Abstract:
Estimates regarding pregnancy intentions provide insights into the reproductive
health status of people. Unintended pregnancy contributes significantly to adverse
outcomes like unsafe abortions, maternal fatalities, malnutrition, mental health issues
due to stress, and transmission of HIV. In Kenya, prevalence of unintended
pregnancies has risen from 34% in 2014 to 41.9% in 2020, with an accompanying
increase in abortion rates from 24% to 34% between 2015 and 2019. The study
aimed to identify the determinants of unintended pregnancies among pregnant
women receiving care at the antenatal clinic in Kenyatta National Hospital, Nairobi,
Kenya. This study took place at the antenatal clinic, KNH and it adopted a cross
sectional study design that had a sample size of 227 study participants. All the study
participants were sampled from women who were currently pregnant and attending
the antenatal clinic in addition met the inclusion and exclusion criteria. The data was
collected using a structured questionnaire. A pregnancy was said to be unintended if
it was mistimed or unwanted. A structured questionnaire was used to collect data and
analyzed using the Statistical Package for Social Sciences (SPSS) version 21.
Bivariate analysis examined associations using odds ratios and statistical significance
interpreted at 5%. Multivariate logistic regression analysis determined independent
predictors of unintended pregnancy. Statistical significance of p < 0.05 or p=0.05.
The proportion of unintended pregnancy among the study participants was at 29.9%.
Age under 25 years [aOR 8.1 (95% CI 1.4-48.6)], prior use of contraceptive methods
[aOR 7.9 (95% CI 2.5-25.0), p<0.001], and the woman being the only one who
decides when to become pregnant [aOR 3.8 (95% CI 1.3-11.2), p=0.014] were the
main independent predictors of unintended pregnancy. Unintended pregnancies were
also substantially correlated with infrequent use of family planning services and
unfavourable opinions of facility-based reproductive health education, highlighting
the influence of service delivery on pregnancy outcomes. The study emphasizes the
critical need to improve young women's access to comprehensive, youth-friendly
sexual and reproductive health education and family planning services. To address
these challenges, the Ministry of Health, in collaboration with healthcare providers,
should develop and implement sustainable strategies. These should include
integrated service delivery models that combine family planning with other
reproductive health services such as HIV/AIDS prevention, STI screening, and
maternal and child healthcare.
