Factors associated with uptake of subdermal contraceptive implants in a young Kenyan population

Background: Subdermal contraceptive implants may be a reasonable option for young women in sub-Saharan Africa; little is known about factors associated with method uptake in this subpopulation.

Study design: Four hundred women aged 18-24 years who sought short-acting hormonal contraception were offered an opportunity to use an implant instead. Cross-tabulations and logistic regression analysis were used to examine participant characteristics and other factors associated with choosing an implant.

Results: Twenty-four percent of participants chose the implant. Participants with greater than 4 years of contraceptive need were over three times more likely to choose an implant [odds ratio (OR), 3.4; 95% confidence interval (CI), 1.6-6.9]. Women with health concerns over short-acting hormonal methods (OR, 2.2; 95% CI, 1.3-3.6) and those who expressed some difficulty returning to a clinic (OR, 1.9; 95% CI, 1.1-3.1) were about twice as likely to choose an implant. Product attributes such as long-acting protection and convenience were cited reasons for choosing an implant.

Conclusions: The implant appears to be an attractive option for a fairly large proportion of young women in Kenya. Within this age group of implant users, homogeneity of demographic characteristics relative to short-acting users suggests that the product has broad appeal.