# The intervening role of community-based health education in reducing unmet family planning needs among women of reproductive age 15 and 49 years in Siaya County, Kenya

## TL;DR

Community health education in Kenya helped reduce unmet family planning needs among women by improving knowledge and attitudes.

## Contribution

This study demonstrates the effectiveness of community-based health education in mitigating unmet family planning needs in Siaya County, Kenya.

## Key findings

- The intervention group showed a 17.1% increase in family planning knowledge and a 12% rise in positive attitudes.
- Unmet family planning needs increased by 6.7% in the intervention group versus 20.8% in the control group.
- The intervention had a protective effect against worsening unmet needs, with borderline statistical significance.

## Abstract

unmet family planning needs remain a significant health challenge. In Kenya, 14% of women have an unmet need. In Siaya County unmet need is 21% among the women, and this is high. This study seeks to determine the intervening role of community health education on the reduction of unmet needs among women of reproductive age in Siaya County.

the study employed a quasi-experimental design with non-randomized, geographically distinct clusters. Assignment to the intervention and control arms was based on geographic allocation to avoid contamination into an intervention group that received structured health education for six months, and a control group, which did not. Data were collected at two time points (baseline and end line). The design enabled a difference-in-differences analysis to determine changes in outcomes between the groups over time. The FANTA formula by Robert Magnani determined the sample size of 1,448 respondents for the study. The WHO 30 by 30 two-stage cluster sampling method was used to sample the number of women of reproductive age. Data analysis was done using IBM SPSS version 28.0, with both bivariate and multivariate analyses conducted. Unmet needs for family planning were modeled using a generalized linear mixed-effects model (GLMM).

one thousand four hundred and forty-seven (1447) women of reproductive age (WRA) were interviewed at baseline and end line. There was a 17.1% increase in high family planning (FP) knowledge and a 12% rise in positive attitudes in the intervention, and a decline in the control group. Despite an increase in unmet need for FP in both study arms, the rise was lower in the intervention (6.7%) compared to the counterfactual (20.8%). The intervention had a protective effect against worsening of unmet need (aOR=0.31, 95% CI=0.10-1.00; p=0.051). This effect had borderline statistical significance (p=0.051). Family planning (FP) uptake decreased in the control group by 11.3% but increased in the intervention group by 6.6%, with aOR=2.42, 95% CI=0.92-6.40, p=0.075 indicating marginal statistical significance (p=0.075).

the intervention improves knowledge and attitudes, mitigates worsening of unmet FP needs, and promotes FP uptake.