The Effect of Education, Contraception, and Reproductive Health Knowledge on Unplanned Pregnancy and Child Death in Rural Western Kenya

East Africa carries the highest burden of unplanned pregnancy worldwide. Many studies have stressed the importance of family planning programs in preventing unplanned pregnancy as well as maternal and child morbidity and mortality. However, even when services are available, a decrease in birth rate and poor birth outcomes, including child death, does not necessarily follow. In the context of the highest HIV rates in East Africa, this failure is particularly alarming. Child death in the Nyanza province of Kenya is the highest nationally, and HIV rates among the Luo tribe of that area are also the highest in the country.

This cross-sectional study analyzes 2011 survey data from a sample of 112 Luo women from a culturally traditional, rural part of the Nyanza Province in western Kenya. Women had an average of 4.51 children, and over one-third had had at least one child die. Despite available family planning resources, only 54.63% of women had ever used birth control, while 26.92% of women were currently using birth control. The results of the study indicate that the subset of women who use scientific birth control are statistically significantly younger, more educated, and more knowledgeable about family planning, yet the use of birth control has not been effective in decreasing their number of births or infant deaths. On the other hand, there appears to be another group of women (less educated, older, less knowledgeable) for whom the very notion of planning births or birth intervals seems foreign. More than half of the overall sample said that they knew no women who had more babies than they wanted.

These results show that a single approach to educating and providing family planning methods without acknowledging vast cultural barriers will not be successful. However, knowledge alone is not enough, and structural barriers must also be addressed for successful family planning.