.

Signed ……………………… Date……………………

MR DANIEL MUYA

SENIOR LECTURER, School of Nursing

Mount Kenya University

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DEDICATION

I dedicate this Research Project to my younger siblings, Chelsea, Peace and Trevor. I hope this
inspires you to work even harder and smart in life. To all the young ladies out there, you can
achieve whatever you want despite all the challenges.

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ACKNOWLEGMENT

I thank God for the opportunity, strength, health and providence throughout the period and all
those who helped me in one way or the other.

I thank my supervisor Mr. Daniel for guidance and intellectual support.

I also appreciate my friends and colleagues in the BsCN program who assisted with their support
and ideas.

To my dear parents, you gave me the push and advice that I required and also for the financial
support. THANK YOU.

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ABSTRACT

All individuals have the right to access reproductive health services. The sustainable
development goals aim at promoting universal access to sexual and reproductive health services
one target being to promote contraception. Contraception is an important preventative measure
of unintended pregnancy and sexually transmitted diseases among the youth. The main objective
of this study is to determine the knowledge attitude and practice among undergraduate students
in Mount Kenya University, main campus Thika, in the school of education. The specific
objectives are to determine the prevalence of use family planning, types of family planning and
the challenges to access the family planning methods. The study adopts Anderson’s conceptual
model of health care utilization. The research design will be descriptive cross-sectional study.
The sample size will be determined by fisher’s statistical formula. Simple random sampling will
be used to obtain the required number of correspondents. Data will be collected through use of
questionnaires and data will be analyzed quantitatively. This study will help assess the uptake of
family planning methods and help find out the challenges that lead to not using the methods.

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TABLE OF CONTENTS

Contents
DECLARATION.............................................................................................................................2
DEDICATION.................................................................................................................................3
ACKNOWLEGMENT....................................................................................................................4
ABSTRACT....................................................................................................................................5
LIST OF ABBREVIATIONS..........................................................................................................9
CHAPTER ONE: INTRODUCTION............................................................................................10
1.1 Background Information..........................................................................................................10
1.2 Statement of the problem.........................................................................................................12
1.3 Study objectives.......................................................................................................................13
1.3.1 Broad objective.....................................................................................................................13
1.3.2 Specific objective..................................................................................................................13
1.4 Research questions...................................................................................................................13
1.5 Justification of the study.....................................................................................................14
1.6 Limitation of the study.............................................................................................................14
1.7 Theoretical Framework............................................................................................................15
1.8 Conceptual Framework............................................................................................................16
CHAPTER TWO: LITERATURE REVIEW................................................................................17
2.0 Introduction..............................................................................................................................17
2.1 Contraception and the young people.......................................................................................17
2.2 Knowledge and awareness of family planning methods.........................................................17
2.2.1 Types of contraceptives........................................................................................................17
2.2.2 Barrier Methods....................................................................................................................18
2.2.3Natural Methods....................................................................................................................18
2.2.4 Voluntary Surgical Intervention...........................................................................................18
2.2.5 Intrauterine Contraceptive Devices (IUCDs).......................................................................18
2.2.6 Emergency Contraception....................................................................................................19
2.3 Importance of family planning................................................................................................19
2.4 Knowledge and awareness of family planning methods.........................................................20

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2.4.1 Reproductive health policy...................................................................................................20
2.5 Barriers of uptake of family planning among the youths........................................................20
CHAPTER THREE: RESEARCH METHODOLOGY................................................................22
3.1 Introduction..............................................................................................................................22
3.2 Research Design......................................................................................................................22
3.3 Location of the Study...............................................................................................................22
3.4 Target Population.....................................................................................................................22
3.5 Criteria.....................................................................................................................................22
3.5.1 Inclusive criteria...................................................................................................................22
3.5.2 Exclusive criteria..................................................................................................................23
3.6 Variables..................................................................................................................................23
3.6.1 Independent variables...........................................................................................................23
3.6.2 Dependent variables..............................................................................................................23
3.7 Sample Size and Sampling Procedures....................................................................................23
3.7.1 Sample Size Determination..................................................................................................23
3.7.2 Sampling Procedures............................................................................................................24
3.8 Data Collection Tools and Methods........................................................................................24
3.9 Validity and Reliability of the Data.........................................................................................24
3.9.1 Validity.................................................................................................................................24
3.9.2 Reliability.............................................................................................................................24
3.10 Data Management..................................................................................................................25
3.11 Ethical Considerations...........................................................................................................25
CHAPTER FOUR: DATA FINDINGS AND ANALYSIS..........................................................26
4.0 Introduction..............................................................................................................................26
4.1 Background information of the students..................................................................................26
4.2 Sexual debut.............................................................................................................................28
4.3 Religion of the respondents.....................................................................................................28
4.4 Sources of information on family planning.............................................................................29
4.5 Known family planning methods (Multiple response)............................................................29
4.6 Attitude towards contraceptives (multiple response)..............................................................30
4.7 Motivation behind specific family planning method...............................................................32

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4.8 What other people say about contraceptives...........................................................................32
4.9 Forces behind unwillingness to seek reproductive health services.........................................33
4.91 Chapter summary...................................................................................................................34
CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS............................................35
5.1 Summary of findings...............................................................................................................35
5.2Conclusion................................................................................................................................36
5.3Recommendations.....................................................................................................................36
REFERENCES..............................................................................................................................39
APPENDICES: APPENDIX 1: QUESTIONNAIRE UNIT.........................................................41
APPENDIX 2: WORK PLAN.......................................................................................................45
APPENDIX: BUDGET.................................................................................................................46

LIST OF FIGURES

Figures 1.1: conceptual framework

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LIST OF ABBREVIATIONS

WHO- World Health Organization

RH- Reproductive Health

SDGs – Sustainable Development Goals

SRH- Sexual and reproductive health

KNBS- Kenya national bureau of statistics

KDHS- Kenya demographic health survey

TFR- Total fertility rate

MOH- Ministry of health

UNFPA- United Nations Fund for Population Activities

NCPD-National Council for Population Development.

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CHAPTER ONE: INTRODUCTION

1.1 Background Information

Contraceptive use is a human right and is identified as a priority in the National Reproductive
Health Policy (NCPD and UNFPA, 2013). All individuals have the right to access the services,
including all pertinent data regarding benefits and scientific progress made in the area of
contraception. A rights based approach on the provision of contraceptives assumes a holistic
view of clients, which includes taking into account client’s sexual and reproductive health (RH)
care needs. Appropriate eligibility criteria and practice recommendations in helping clients
choose and use a contraception method need to be considered (WHO, 2016). There are several
methods of contraception, which include oral contraceptives, injectables, emergency
contraceptive pills and intra- uterine devices.

The sustainable development goals (SDGs) that replaced the Millennium development goals
(MDGs) at the end of 2015 aim at promoting universal access to sexual and reproductive health
(SRH) services (United Nation, 2015). One of the main targets to reach the SDGs (3.7 and 5.6) is
to promote family planning (Bhutta et al., 2016). Also, timely achievement of family planning
targets is expected to hasten achievement across 5 SDG themes of People, Planet, Prosperity,
Peace, and Partnership (Starbird et al; 2016). Implementation of family planning interventions,
however, is context dependent and the countries with stable socio-political infrastructure may be
better suited to successfully implement the interventions and achieve the goals than their
counterparts in conflict afflicted settings. The conflict afflicted settings often have fragile health
systems that can hardly support provision of comprehensive SRH (Lawry et al; 2017).

Worldwide, the estimated total abortions range between 36-53 million yielding an annual rate of
32-46 million abortions per 1,000 women of reproductive age. In Africa alone, over 1.5 million
abortions are procured annually, while in Kenya it is approximated that about 300,000 abortions
are procured each year. Unsafe abortion is an important global public health issue. Globally, 20
million unsafe abortions take place every year, with predominance in developing countries
(WHO, 2016). Several decades after the introduction of modern family planning methods,
Kenya’s population is still growing and is projected to exceed 60 million by 2025 (KNBS 2009).
This stall is attributed to a number of factors including reduced availability of modern
contraceptive methods, diversion of resources to HIV/AIDS, and inadequate support for family
planning programmes. According to the Kenya Demographic Health Survey (DHS) 2013–14,
total fertility rate (TFR) was 4.6, while 42% of married women reported their current
pregnancies as unintended (KDHS, 2014). Contraceptive prevalence was found to be 46%; a
result that did not meet the 2010 target of 62% set by the Kenya National Population Policy for
Sustainable Development (NCPD and UNFPA, 2013).

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In the last decade, youth fertility has declined by 7% but the contribution to overall fertility
(TFR) has increased from 32% in the late 1970s to 37% in 2008 [1]. The proportion of teenagers
who have started childbearing increases from 2% at age 15 to 36% by age 19 (NCPD and
UNFPA, 2013). According to the KDHS (2014), 12% of women aged 20–49 had sex before age
15, and about half had their first sex by their 18th birthday (NCPD and UNFPA, 2013). Research
by the Centre for Study of Adolescence found that four in ten Kenyan girls had sex before the
age of 19, many of them as early as 12. Recent statistics from the Ministry of Planning indicate
that 97% of males and 85% of females aged 15–19 years are not married (KNBS and ICF macro,
2013). This suggests that age at first marriage cannot be used as a proxy for age at first sex and
many young people are having sex before marriage.

Young women in Kenya experience a higher risk of mistimed and unwanted pregnancy
compared to older women. While the total mistimed (26%) and unwanted (17%) pregnancies
among all women (15–49 years) remains high, young women (15–24 years) experience even
higher mistimed (32% vs. 30%) and unwanted (15% vs. 10%) pregnancies compared to women
in other age groups. Every year, about 13,000 Kenyan girls drop out of school due to accidental
pregnancy and 103 out of every 1000 births in Kenya are delivered to girls aged 15–19 (KNBS
and ICF macro, 2013). Accidental pregnancy is a leading cause of abortion (WHO, 2016).
However, contraceptive use remains low among youth; 73% of currently sexually active single
women aged 15–19 report not using any contraception method (NCPD and UNFPA, 2013).

Across all age groups, perceived and actual side effects of contraceptive methods emerged as a
primary barrier to use. Kenya’s DHS (married women n only) found that non-users who did not
intend to use contraception in the future most commonly cited fear of side effects and health
concerns. Side effects are also the most common reason for method discontinuation (NCPD and
UNFPA, 2013). Even when awareness is high, poor knowledge of contraceptive methods and
their side effects has been associated with poor uptake (Wafula et al; 2014). This finding may be
related to the myths and misconceptions that many women hold about potential side effects and
negative outcomes. Myths are heard about from peers and partners, whose influence on
contraceptive demand and uptake is well documented in Kenya (Wafula et al; 2014). Another
key barrier is lack of physical and financial access to family planning commodities. Studies have
shown that health facilities offering family planning are not equitably distributed throughout the
country. Women complain of frequent stock-outs and the associated costs of lost wages,
transport and other financial challenges (Wafula et al; 2014).Studies have shown that, among
youth, lower socioeconomic status has been associated with less condom use (Alena et al; 2013).

Study findings in Kenya indicate high percentage of sexually active students and a low
percentage of contraceptive use (Mutungi, 2016). Some studies indicate high morbidity and
mortality cases among this group that have been attributed to unsafe abortion, complications
associated with child birth and HIV/AIDS (KDHS, 2014). NASCOP indicates higher levels of
STDs cases among youth than adults. Youth are more at risk with respect to STIs and HIV/

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AIDS (NASCOP, 2002). Kenya still has a large unmet need for contraceptive and family
planning services generally, estimated at 25.6 percent in 2011.

1.2 Statement of the problem

Each year an estimated 123 million get pregnant intentionally but 87 million become pregnant
unintentionally. This represents 44%of pregnancies. In Africa 89 per1000 women become
pregnant unintentionally: in eastern Africa, the rate is 112 per 1000 women.

Young women in Kenya experience a higher risk of mistimed and unwanted pregnancy
compared to older women. While the total mistimed (26%) and unwanted (17%) pregnancies
among all women (15–49 years) remains high, young women (15–24 years) experience even
higher mistimed (32% vs. 30%) and unwanted (15% vs. 10%) pregnancies compared to women
in other age groups (KNBS, 2014). Unsafe abortion is an important global public health issue.
Globally, 20 million unsafe abortions take place every year, with predominance in developing
countries (WHO, 2016).an estimated 8.2 million induced abortions occur each year in Africa,
with east Africa having about 14%. In Kenya, complications of unsafe abortion contribute 30-
40% of all maternal deaths, far more than the world wide average of 13%, making unsafe
abortion a significant cause of maternal mortality in the country which stands at 211/100,000
live births (United Nation, 2017).

Despite the challenges experienced by youth in Kenya, there is limited access to reproductive
health services. The majority of the sexually active youth are not using contraception. This
predisposes youth to a wide range of reproductive health problems, which include sexually
transmitted infections including HIV/AIDS, teenage pregnancy, unsafe abortion practices and
college dropout among others (NCAPD, 2010). Various barriers have been identified that hinder
youth from accessing family planning methods. Shame is also a significant factor preventing use
of family planning (specifically condoms), particularly for unmarried youth. Young people
perceive women who carry condoms as promiscuous Omollo (2014), and that asking a partner to
use condoms would reveal them as sexually wayward or untrustworthy. Young people also noted
that while married people may freely ask for family planning, they are inhibited because of the
shame associated with procuring contraceptives (Omollo 2014).

At service level, many providers and available health information indicate that family planning
are only for those who are “mothers”, and are not suitable for those who have not yet had a child.
At the policy level, a recent commentary in the Lancet advocates for the replacement of the term
“family planning” with “contraception”; a more neutral term that applies to users, with or
without families. Despite the high proportion of unmarried sexually active youth in Kenya, the
majority of research on barriers to family planning has been conducted among married women;
research among youth is limited to condoms only (NCPD and UNFPA, 2013). Communications
target married women and highlight the need to limit family size. Behaviour change

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communications do not respond to youth, whose needs are mainly to delay childbearing, and
there is a gap in active and consistent national communication to create awareness and demand
for family planning among 15–24 year olds.

The research topic will be used to inform the assessment of the uptake of family planning
methods among undergraduate students, in Mount Kenya University.

1.3 Study objectives

1.3.1 Broad objective

To determine knowledge, attitude and practice of contraception among undergraduate students in

the school of education in mount Kenya university.

1.3.2 Specific objective

1. To assess the knowledge of students about contraceptive methods

2. To identify their attitudes towards contraception
3. To explore contraceptives methods used by students
4. To identify the role of education on contraceptives.

1.4 Research questions

1. What is the knowledge of contraceptive methods among undergraduate students, in

school of education in Mount Kenya University?
2. What are the types of contraception methods among undergraduate students, in Mount
Kenya University?
3. What are the students’ attitudes towards contraception?
4. What is the role of education on contraceptives and is it being achieved among students
in the school of education in Mount Kenya University?

1.5 Justification of the study

In recognition of the reproductive health challenges facing the youth, there is need for a study to
establish the utilization of contraceptive services among youth in Mount Kenya University (main
campus) in Thika. This kind of study has not been carried out before. The study helped to assess
the magnitude of contraceptive services need for undergraduate students at MKU and their
difficulties in accessing the same. The factors that facilitate clients to use contraceptives are very
important in providing satisfaction to consumers of services as well as prevent risk, which may

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occur if services were not provided. Exploring these factors would help the policy makers and all
stake holders involved in provision of contraceptives or youth reproductive health services in
improving the services and attract youth to use them.

As a result, reproductive health problems such as unwanted pregnancy, complications of

pregnancy, unsafe abortions and HIV/AIDS among the youth would be reduced. The results of
the study will enable identification of service needs of young people with respect to
contraceptive services. Results will also provide information on level of awareness; utilization
and difficulty undergraduate students may be having in accessing reproductive health services.
The results will help to assess the quality of information students are having on contraceptives
which often contribute to their attitude toward its use. The findings of the study will assist
achieve to reach the SDGs (3.7 and 5.6) is to promote family planning (Bhutta et al.,2016). Also,
timely achievement of family planning targets is expected to hasten achievement across 5 SDG
themes of People, Planet, Prosperity, Peace, and Partnership (Starbird et al; 2016).

1.6 Limitation of the study

Study will be limited to only undergraduate students from the school of education in Mount
Kenya University students in the main campus, and available during the study period.

The study will be limited to questionnaire as the main data collection tool

1.7 Theoretical Framework

The study will adopt Andersen’s conceptual model. According to Andersen’s conceptual model
of health care utilization (Andersen, 1995) access and utilization of health care is related to three
main individual factors. They are the predisposing, enabling and need factors; the (PEN) model.

Predisposing factors refer to the socio-cultural characteristics existing prior to the onset of the
illness. They include the demographic characteristics like age, sex, education, occupation and
social networks, health beliefs which include attitudes and values (Ministry of Health, 2013).

Enabling factors on the other hand determine the logistical aspects of obtaining healthcare. They
include personal or family characteristics like income and medical insurance. The need factors
focuses mainly on the health status of the individual. In the case of this study, the model will
help in assess the uptake of family planning methods among undergraduate students, in Mount
Kenya University. Predisposing factors such as demographics, socio-economic and existing
socio-cultural factors will be essential to predict the uptake of family planning methods.

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1.8 Conceptual Framework

Independent variables

Socio-demographics

Age

Marital status

Sexual behaviors

Knowledge and awareness

of family planning

Sources of
information Knowledge attitude and
Reproductive health practice
policy

Availability of family
planning facilities

Youth friendly
services

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CHAPTER TWO: LITERATURE REVIEW

2.0 Introduction

2.1 Contraception and the young people

Young people often have no access to the contraceptive services and the education they need
(Bankole, 2017). Some findings in Kenya indicate high percentage of sexually active students
and a low percentage of condom use among the sexually active students (Mutungi, 2016). Some
of the biggest barriers are cultural taboos about young people’s sexuality. To address population
issues, combat maternal death and give young people a good health start on their lives, their right
to reproductive health and contraception information and services must be promoted and change
in policies and regulations encouraged (UNAIDS, 2017).

Currently, many societies disapprove premarital sex and consider reproductive health care for
young people inappropriate. As a result, parents, educators and health care providers often are
unwilling to give young people the information and services needed about contraception. Young
women consistently report less contraceptive usage than men, evidence of their unequal power in
negotiating safer sex or restrictions on access to services such as lack of information, shame,
laws, health provider attitudes and practices or social norms (Nare et al., 2017).

According to United Nations Fund for Population Activities (UNFPA), young people may
hesitate to visit contraception/ family planning clinics because of lack of usual consent.
Inconvenience locations and hours, high costs of some methods, limited contraceptive choices
and supplies, and negative or judgmental provider attitudes. Laws and policies also may restrict
youth’s access to information and services, for example, by limiting contraceptive and family
planning services to married people or those over 16 years, or requiring parental or spousal
consent (Santelli, 2017).

2.2 Knowledge and awareness of family planning methods

2.2.1 Types of contraceptives

Contraception (birth control) prevents pregnancy by interfering with the normal process of
ovulation, fertilization and implantation. Family planning allows people to attain their desired
number of children and determine the spacing of pregnancies. It is achieved through use of
contraceptive methods and the treatment of infertility (WHO, 2013). There are different kinds of
birth control that act at different points in the process (Whitney, 2013). Not all contraceptive
methods are appropriate for all situations and the most appropriate method of birth control

16
depends on a woman's overall health, age, frequency of sexual activity, number of sexual
partners, desire to have children in the future and family history of certain diseases. Individuals
should consult their health care providers to determine which method of birth control is best for
them. Some types carry serious risks, although those risks are elevated with pregnancy and may
be higher than the risks associated with the various methods (KDHS 2014).

According to World Health Organization (WHO), modern contraception refers to birth control
by prevention of conception or impregnation by use of pills, condoms (female and male),
Intrauterine Devices (IUD), Tubal ligation, vasectomy, Caps, Lactation amenorrhea method
(LAM) and injectable. This is the definition that was employed in this study. There are two
permanent methods of contraception: female sterilization/tubal ligation and vasectomy (male
sterilization).

2.2.2 Barrier Methods

They prevent the sperm from gaining access to the upper reproductive tract and making contact
with the egg. The methods include male and female condoms, spermicides, diaphragms and
cervical caps (MOH, 2007).

2.2.3Natural Methods

Natural contraception involves learning to achieve or avoid pregnancy by applying proper sexual
behaviour during the fertile and infertile phases of the menstrual cycle. The methods include
Billing’s method, Basal body temperature, Symptom-thermal method; Calendar method,
Standard day’s method and Coitus interrupt us. The mechanism of action is abstinence during the
fertile period so that the sperm and egg do not meet (MOH, 2007).

2.2.4 Voluntary Surgical Intervention

This is surgical contraception by permanently terminating fertility voluntarily. The methods

include tubal ligation (TL) and vasectomy. Voluntary surgical intervention is permanent and
irreversible and is recommended to those families who are sure they have the desired family size
(MOH, 2012).

2.2.5 Intrauterine Contraceptive Devices (IUCDs)

The IUCD is a flexible device that is inserted into the uterine cavity by a trained service
provider. This is a safe and highly effective, long acting contraceptive method. The IUCD does
not affect breastfeeding, interfere with sexual intercourse or have hormonal side effects. The

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most important considerations for clients choosing a method are effectiveness and safety (MOH,
2012).

2.2.6 Emergency Contraception

Emergency contraception prevents pregnancy after unprotected sex. Emergency pills contain the
same hormones used in oral contraceptives. They can be obtained by using higher doses of
regular packets of pills or by buying pills designed for that purpose. They are not intended to be
used as a regular contraceptive method, but can help a woman avoid pregnancy if used up to five
days after having unprotected sex (Smith et al., 2009)

2.3 Importance of family planning

An analysis of the contribution of contraception and family planning to the Millennium

Development Goals (MDGs) by Moreland and Talbird (2016) showed that satisfying unmet
family planning needs in Kenya would avert 14,040 maternal deaths and 434,306 child deaths by
the MDG target date of 2015. In a study carried out by USAID/HPI (2011), it was noted that the
cost savings in providing services to meet MDGs outweigh the additional costs of contraception
and family planning by a factor of almost 4 to 1. Specifically, the total cost of contraception and
family planning estimated at $7 million, which implies that total savings will be $200 million
(Moreland & Talbird, 2016).

Contraception and family planning services offer various economic benefits to the household,
country and the world at large. Family planning permits individuals to influence the timing and
the number of births which is likely to save lives of children. Secondly, by reducing unwanted
pregnancies, contraceptive service can reduce injury, illness and deaths associated with child
birth, abortions and sexually transmitted infections (STIs) including HIV/AIDS (Walker, 2008).
The greatest impact of contraception on maternal mortality is for those women who are <20
years of age. While it is a sensitive issue in many cultures, delaying pregnancy by increasing
contraception use among both married and unmarried women <20 could save many lives
(Santeli, 2017).

Contraception reduces deaths from AIDS. The consistent and correct use of condoms can
significantly reduce the rate of new infections (NASCOP, 2014). Many HIV-positive women and
couples want to avoid becoming pregnant and many effective methods are available to assist
them. By averting unintended and high-risk pregnancies, contraception reduces mother to child
transmission of HIV (PMTCT) and the number of AIDS orphans, whose life chances are
seriously diminished because they have lost a parent, particularly the mother (Smith et al., 2009).

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2.4 Knowledge and awareness of family planning methods

Studies in Africa, have generally documented low knowledge and awareness levels of effective
contraceptive use amongst higher educational students (Ahmed et al; 2013). Several factors
including age, culture, ethnicity, and religion, poor access to contraceptive services, peer
pressure and lack of partner support were identified as contributing to the non-utilisation of
contraceptives in tertiary institutions. In a study amongst 15 to 24 year old South African
women, it was estimated that only 52.2% of sexually experienced women are using
contraceptives (Golbasi et al; 2012). Because 80% of undergraduate students at higher
educational institutions are sexually active, it is important that they have access to safe,
accessible and adequate contraceptive services (Signh et al; 2015).

The global incidence of unplanned pregnancies amongst students at higher educational

institutions every year continues to increase despite the high awareness and knowledge on
regular modern contraceptives and emergency contraceptives among students in higher
educational institutions (WHO, 2013). Despite the immense contraceptive benefits for students
in higher educational institutions, there is no direct positive correlation between the universal
awareness, knowledge and use of contraceptives which challenges global health efforts. The poor
utilisation of contraceptives in tertiary institutions is associated with many interrelated factors
ranging from personal to institutional setbacks (Signh et al; 2015).

2.4.1 Reproductive health policy

The RH communication strategy outlines the components that any healthy communication
campaign should have in order to ensure its effectiveness. Some of the components include being
results oriented, evidence based, client cantered, participation, benefit oriented, service linked,
multi-channelled, technical quality, advocacy related, expanded to scale, programmatically
sustainable and cost effective.

This implementation guide is based on current implementation and coordination structures of the
MOPHS, though these will change when Kenya’s new constitution, with its focus on counties, is
operationalized. The target populations for the guide are: provincial health management teams,
district health management teams, APHIA Plus partners implementing RH/FP activities,
coordinating agencies civil society organizations, including NGOs, CBOs, and faith-based
organizations (FBOs), community networks and private providers.

2.5 Barriers of uptake of family planning among the youths

While contraceptive use has grown in Kenya over the years, both unmet need for family planning
and unintended pregnancies remain very high suggesting important barriers to effective
contraception (APHRC Policy Brief No.26, 2011). In Africa, 53% of women of reproductive age

19
have an unmet need for modern contraception. In Kenya the unmet need for FP among youth
ages 15 –24 is 30% (KDHS 2008/9), in Asia and Latin America and the Caribbean regions with
relatively high contraceptive prevalence the levels of unmet need are 21% and 22%, respectively
(WHO, 2013).In order to curb this problem contraceptive providers should make contraception
information accessible to increase people’s knowledge and awareness of the available modern
contraceptive methods, which may eventually affect their perceptions and behaviour. It is also
important to spread information about health and family planning using multiple channels to
reach intended target group. The C-Word campaign targets the youth and as a result electronic,

print and social media are most appropriate. Some of the contributing factors towards the high
unmet need are fast growing population and shortage of family planning services (WHO, 2013).

An estimated 222 million women in developing countries would like to delay or stop
childbearing but are not using any method of contraception. Reasons for this include: limited
choice of methods; limited access to contraception, particularly among young people, poorer
segments of populations, or unmarried people; fear or experience of side effects; cultural or
religious opposition; poor quality of available services; gender-based barriers (WHO, 2013).

Socio-cultural beliefs and practices, gender dynamics, poor male engagement, and weak health
management systems continue to impede the demand for and utilization of RH/FP services
(KDHS 2014). Another barrier to effective communication intervention includes lack of Youth
friendly services and facilities not available in most regions of the country (MOH 2012).This
study intends to find out some of the challenges encountered by the youth towards accessing
modern contraceptives and how they can be overcome.

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CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Introduction

This section describes the methodology that will be used in this study. The research design,
location of the study, target population, criteria, variables, sample size and sampling procedures,
data collection tools and methods, validity and reliability of the data, data management and
ethical considerations

3.2 Research Design

This will be a descriptive cross-sectional study which analyses data at specific point in time. This
will save time and cost of carrying out study. The study will adapt quantitative collection method
aimed at assessing knowledge, attitude and practice contraceptive methods among undergraduate
students, in Mount Kenya University.

3.3 Location of the Study

Mount Kenya University (MKU) is a private, multi-campus, chartered university in Kenya.

MKU is one of the largest private universities in the country, with a student body in excess of
52,000, as at September 2015. The university has severally school including the school of
education that has the largest study body and has four departments. The study will focus on the
department of arts.

3.4 Target Population

The target population will consist of undergraduate students in Mount Kenya university main
campus, Thika, from the school of education department of arts.

3.5 Criteria

3.5.1 Inclusive criteria

Undergraduate students from school of education department of arts.

3.5.2 Exclusive criteria

Those who will not consent

21
Those not from the department of arts in the school f education.

3.6 Variables

3.6.1 Independent variables

The independent variables will be:

1. Socio demographic factors

2. Socio cultural factors
3. Knowledge and awareness

3.6.2 Dependent variables

The dependent variable will be knowledge attitude and practice of contraceptive methods among
undergraduate students, from school of education in Mount Kenya University.

3.7 Sample Size and Sampling Procedures.

This section presents sample size determination and sampling procedure.

3.7.1 Sample Size Determination

The minimum sample size was determined using the Fisher’s et.al (1998) statistical formula for
calculating sample size;

n= Z2 pq/d2

Where; n = Minimum sample size for a statistically significant survey,

Z = Normal deviate at the portion of 95% confidence interval = 1.96,

P = Contraceptive prevalence rate among the youth in Kenya was 22% (KDHS, 2014) q = 1- p,

d = Margin of error acceptable or measure of precision

= 1.96 x 1.96(0.22) (0.78) (1.5) / (0.05) (0.05)

= 395.531136

= 396 (+ 10% to cater for non respondents)

22
= 436

3.7.2 Sampling Procedures

Simple random sampling will be used to obtain the required number of respondents from the
sampling frame (Targeted population- total number of all undergraduate students at Mount
Kenya University main campus. This will be obtain from different classes, hostels

3.8 Data Collection Tools and Methods

Data will be collected through use of self administered questionnaire. The questionnaires
consists of four parts, general, knowledge, attitude and practice sections. The questionnaire has
closed ended questions.

3.9 Validity and Reliability of the Data

3.9.1 Validity

The validity of the questionnaire will be based on expert opinion, where the supervisor will
review the study variables. Changes made to the data collection tool will be made prior to
collecting the data. Field test will be also applied where results arising will be considered in
improving the validity of the questionnaire and for logistical planning.

3.9.2 Reliability

Reliability will be assured by; Recruitment of trained researcher in data collection. They will be
trained to translate questionnaire and coding of questionnaires. The training will also include
obtaining an inform consent to limit biasness of the study. Support supervision of the research
assistant will be done on randomly to ascertain research ethics will be followed. Finally the
researcher will check for completeness, consistency and accuracy of completed questionnaires
and will address any gaps identified.

3.10 Data Management

Quantitative data collected using the survey method will be analyzed using descriptive statistics.
This will be done using pie charts, graphs and percentage as needed, tabulated using the
statistical package for social sciences (SPSS) 22 version software. The information will be
grouped into broad themes, organized, summarized and presented in direct quotations of relevant
verbatim responses and selected comments.

23
3.11 Ethical Considerations

Clearance will be obtained from Mount Kenya University. Participants will be enrolled into the
study only after voluntary informed written consent is issued. The participants will be free to
withdraw from the study at any time. There will be no monetary benefits associated with
participation in the study.

24
CHAPTER FOUR: DATA FINDINGS AND ANALYSIS

4.0 Introduction

This chapter contains the findings from the field concerning data that was collected from
participants who were interviewed and filled questionnaires. The data was analyzed descriptively
to establish: The knowledge of students about contraceptive methods, to identify their attitudes
towards contraception, to explore contraceptives methods used by students and to identify the
role of education on contraceptives.

4.1 Background information of the students

Table 4.1 below shows that 436 students participated in the study. Of these, male (279) students
were the majority compared to female (157) students. They showed more interest to participate
in this particular study. Most students were between the age of 18 and 20 years and averagely,
399 of them use contraceptives. A smaller percentage (9.12%) were aged between 24-26yrs and
40(9.12%) of them used contraceptives. This shows that most of the students, who were in the
reproductive age, were actually using a certain form of contraceptive at the time of the study.
Most students were in the second year of study 230(52.75%). Results indicated high sexual
activity among the students as a great percentage 383(87.66%) agreed to have had a sexual
experience by the time this study was conducted. More males than females were using
contraceptives, 71.16% and 34.93% respectively at the time of the study.

The study as presented in table 4.1 also indicated that 383(87.73%) of the respondents have had
sex by the time the study was conducted.However, 53(12.16%) of the respondents indicated that
they had not experienced sex by the time of the study.

These findings concur with UN 2015 world contraceptive trends report which indicates that
2/3 of women in union by 2015 were utilizing a certain form contraceptive. Also, Hogue et al
(2013) conducted a cross-sectional study among 346 university students in Botswana that
showed that Contraceptive use was high among this population as about 76% of the
participants reported that they always used contraceptives whenever they had sexual activity.
Sexual activity was found to be high in campus as 75.1% of the respondents in study done by
Eniojukan et al., (2014) were sexually active with contraceptive prevalence of 58.2%. Several
other studies including studies by Ochako et al., (2014); Peltzer, et al., 2011; Nsubuga et al.,
(2015); Hogue et al., (2013); Ugoji (2012) & Somba et al., (2014) also confirm high sexual
activity among university students. Moreover, Nsubuga et al., (2015) in a study conducted in
Makerere University in Uganda found out that about 70% of the female students had ever
engaged in sexual activity and 46% were using contraceptives. They also found out that most
youths became first sexually active at a very young age, usually between 15-19 years of age

25
similar to the current study. Findings on early sexual experience also agree with a study by
Ugwu (2016), carried out to describe how knowledgeable youths in Abuja, Nigeria were
regarding contraceptives and the level of contraceptive utilization. He found out that most
youths became first sexually active at a very young age, usually between the same ages of 18-
20 years.

Table 4. 1 Use of contraceptive methods on individual characteristics

Individual Condom Emergency pills Withdrawal method Implants

characteristics
Age Total use in % Tota Use in Tota Use in % Tot Use in %
l % l al
18-20 340 77.98 311 71.33 250 57.34 324 74.31
21-23 60 13.76 77 17.66 123 28.21 100 22.94
24-26 36 8.26 48 11.01 63 14.45 12 2.75
Year of study
1st 36 8.26 245 56.19 124 28.44 234 53.67
2nd 230 52.75 68 15.60 102 23.39 100 22.94
3rd 80 18.35 100 22.94 120 27.52 50 11.47
4th 70 16.06 23 5.28 90 20.64 52 11.93
Ever had sex?
Yes 400 91.74 399 91.52 375 86.01 356 81.65
No 36 8.26 37 8.48 61 13.99 80 18.35
Ever used
contraceptive
s?
Yes 411 94.27 400 91.74 399 91.51 387 88.76
No 25 5.73 36 8.26 37 8.49 49 11.23
Gender
Male 279 63.99 430 98.62 398 91.28 134 30.73
Female 157 36.00 6 1.38 38 8.72 302 69.27

4.2 Sexual debut

Table 4. 2 Sexually active age

Study year Response Frequency %

1st year 18-20 231 52.98
2nd year 20-22 102 23.39
3rd year 22-24 90 20.64
4th year 24-26 11 2.52
Total 436 100

26
The study, as shown in table 4.2, found out that 1st year students 231(52.98%) had their sexual
debut between the ages of 18 and 20 years which is an early age, actually described as teenage.
The study also found out that 2nd year students had their sexual debut between the ages of 20 and
22 and at a rate of 102(23.39%), 3rd year students had their sexual debut between the ages of 22
and 24 and at a rate of 90 (20.64%) and 4 th year students had their sexual debut between the ages
of 24 and 26 at a rate of 11(2.52%). According to this analysis, it was therefore realized that that
most students had their sexual debut at a teenage age.

4.3 Religion of the respondents

The study sought to know the various religions of the respondents as this could very well inform
the study on religious factors that promote or hinder uptake of contraceptives.

Table 4. 3 Religion of respondents

Response Frequency %
Protestant 178 40.83
Catholic 134 30.73
Muslim 90 20.64
Other( specify) 34 7.80
104 436 100
The study, according to table 4.3, found out that protestants were leading in number at
178(40.83), Catholic followed with 134(30.73), Muslims were 90(20.64%).There were other
respondents who indicated that they are confined to other religious denominations at 34(7.80%)

As realized later on in table 4.6, religion played a significant role in determining the choice of
contraceptive method or its avoidance.

4.4 Sources of information on family planning

The study sought to determine factors that contribute to uptake of family planning.

Table 4. 4 source of information on family planning

Response Frequency %
Health personnel 104 23.85
Media 146 33.49
Friends 100 22.94
Family 86 19.72
Total 436 100
According to table 4.4, the respondents indicated that health personnel 104(23.85%) are the
source of information on family planning. Additionally, 146(33.49%) of the respondents
indicated that the media played a key significant role in providing information on family

27
planning.100(22.94%) of the respondents agreed that friends play a significant role in providing
family planning information.Lastly,86(19.72%) of the respondents asserted that family was
crucial in providing information on contraceptive use.

4.5 Known family planning methods (Multiple response)

The study sought a multiple response on well-known family planning methods.

Table 4. 5 Response on the type of family planning known.

Response Frequency %
Male condom 75 17.20
Female condom 67 15.37
Diaphragm 42 9.63
Injectables 79 18.12
Iucd 60 13.76
Implants 61 13.99
Pills 52 11.93
Total 436 100
The study found out that 75(17.20%) of the male respondents agreed that they use male condoms
as a contraceptive, 67(15.37%) of the female respondents argued that they use female condoms a
contraceptive method.Additionally,42(9.63%) of the respondents agreed that they use diaphragm
as their contraceptive method,79(18.12%) used injectables,60(13.99%) used Iucd,61(13.99%)
used implants and 52(11.93%) used emergency pills.

4.6 Attitude towards contraceptives (multiple response)

The study sought to investigate various attitudes exhibited by respondents towards

contraceptives.

Table 4. 6 Response on attitude toward contraceptives

Frequency in no. and (%) Strongly Agree I don’t Disagree Strongly

Response agree know disagree

it’s against my religion 184(42.20) 134(30.73) 70(16.06) 68(15.60) 30(6.88)

Only female should use 134(30.73) 184(42.20) 30(6.88) 70(16.06) 68(15.60)
Contraceptives are ineffective 122(27.98) 102(23.39) 60(13.76) 52(11.93) 100(22.94
Contraceptives encourage 134(30.73) 102(23.39) 64(14.68) 82(18.81) 54(12.39)
promiscuity
Contraception does not have 70(16.06) 68(15.60) 30(6.88) 134(30.73) 184(42.20)

28
 any effects on the wellbeing of
the individual and family
Contraceptive education 190(43.58) 100(22.94) 20(4.59) 53(12.16) 73(16.74)
should be on the increase
Total 436 100%
The study found out that 184(42.20%) and 134(30.73%) of the respondents strongly agreed and
agreed respectively that contraceptive use is against their religion.70 (16.06%) of the respondents
said that they didn’t know anything while 68(15.60%) and 30(6.88%) disagreed and strongly
agreed respectively that contraception use is against their religion.

It was also realized that 134(30.73%) and 102(23.39) of the respondents strongly agreed and
agreed respectively that only females should use contraceptives.30(6.88%) of the respondents
said that they didn’t know anything while 70(16.06%) and 68(15.60%) of the respondents
disagreed and strongly disagreed respectively that only female gender should use contraceptives.

The study also realized that 122(27.98%) and 102(23.39%) of the respondents strongly agreed
and agreed respectively that contraceptives are ineffective.60 (13.76%) said that they do not
know anything while 52(11.93) and 100(22.94%) disagreed and strongly disagreed respectively
that contraceptives are ineffective.

The study also realized that 134(30.73%) and 102(23.39%) strongly agreed and agreed
respectively that contraceptives encourage promiscuity.64 (14.68%) said that they didn’t know
anything about that.Additionally, 82(18.81%) and 54(12.39%) disagreed and strongly disagreed
respectively that contraceptives encourage promiscuity.70(16.06%) and 68(15.60%) of the
respondents strongly agreed and agreed respectively that Contraception does not have any effects
on the wellbeing of the individual and family. Of the respondents,30(6.88%) said that they didn’t
know anything while 134(30.73%) and 184(42.20%) of the respondents disagreed and strongly
disagreed respectively that Contraception does not have any effects on the wellbeing of the
individual and family.

Lastly, 190(43.58%) of the respondents strongly agreed while 100(22.94%) agreed that
Contraceptive education should be on the increase.20 (4.59%) of the respondents said that they
don’t know anything on whether contraceptives education should be on the rise or not.Lastly,

29
53(12.16%) and 73(16.74%) disagreed and strongly disagreed respectively that Contraceptive
education should be on the increase.

4.7 Motivation behind specific family planning method

Table 4. 7 What made you choose the family planning method you are using? Tick all that
apply

Response Frequency %
Side effects of other methods 75 17.20
Provider influence 67 15.37
Partner influence/Advice 42 9.63
Friends influence 79 18.12
Family member influence 60 13.76
Desire to avoid hormonal contraceptives 61 13.99
Cheap method 52 11.93
Total 436 100
The study found out that side effects of other methods ,75(17.20%) contributed to choice of a
contraceptive method,67(15.37%) of the respondents argued that provider influence was a factor
behind choice of the specific methods,42(9.63%) argued that partner influence or advice formed
part of the decision on a certain method,60(13.76%) argued that influence from friends
contributed greatly to a choice of a family planning method while 60(13.76%),61(13.99%) and
52(11.93%) argued that family member influence, desire to avoid hormonal contraceptives and
the method selected being cheap respectively formed part of the decision making process on
contraceptive choice.

4.8 What other people say about contraceptives

The study sought to know what the respondents said on what other people say about
contraceptive use.

Table 4. 8 Response on what other people say about contraceptives

Response Frequency percentage

Women who haven’t had children so far, cannot use long term methods 153 35.09

Can cause infertility 145 33.26

Family planning methods spreads infection in all over the body 102 23.38
Associated with cancer 36 8.26

30
Table 4.8 shows that 153(35.09%) of the respondents indicated that other people say women who
hadn’t children could not use long term methods of contraception, 102(23.38%) indicate that it
causes infertility, 102(23.38%) argued that it spreads infections all over the body and 36(8.26%)
of the respondents argued that other people said that contraception use is associated with cancer.

4.9 Forces behind unwillingness to seek reproductive health services

The study sought to establish the forces behind unwillingness in young people to seek
reproductive health services.

Table 4. 9 Response on forces behind young people unwilling to seek reproductive health
services

Response Frequency Percentage

Do not know where to get them 65 14.91
Too scared/shy 80 18.35
Unfriendly staff 70 16.06
Services too expensive 67 15.37
It’s shameful 60 13.76
Ignorance 94 21.56
Total 100 346
According to table 4.9,the study established that 65(14.91%) of the respondents argued that
young people do not know where to get contraceptives from80(18.35%) of the respondents
argued that young people are too scared/shy to go for the reproductive health
services,70(16.06%) indicated that young people view contraceptives as an unfriendly
thing,67(15.37%) argued that reproductive health services are too expensive,60(13.76%) argued
that it is a shameful thing to go for the services and 94(21.56%) argued that most young people
do not go for the services because of ignorance.

4.91 Chapter summary

The response above is similar to a study by Peltzer et al. (2011) done among students in Lesotho
University to describe their awareness and utilization of contraceptives and also the barriers that
exist in their use, the male condom was found to be the most preferred method among students.
Further, this finding was similar to a study done by Hoque et al (2013) to describe awareness
and contraceptive use practices among university students done in Botswana which found out
that students most preferred contraceptives were condoms (95.6%) followed by oral pills by
86.7%.The findings are also in line with a study conducted by Eniojukan, et al (2014) in a
university community in Delta state Nigeria which found out that condoms and oral
contraceptives were the most preferred forms of contraception

31
CHAPTER FIVE: CONCLUSION AND RECOMMENDATIONS

5.1 Summary of findings

The purpose of this study was to investigate the knowledge of students about contraceptive
methods, to identify their attitudes towards contraception, to explore contraceptives methods
used by students and to identify the role of education on contraceptives. In particular, the study
sought to determine which contraceptive methods are available and establish the type of
contraceptives used by students. The study also investigated the reasons for selection of some
contraceptives over others by assessing reasons for preference of some and those for failure to
use of others. The study involved 436 Mount Kenya University students because university
students engage in risky sexual behaviour at an early age. Both quantitative and qualitative
methods were applied concurrently to obtain the required information from participants in order
to corroborate the findings.

Male condom was the most available form of contraception and also the most used by students.
Availability therefore came out as a determinant of contraceptive use as many participants said

32
during group discussions and interviews that what is available is what they go for. Also, issue of
cost came out as a determinant for contraceptive use as participants said that they preferred
condoms because they were offered freely in the university and cost less in the shops compared
to other methods.

Knowledge on the benefits and effects of contraceptives also came out strongly as a factor
that influenced intentions to use and the choice of contraceptives used. The ability of the male
condoms to prevent both pregnancy and STIs hence offering dual protection influenced
students to choose it over other methods that only prevented pregnancy. Having seen other
students suffer or drop out of school due to unplanned pregnancy played out as a major factor
that shaped the student’s intentions to use contraceptives as many did not want to fall in the
same trap of unwanted pregnancies like their friends. Contraceptive use was hindered mainly by
fear of side effects despite the interest expressed by students in using them. Some had personally
experienced negative side effects which led to inconsistent use or total withdrawal from the
method hence exposing them to the risk of unwanted pregnancies. To others fears were based on
misconceptions and negative rumours.

What others said about particular contraceptives and how students perceive these methods
was a major factor that determined whether or not they would use them.
Cultural and religious beliefs also came out strongly as factors that determined whether or not
students use contraceptives. Some participants indicated that contraceptive practice was
against their cultural and religious believes. Some local cultures and religions regarded
contraceptive use as an indication of promiscuity. Those belonging to such cultures and
religions would fail to consider using contraceptives for fear of being condemned or being
punished for their sins.

Lastly and more importantly, relationship dynamics unfolded as an important factor that
determined whether a couple would use contraceptive method or not. Partner disapproval of
all or particular contraceptives was a big hindrance to contraceptive use. Those who did not
discuss on contraceptive use with their partners were less likely to use contraceptives
compared to those who discussed. On the other hand, the thought that using contraceptives
added value to relationships, was an indication that one loved their partner that’s why they
protected them and that they enabled couples to enjoy sex without worrying about pregnancy
or infections motivated students to use contraceptives.

33
5.2Conclusion

The study demonstrates that there is high contraceptive use among Mount Kenya University
students. However, only contraceptive method accounts for over 70% of all contraceptives used
that is the male condom. This is due to its wide availability, and students are more
knowledgeable about it, which does not match any other contraceptive method. Benefits of
contraceptive use go beyond health, to developing communities through controlling population
and enhancing opportunities in life. Using contraceptives was also influenced by the confidence
that they would actually post pregnancy, their ability to prevent both pregnancy and STIs
simultaneously, and relationship dynamics. However, there is a group of students, who do not
use contraceptives even if they are available due to other factors that use including mainly
fear of the side effects associated with contraceptives, misconceptions, partner disapproval,
cultural and religious beliefs.

5.3Recommendations

The ministry of health in collaboration with the ministry of education should find a way of
improving knowledge and availability of all other forms contraceptives, especially the long
acting reversible methods to match that of condoms. This will help provide a wider range of
choice and offer better protection against unplanned pregnancies to students and also reduce
overreliance on one method.

Existing policies on reproductive health education need to be revised to include sexual health
education at all levels of education. Studies should be conducted to explore ways of reducing
fear of side effects, stigma, misperceptions and misconceptions in order to promote effective use
of contraceptives.

34
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36
APPENDICES: APPENDIX 1: QUESTIONNAIRE UNIT

TITTLE: UPTAKE OF FAMILY PLANNING METHODS AMONG UNDERGRADUATE

STUDENTS, IN MOUNT KENYA UNIVERSITY

Dear respondent,

The information provided here will be held with privacy and high level of confidentiality and
will only be used be used for academic purpose. The participation in this study is voluntary.

Section 1: social Demographic Information

Age of the respondent (in years)

18-20 years

21-23years

24-26years

Department

Arts
Science
Special needs
Early childhood

Religion

Protestant

Catholic

Muslim

Other (specify)..........

At what age you became sexual active?………………………………

37
Section 2: Factors influencing uptake of family planning

Have you ever heard about contraceptive and family planning?

yes
no
If yes where?
Health personnel
Media
Friends
Family
Others(specify|)……………………….
Which family planning do you know ?(multiple response)
Male condom
Female condom
Diaphragm
Injectables
Iucd
Implants
Pills

ATTIUDE TOWARDS CONTRACEPTION

Question Strongly Agree I Disagree Strongly

agree don’t disagree
know
its against my religion
Only female should use
Contraceptives are ineffective
Contraceptives encourage
promiscuity
Contraception does not have
any effects on the wellbeing
of the individual and family
Contraceptive education
should be on the increase

Have you used any contraceptives method before?

Yes

38
No

If yes what method (s) have you used………………………..

What made you choose the family planning method you are using? Tick all that apply

Side effects of other methods

Provider influence

Partner influence/Advice

Friends influence

Family member influence

Desire to avoid hormonal contraceptives

Cheap for me

What have you heard other people say about family planning? Tick all that apply

Women who haven’t had children so far, cannot use long term methods

Can cause infertility

Family planning methods spreads infection in all over the body

Associated with cancer

Does your religion allow the use of family planning methods?

yes

no

At what age you became sexual active?

……………………………………………

Why do you think other young people do not seek reproductive health services.
Do not know where to get them
Too scared\too shy
Unfriendly staff

39
Services too expensive
Its shameful.
Ignorance

40
 APPENDIX 2: WORK PLAN

YEAR/MONTH Augu Septembe Octobe Novembe December

st r r 2019 r
ACTIVITY 2019
2019 2019 2019

Concept writing/presentation

Project development and approval

Submission

Training of assistance and pre-testing

of questionnaire

Data collection, analysis, and report

writing

Defense and presentation

APPENDIX: BUDGET

NO ITEM DESCRIPTION ESTIMATED AMOUNT

41
1. Stationery 1 reams of photocopy papers

@ 1000 each. KShs. 2000

5 pen @ 10

5 files @ 50 each

1staplers @ 150

3 Travelling

KShs. 300 per day for 5 days KShs. 1500

4. Accommodation

KShs. 1000 per day for 5 days KShs. 5000

5. Food

Breakfast @ 100, lunch @ 200,

Supper @ 200 for 5 days KShs. 2500

6. Services Photocopying, printing, typesetting

and all other services
KShs. 4000

TOTALS KSHS. 20000

42