Prevalence and Determinants of Covert Contraceptive Use in Kenya: a Cross-Sectional Study

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Abstract Background: Family planning (FP) is a key intervention for preventing unplanned pregnancies, unsafe abortions, and maternal death. Involvement of both women and their partners promotes contraceptive acceptance, uptake and continuation, couple communication and gender-equitable attitude. It is a key strategy for addressing about 17.5% of the unmet needs in FP in Kenya. This study assessed the prevalence and determinants of covert contraceptive use (CCU) in Kenya.Methods: We used data from the sixth and seventh rounds of the performance monitoring for accountability surveys. We defined CCU as ”the use of contraceptives without a partner’s knowledge”. We used frequencies and percentages to describe the sample characteristics and the prevalence of CCU and assessed the determinants using bivariate and multivariable logistic regressions.Results: Of the 3,892 married women using contraceptives included in this study, 62.9% were 20−34 years, 65.4% lived in rural areas, 51.3% had primary education and 82.4% had two or more children. The mean age at first sexual encounter was 17.3 years (standard deviation: 3.0). The prevalence of CCU was 12.2% (95% CI: 10.4%−14.2%) and was high among 35−49 years (12.8%), uneducated (22.3%) and poorest (18.2%) women. Siaya (22.9%), Kericho (16.7%) and Kakamega (13.1%) counties had the highest prevalence of CCU. Injectables (53.3%) and implants (34.6%) were the commonest methods among women who practice CCU. County of residence, education, wealth, parity, and age at sexual debut were associated with CCU.Conclusion: About one in 10 married women in Kenya use contraceptive covertly, with injectables and implants being the preferred methods. Our study highlights a gap in partner involvement in FP and calls for efforts to strengthen their involvement to increase contraceptive use in Kenya while acknowledging the rights of women to make independent choices.

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