Interests and preferences regarding family planning self-care interventions: cross-sectional surveys with Kenyan and Nigerian women

Abstract

Self-care interventions for family planning encourage women to play a central role in their own health care. This study assesses women’s interests and preferences related to mobile access to information and products amenable to self-administration, and examines factors associated with preferred place of access. We added a module to the female questionnaire of the cross-sectional Performance Monitoring for Action survey in Kenya (n = 9,489) and in two Nigerian states (Kano (n = 1,144) and Lagos (n = 1,426)) between November 2021 and January 2022. We analysed data on interests and preferences related to mobile access to information and various places of access for oral contraceptive pills, emergency contraception, and DMPA subcutaneous self-injection and fitted multinomial regression models to examine the factors associated with preferred place of access for each contraceptive product. Across sites, 69–85% of women were interested in accessing family planning and fertility information on their own. Among them, 88–90% were interested in receiving information via voice/text and 49–72% through social media. The preferred access point across products and sites was the health facility (56–82% of women), with some interest in other sources. Across sites, 71% or more of respondents said engaging with a provider was “very/somewhat important” when starting or while using all three methods. Multivariable analyses revealed differences in preferred place of access between subgroups of potential end users. Findings highlight opportunities for self-care interventions through health facilities and other access points and the need for multipronged tailored interventions that offer a range of touchpoints with the health system to enable choice.