CORRELATES OF CONTRACEPTIVE FAILURE AMONG CLIENTS ATTENDING AN ANTENATAL CLINIC IN NAIROBI

This paper presents a study analysing 100 cases of contraceptive failu re and an equal number of controls in Nairobi, The study population in cluded all the patients who attended the antenatal clinic at Kenyatta National Hospital, during a ten-week study period and who had conceive d while on a contraceptive method, The controls were patients who were carrying a planned pregnancy, The objective of the study was to deter mine the sociodemographic patterns, level of counselling and attitudes of patients who presented to antenatal clinic after contraceptive fai lure and to formulate recommendation on how to manage these patients, User failure was more common than method failure. High parity and a hi gh number of living children were associated with increased risk of co ntraceptive failure (OR 3.7 and 4.6, respectively), Other factors foun d to be associated with increased risk of contraceptive failure were: inadequate counselling at contraceptive initiation (OR 4.0), poor know ledge of different contraceptive methods (OR 1.9), short duration of c ontraceptive use (OR 3.3), and non-compliance, with 40% of the cases h aving been non-compliant, Thirty per cent of the patients who had cont raceptive failure were unhappy about the pregnancy, This paper finds t hat better counselling on contraceptive use and compliance would reduc e contraceptive failure and diminish the negative programme effects of failed contraception. Counselling would also enhance acceptance of th e pregnancy and minimise the chances of negative psychological sequela e.