Use effectiveness of the symptothermal method to ameliorate unmet need for family planning in Kisumu County, Kenya.

Abstract

Background: This study assessed the use effectiveness of the symptothermal method (STM) to ameliorate the unmet need for family planning.

Methods: The study adopted a quasi-experimental design. A total of 260 women, comprising 136 STM users (interventional group) and 124 oral contraceptive pill (OCP) users (control group), were recruited. Intervention was conducted for 3 months with longitudinal monitoring for 12 months. Questionnaires, cycle charts and thermometers were used for data collection and data were analysed using SPSS version 23 (IBM, Armonk, NY, USA). To estimate the use effectiveness of STM vs OCPs, survival analysis of the Life table and Kaplan-Meier with log rank, was performed at 95% confidence interval (CI). To estimate the hazard ratio based on the effects of its covariates, a Cox proportional hazards model with 95% CI was applied. The Cox proportional hazards assumption was checked and four categorical covariates were adjusted for in the Cox model analysis.

Results: In the STM group, no pregnancy occurred. Use effectiveness of STM for 12 months was 100%. For OCPs, three pregnancies occurred. The use effectiveness was 97-99% with failure of 1-2%. The Cox proportional hazards model had a hazard ratio of 0.01 (p=0.058), indicating that the risk of unintended pregnancy was lowered by 99% in STM users compared with OCP users. A p-value >0.05 indicated no significant difference between the two groups.

Conclusions: Our study demonstrated that STM, when used correctly, is very effective in ameliorating the unmet need for family planning based on the World Health Organization's algorithm on STM effectiveness as an alternative to artificial contraceptive methods.