Socioeconomic inequality and its drivers in unmet needs for family planning in Kenya.
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| Název: | Socioeconomic inequality and its drivers in unmet needs for family planning in Kenya. |
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| Autoři: | Wakibi SN; University of Nairobi, Nairobi, Kenya. samwakibi23@gmail.com. |
| Zdroj: | BMC public health [BMC Public Health] 2025 Nov 26; Vol. 25 (1), pp. 4167. Date of Electronic Publication: 2025 Nov 26. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| Výrazy ze slovníku MeSH: | Family Planning Services*/statistics & numerical data , Socioeconomic Factors* , Health Services Needs and Demand*/statistics & numerical data , Healthcare Disparities*/statistics & numerical data, Humans ; Kenya ; Female ; Adult ; Adolescent ; Middle Aged ; Young Adult |
| Abstrakt: | Competing Interests: Declarations. Ethics approval and consent to participate: No ethical approval was needed. The manuscript used secondary data from a national survey and no consent is required. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Background: Family planning has both health and social benefits for women. A lack of access can lead to unwanted pregnancies, unsafe abortion, high maternal and infant mortality, and loss of economic opportunities. The global unmet need for family planning was 15.6% in 2019, while the unmet need for modern family planning among women aged 15-49 years in low- and middle-income countries was unacceptably high at 24%. In Kenya, it was 20% in 2022 despite SDG target 3.7.1 guaranteeing universal coverage. Methods: Most studies on unmet needs focus on the prevalence and factors associated with the uptake of family planning, but assessments of socioeconomic inequality within low-utilization groups are rarely given much attention. This is despite socioeconomic inequality being a central theme in achieving the SDGs. This study assessed socioeconomic inequality in the unmet need for family planning measured by the household wealth index and used putative determinants to explain the inequality. The study used data from the KDHS (2022). Associations between individual factors and unmet needs for family planning were determined using logistic regression models, whereas socioeconomic inequality was assessed using concentration curves and concentration indices. Results: The prevalence rate of unmet needs was 14%; 7.6% for spacing and 6.4% for limiting. And among the poorest women was 21.6% compared to 10.1% among the richest. Being poor (OR: 1.788, 95% CI: 1.324-2.414), young (OR: 1.569, 95% CI: 1.212-2.030), having more than one living child (OR: 1.393, 95% CI: 1.157-1.676), not employed (OR: 1.561, 95% CI: 1.375-1.772), having no education (OR: 1.456, 95% CI: 1.022-2.074) and lacking media exposure (OR: 1.249, 95% CI: 1.027-1.519) increased the odds of unmet needs. The socioeconomic inequality in unmet needs was pro-poor (CIX < 0) and was substantially high (CIX<-0.4) among women with more than three children (CIX=-0.41), with no education (CIX=-0.46) or partners have no education (CIX=-0.68) or lack media exposure (CIX=-0.49). Conclusion: The study recommends youth friendly - highly subsidized family planning services and commodities, and family planning information and education for women of low socioeconomic status. (© 2025. The Author(s).) |
| References: | Health Econ. 2018 Mar;27(3):576-591. (PMID: 29094775) Lancet Glob Health. 2014 Jun;2(6):e323-33. (PMID: 25103301) Clin Med (Lond). 2006 Nov-Dec;6(6):559-72. (PMID: 17228555) PLoS One. 2019 Aug 9;14(8):e0220970. (PMID: 31398240) JAMA. 2005 Dec 14;294(22):2879-88. (PMID: 16352796) PLoS One. 2022 Feb 10;17(2):e0263885. (PMID: 35143584) Reprod Health. 2020 Oct 23;17(1):163. (PMID: 33097088) Afr J Reprod Health. 2012 Sep;16(3):48-56. (PMID: 23437499) Circulation. 2015 Sep 1;132(9):873-98. (PMID: 26240271) Int J Prev Med. 2013 Jun;4(6):671-83. (PMID: 23930185) Nature. 2013 Mar 21;495(7441):305-7. (PMID: 23518546) BMC Public Health. 2012 Mar 19;12:198. (PMID: 22429978) Stud Fam Plann. 2008 Mar;39(1):18-38. (PMID: 18540521) Best Pract Res Clin Obstet Gynaecol. 2020 Jul;66:107-118. (PMID: 32527659) J Biosoc Sci. 2024 Jan;56(1):90-103. (PMID: 37309650) Lancet Glob Health. 2020 Sep;8(9):e1152-e1161. (PMID: 32710833) |
| Contributed Indexing: | Keywords: Concentration index; Family planning; Socioeconomic inequality; Unmet need |
| Entry Date(s): | Date Created: 20251127 Date Completed: 20251127 Latest Revision: 20251129 |
| Update Code: | 20251129 |
| PubMed Central ID: | PMC12659579 |
| DOI: | 10.1186/s12889-025-25395-0 |
| PMID: | 41299462 |
| Databáze: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: Declarations. Ethics approval and consent to participate: No ethical approval was needed. The manuscript used secondary data from a national survey and no consent is required. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.<br />Background: Family planning has both health and social benefits for women. A lack of access can lead to unwanted pregnancies, unsafe abortion, high maternal and infant mortality, and loss of economic opportunities. The global unmet need for family planning was 15.6% in 2019, while the unmet need for modern family planning among women aged 15-49 years in low- and middle-income countries was unacceptably high at 24%. In Kenya, it was 20% in 2022 despite SDG target 3.7.1 guaranteeing universal coverage.<br />Methods: Most studies on unmet needs focus on the prevalence and factors associated with the uptake of family planning, but assessments of socioeconomic inequality within low-utilization groups are rarely given much attention. This is despite socioeconomic inequality being a central theme in achieving the SDGs. This study assessed socioeconomic inequality in the unmet need for family planning measured by the household wealth index and used putative determinants to explain the inequality. The study used data from the KDHS (2022). Associations between individual factors and unmet needs for family planning were determined using logistic regression models, whereas socioeconomic inequality was assessed using concentration curves and concentration indices.<br />Results: The prevalence rate of unmet needs was 14%; 7.6% for spacing and 6.4% for limiting. And among the poorest women was 21.6% compared to 10.1% among the richest. Being poor (OR: 1.788, 95% CI: 1.324-2.414), young (OR: 1.569, 95% CI: 1.212-2.030), having more than one living child (OR: 1.393, 95% CI: 1.157-1.676), not employed (OR: 1.561, 95% CI: 1.375-1.772), having no education (OR: 1.456, 95% CI: 1.022-2.074) and lacking media exposure (OR: 1.249, 95% CI: 1.027-1.519) increased the odds of unmet needs. The socioeconomic inequality in unmet needs was pro-poor (CIX < 0) and was substantially high (CIX<-0.4) among women with more than three children (CIX=-0.41), with no education (CIX=-0.46) or partners have no education (CIX=-0.68) or lack media exposure (CIX=-0.49).<br />Conclusion: The study recommends youth friendly - highly subsidized family planning services and commodities, and family planning information and education for women of low socioeconomic status.<br /> (© 2025. The Author(s).) |
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| ISSN: | 1471-2458 |
| DOI: | 10.1186/s12889-025-25395-0 |