Gates Open Research最新文献

{"title":"\"Life mapping\" exploring the lived experience of COVID-19 on access to HIV treatment and care in Malawi","authors":"Jane Harries, Ruby T. Zolowere, Khokhelwa Zokwana, Krista Lauer, Jelena Bozinovski, Solange L. Baptiste","doi":"10.12688/gatesopenres.15927.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15927.1","url":null,"abstract":"Background The COVID-19 pandemic in Malawi exacerbated, existing public health challenges including access to HIV treatment and care services. “Life Mapping,” a component of the Citizen Science community-led project in Malawi, documented the lived experiences and perspectives of people living with HIV in the context of COVID-19. Methods Citizen Science Life Maps is a three-year qualitative, longitudinal project utilizing collaborative and participatory research methods through digital storytelling to document peoples’ daily lives. Twenty participants living with HIV were recruited between 2022 and 2023 in two central regional districts of Malawi and two urban areas. The participants were given mobile smart phones to document the impact of COVID-19 on HIV prevention and treatment services, HIV treatment literacy, mental health and the COVID -19 vaccine. Data was analyzed using a thematic analysis approach. Results Access to HIV prevention and treatment slowly recovered yet introducing multi-month anti- retroviral dispensing raised concerns. In the absence of mental health care services, participants were resourceful in seeking alternative ways to deal with mental health. However, state sponsored violence in relation to COVID-19 public health measures impacted negatively not only on mental well-being but also on HIV treatment adherence. Whilst most recognized the importance of the COVID-19 vaccine, especially for people living with HIV, myths, misinformation, and conspiracy theories around the vaccine persisted especially religious themed misinformation. Conclusions This is the first study conducted in Malawi exploring the impact of the COVID-19 pandemic on people’s everyday lives including HIV treatment using digital participatory community-based research methods. The relationship between misinformation and COVID-19 vaccine hesitancy is complex and medical and scientific approaches may not be sufficient to prevent misinformation. Fear and misinformation are likely attributed to global uncertainty during the pandemic and the speed at which vaccines were developed with minimal opportunity to prepare global communities.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":" 568","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive access and use before and during the COVID-19 pandemic: a mixed-methods study in South Africa and Zambia","authors":"Rebecca L. Callahan, Alice F. Cartwright, M. Beksinska, Margaret Kasaro, Jennifer H. Tang, Cecilia Milford, Christina Wong, Marissa Velarde, Virginia Maphumulo, Mariam H Fawzy, Manze Chinyama, Esther Chabu, Mayaba Mudenda, Jennifer A Smit","doi":"10.12688/gatesopenres.14590.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.14590.2","url":null,"abstract":"Background The COVID-19 pandemic affected global access to health services, including contraception We sought to explore effects of the pandemic on family planning (FP) service provision and use in South Africa and Zambia, including on implant and intrauterine device (IUD) users’ desire and ability to obtain removal. Methods Between August 2020 and April 2021, we conducted surveys with 537 women participating in an ongoing longitudinal contraceptive continuation study. We also carried out in-depth interviews with 39 of the survey participants and 36 key informants involved in FP provision. We conducted descriptive analysis of survey responses and thematic analysis of interviews. Results Contraceptive use changed minimally in this sample with the emergence of COVID-19. Fewer than half of women (n=220) reported that they tried to access FP since the start of the pandemic. The vast majority of those seeking services were using short-acting methods and 95% were able to obtain their preferred method. The proportion of women not using a method before and after the start of the pandemic did not change in Zambia (31%), and increased from 8% to 10% in South Africa. Less than 7% of implant or IUD users in either country reported wanting removal. Among the 22 who sought removal, 10 in Zambia and 6 in South Africa successfully obtained removal. In qualitative interviews, those reporting challenges to service access specifically mentioned long queues, deprioritization of contraceptive services, lack of transportation, stock-outs, and fear of contracting COVID-19 at a facility. Key informants reported stock-outs, especially of injectables, and staff shortages as barriers. Conclusions We did not find a substantial impact of COVID-19 on contraceptive access and use among this sample; however, providers and others involved in service provision identified risks to continuity of care. As the COVID-19 pandemic wanes, it continues to be important to monitor people’s ability to access their preferred contraceptive methods.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors","authors":"G. Praulins, Annabel Murphy-Fegan, Jack Gillespie, Frank Mechan, Katherine Gleave, Rosemary Lees","doi":"10.12688/gatesopenres.15433.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15433.1","url":null,"abstract":"Background Resistance monitoring is a key element in controlling vector-borne diseases. The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) have each developed bottle bioassay methods for determining insecticide susceptibility in mosquito vectors which are used globally. Methods This study aimed to identify variations in bottle bioassay methodologies and assess the potential impact on the data that is generated. Our approach involved a systematic examination of existing literature and protocols from WHO and CDC, with a focus on the specifics of reported methodologies, variation between versions, and reported outcomes. Building on this, we experimentally evaluated the impact of several variables on bioassay results. Results Our literature review exposed a significant inconsistency in the how bioassay methods are reported, hindering reliable interpretation of data and the ability to compare results between studies. The experimental research provided further insight by specifically identifying two key factors that influence the outcomes of bioassays: mosquito dry weight and relative humidity (RH). This finding not only advances our comprehension of these assays but also underscores the importance of establishing precisely defined methodologies for resistance monitoring. The study also demonstrates the importance of controlling bioassay variables, noting the significant influence of wing length, as an indicator of mosquito size, on mortality rates in standardized bioassays. Conclusions Generating data with improved protocol consistency and precision will not only deepen our understanding of resistance patterns but also better inform vector control measures. We call for continued research and collaboration to refine and build consensus on bioassay techniques, to help bolster the global effort against vector-borne diseases like malaria.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"69 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141268216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening district health management and planning: an evaluation of a multi-country initiative in Eastern and Southern Africa","authors":"Braeden M. Rogers, Kate Gooding, G. Appleford, Martina Bennett, Ernesha Webb Mazinyo","doi":"10.12688/gatesopenres.15007.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15007.1","url":null,"abstract":"Background District health management and leadership capacity is increasingly recognised as critical to health system performance. District health managers play a central role in effective implementation and tailoring of national health policies, and they need adequate skills and support. The District Health System Strengthening Initiative (DHSSi) was implemented over 2019-22 in Malawi, Kenya, Tanzania and Uganda to strengthen sub-national capacity for evidence-based planning and a broader set of management competencies needed to operationalize district plans. To support learning and adaptation, a three-year evaluation was conducted to assess progress against outcomes and to inform ongoing implementation and future investment. Methods The evaluation used a mixed-methods theory-based approach. Evaluation questions were structured using criteria of relevance, coherence, efficiency, effectiveness, sustainability and impact, and corresponded to outputs, outcomes and impacts in the DHSSi Theory of Change. The evaluation was conducted over three annual rounds, and combined data from document review, observation, interviews and group discussions with cross-country, national and district stakeholders, and analysis of secondary quantitative data. Results Experience of DHSSi implementation indicated the relevance of supporting district management and planning, with gaps in current capacity, government interest, and indications of the potential to improve district practice. DHSSi experience also highlighted challenges to effective achievement of stronger capacity, and to translation of skills to improved management practice and, ultimately, to improved service delivery. A range of factors beyond skills affected district capacities, motivation and opportunities for effective planning and management, including areas such as funding, planning templates, health information systems, staff turnover, partner alignment and political structures. Conclusions Strengthening sub-national health management is an important agenda in efforts to expand high-quality primary health care. Future initiatives should prioritize detailed understanding of the range of influences on district management, and work to strengthen the enabling environment for effective district practice.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"22 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of latent contraceptive ideational profiles among urban women in Senegal: Transitions and implications for family planning programs","authors":"E. Mangone, Ilene Speizer, Nisha O'Shea, Kristen Hassmiller Lich","doi":"10.12688/gatesopenres.15409.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15409.1","url":null,"abstract":"Background Latent ideational segmentation is an important technique that can enhance family planning (FP) communication campaigns by providing insight into prototypical “profiles” of women among heterogenous populations based on shared ideational characteristics that underpin contraceptive decision-making. This can improve the development of responsive, tailored content and help programs connect with intended audiences. In Senegal, 24% of married women who want to avoid pregnancy are not using modern contraceptive methods and in 2020, the Government of Senegal fell short of reaching its goal of increasing the modern contraceptive prevalence to 45%. Social, cultural, and cognitive factors are probable deterrents to contraceptive use. The objective of this study was to identify and interpret meaningful contraceptive ideational profiles (CIPs) among urban Senegalese women and examine how and why CIP structure, interpretation, and membership changed over time. Methods Using longitudinal data from 4,047 urban, in-union Senegalese women of reproductive age in 2011 and 2015, we applied latent transition analysis to identify and interpret prototypical profiles of women based on their contraceptive awareness, beliefs, self-efficacy, partner FP acceptance, partner communication, and community support. Results We identified four longitudinal CIPs and labeled them “CIP1: Lowest efficacy and FP awareness, highest misconceptions, unsupported,” “CIP2: Low efficacy and FP awareness, rejects misconceptions, unsupported,” “CIP3: Moderate efficacy, high FP awareness, high misconceptions, moderate support,” and “CIP4: Highest efficacy and FP awareness, fewest misconceptions, most supported.” At endline, more women were in higher-order CIPs compared to baseline. Exposure to FP communication via TV, radio, religious leaders, and health workers was associated with lower odds of membership in lower-order CIPs at endline, as was exposure to messages about FP and birth spacing. Conclusions This study demonstrated the potential of latent CIP methodologies to enhance current social and behavior change approaches by identifying and responding to unique and complex ideational attributes.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated data for census-scale entity resolution research without privacy restrictions: a large-scale dataset generated by individual-based modeling","authors":"Beatrix Haddock, Alix Pletcher, Nathaniel Blair-Stahn, O. Keyes, Matt Kappel, Steve Bachmeier, Syl Lutze, James Albright, Alison Bowman, Caroline Kinuthia, Zeb Burke-Conte, Rajan Mudambi, Abraham Flaxman","doi":"10.12688/gatesopenres.15418.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15418.1","url":null,"abstract":"Background Entity resolution (ER) is the process of identifying and linking records that refer to the same real-world entity. ER is a fundamental challenge in data science, and a common barrier to ER research and development is that the data fields used for this fuzzy matching are personally identifiable information, such as name, address, and date of birth. The necessary restrictions on accessing and sharing these authentic data have slowed the work in developing, testing, and adopting new methods and software for ER. We recently released pseudopeople, a Python package that allows users to generate simulated datasets approaching the scale and complexity of the data on which large organizations and federal agencies, like the US Census Bureau regularly perform ER. With pseudopeople, researchers can develop new algorithms and software for ER of US population data without needing access to personal and confidential information. Methods We created the simulated population data available through pseudopeople using our Vivarium simulation platform. Our model simulates individuals and their families, households, and employment dynamics over time, which we observe through simulated censuses, surveys, and administrative data collection systems. Results Our simulation process produced over 900 gigabytes of simulated censuses, surveys, and administrative data for pseudopeople, representing hundreds of millions of simulants. A sample simulated population of thousands of simulants is now openly available to all users of the pseudopeople package, and large-scale simulated populations of millions and hundreds of millions of simulants are also available by online request through GitHub. These simulated population data are structured for use by the pseudopeople package, which includes additional affordances to add various kinds of noise to the data to provide realistic, sharable challenges for ER researchers.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"8 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of early sex debut among adolescents and young women: A National cross-sectional study","authors":"Samuel Kiiru, M. Thiongo, Peter Gichangi","doi":"10.12688/gatesopenres.15272.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15272.1","url":null,"abstract":"Background Early sexual debut among adolescents and young women may predispose them to unwanted pregnancies and sexually transmitted diseases. In Kenya, this consequently results in education discontinuation hence poverty levitation. Sexual debut has been studied in relation to HIV, school programs or review of demographic and health surveys. We report correlates of early sexual debut among women aged 15-24 years from a household-based survey in Kenya. Methods Performance, Monitoring for Action (PMA) is a cross-sectional survey using a multi-stage cluster design with urban-rural stratification. The sampling was done at the county level using probability proportional to size to select 11 counties and enumeration areas (EAs) achieving 308 EAs. Interviews were conducted from 35 randomly selected households, from which the eligible women were also interviewed. Descriptive statistics were generated to determine the social demographic characteristics of respondents, and bivariate analysis for the correlation of independent variables and early sexual debut. A logistic regression model was used to determine the association between social demographic characteristics and early sexual debut among women of 15-24 years old. P <0.05 was considered significant. Results A total of 3,706 women were interviewed, and about 1 in 100 (10.2%) of the respondents reported having ever engaged in sexual intercourse before the age of 16 years. Educational level, ever-given birth, contraceptive use and wealth status were found to be statistically associated with early sexual initiation in Kenya. Women who reported having ever given birth had higher odds of early sexual initiation (AOR 2.36, 95% CI, 1.51-3.68, p<0.005) than those who have never given birth. Respondents who were contraceptive users were 1.4 times more likely (AOR 1.39, 95% CI, 1.01-1.90, p<0.001) to have experienced early sex debut than non-users. Conclusions Several individual factors influence early sexual debut, and hence interventions at the policy and program levels are required.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"46 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care-seeking behavior for childhood illnesses in western Kenya: Qualitative findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) Study","authors":"Sarah Ngere, Maria Maixenchs, S. Khagayi, Peter Otieno, Kennedy Ochola, Kelvin Akoth, Aggrey Igunza, Benard Ochieng, D. Onyango, Victor Akelo, John Blevins, Beth A. Tippett Barr","doi":"10.12688/gatesopenres.14866.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.14866.1","url":null,"abstract":"Background Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers’ health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. Methods We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Results Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child’s illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Conclusion Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"83 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140665462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A network of care to improve the continuity and quality of maternal and perinatal services in Makueni County, Kenya: study protocol","authors":"P. Owira, Dennis Mulwa, O. Kiptoo, Sophie Chabeda, Samuel Mwaura, A. Hyre, Marleen Temmerman, Reena Sethi, Lisa M. Noguchi, G. Manguro","doi":"10.12688/gatesopenres.14851.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.14851.1","url":null,"abstract":"Background Kenya’s high maternal and perinatal mortality rates exceeds its recommended 2030 targets. The lack of effective collaboration between health facilities and workers contributes to delays and uncoordinated provision of care, leading to negative maternal and neonatal health (MNH) outcomes. Network of Care (NOC) is an effective strategy to improve health facility network efficiencies and MNH outcomes. Utilizing NOC to improve health system coordination and MNH outcomes in Kenya has not been studied. We present a study protocol for implementation research to investigate the feasibility and acceptability of establishing a county-level NOC on relationships among health facilities and workers, the feasibility of NOC for the Makueni county health system, and the impact of NOC on the quality of MNH services and emergency referrals within the county health system. Levels of communication, collaboration, and trust between NOC health facilities and levels of preparedness for management of MNH complications are also evaluated. Methods The study employed a mixed methods design with quantitative data from health worker self-administered phone surveys, health facility referral forms, and facility registers collected at baseline, then every three months from September 2021 to July 2023. Health worker focus group discussions and county management key informant interviews were conducted at baseline, midline, and endline. The study purposively selected 60 public and private health facilities in Makueni. These facilities were a sub-sample of 344 facilities with the highest maternity caseloads. A descriptive and thematic analysis of communication, collaboration, and trust between NOC health facilities and workers, and referral system changes will take place. Trend analysis of MNH indicators for Makueni from the Kenya Health Information System will be done. Conclusion This study aims at informing decision-makers locally and globally on whether NOC is feasible and acceptable as a county-level model of care in Kenya with application to similar LMIC settings.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"20 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing contraceptive uptake among women of reproductive age in Kenya","authors":"Jane Bitutu Nyakundi, S. Yonge, Samuel Kiiru, Peter Gichangi","doi":"10.12688/gatesopenres.15283.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15283.1","url":null,"abstract":"Background Modern Contraceptive Methods (MCM) use is among the interventions preventing unplanned pregnancies and unsafe abortions globally. Nevertheless, MCM uptake is still low. We aimed at determining factors influencing contraceptive uptake among women of reproductive age 15 to 49 years, in Kenya. Methods We used secondary data collected by Performance, monitoring for Action (PMA). PMA used cross sectional multi-stage cluster survey design and collected the data between November and December 2019. The study was approved by NACOSTI/202974 and KNERC KNH/ERC/R/192. Results The study obtained a sample size of 9477 women of reproductive age (WRA) from 11 counties in Kenya. Both descriptive and inferential statistical analysis with a P value of 0.05 was done using Stata 16.1. The prevalence of modern contraceptives uptake was 43.2% among all WRA, which was lower among rural dwellers 41.4% (95% CI 39.62, 43.17) as compared to urban dwellers 47.5 (95% CI 44.39,50.55). More than half (53.4%) of the married women were using a modern contraceptive, while only about two in every 10 of the unmarried were using a modern contraceptive. Women affiliated with the Islam religion were less likely to use modern contraceptive (aPOR 0.6, 95% CI 0.42, 0.89 p=0.010) as compared to the Catholics. Family planning (FP) services were found to be lower (aPOR 0.535(95% CI 0.29,0.98 p=0.043) in National Hospital Insurance Fund (NHIF)-covered facilities than in non-NHIF-covered ones. Adolescent FP service provision and prescription was significant (aPOR 4.0 95% CI; 1.05,15.41, p=0.42). Conclusion Low uptake for MCM is influenced by sociodemographic factors and Health system factors. Efforts to increase MCM uptake should focus on rural residents, unmarried women, Islamic religion women and accreditation of NHIF services in all facilities.","PeriodicalId":504483,"journal":{"name":"Gates Open Research","volume":"7 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}