Contraceptive Failure among Women in Homa Bay County of Kenya: A Matter of User and Provider Deficiencies

Although the Kenya family planning program appears successful at the national level— with contraceptive prevalence rate (CPR) in 2014 surpassing the 2015 target of 56%— sub-national variations suggest the need to understand the patterns at the local levels to inform programs to either sustain or improve further the levels that the country has attained. This chapter examines the reasons for contraceptive failure among 166 women aged 15–39 years in three sub-counties of Homa Bay County in Kenya. The findings show that failure of methods such as injectables, pills and condoms was mostly because of chal- lenges with client adherence and inconsistent use. Failure of long-acting and permanent methods such as implants and female sterilization was partly due to limited provider capacity to offer the methods and partly due to inability to afford the costs of resup plies of implants. These patterns were further exacerbated by limited access to adequate information on the part of users, which could enable them make informed contraceptive choices. The experiences of women regarding contraceptive failures—including highly effective long-acting and permanent methods—suggest the need for targeted interven tions to address challenges that might hamper the success of the family planning pro- gram in such localized settings.