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Improving young mothers’ contraceptive use and continuation through home and mobile-based counseling in Nairobi slums - Endline, N/A

Kenya, 2022 - 2023
Health and Well-Being (HaW)
Yohannes Dibaba Wado, PhD
Last modified April 22, 2026 Page views 2773 Documentation in PDF Metadata DDI/XML JSON

Identification

IDNO
DDI-KEN-APHRC-GCC-2023-v1.0
Title
Improving young mothers’ contraceptive use and continuation through home and mobile-based counseling in Nairobi slums - Endline, N/A
Subtitle
N/A
Country
Name Country code
Kenya KEN
Abstract
Background:
There was a high unmet need for contraception among parenting adolescents and young women in Kenya, which put them at risk of closely spaced births. Such closely spaced births increased obstetric risks and adverse birth outcomes, including maternal complications, stillbirths, and premature deliveries. Repeat pregnancies also had socioeconomic implications for adolescent girls and reduced their chances of reentry into school and economic prospects. Yet there was limited evidence on approaches to increase uptake and continuation of contraceptives among parenting adolescents to prevent rapid repeat pregnancies.

Aim:
This intervention study tested the acceptability and effectiveness of individualized contraception counselling by Community Health Volunteers (CHVs) through home visits and mobile SMS in improving the uptake and continuation of contraception among parenting adolescent and young women (ages 15–24) in Nairobi slums.

Methods:
We generated evidence demonstrating the acceptability and effectiveness of the CHV community-based intervention in two slums in Nairobi. Young mothers in the intervention site (Korogocho) received the intervention package that included CHVs providing counseling and follow-up support. Young mothers in the comparison site (Viwandani) received the usual standard of health care. To determine the effects of the intervention, we aimed to conduct a quasi-experimental evaluation and tracked, monitored, and evaluated the project using key indicators of contraceptive uptake, method mix, and continuation of use. A total of 402 parenting adolescents and young women were recruited—201 from the intervention site, Korogocho slum, and another 201 from a comparison site, Viwandani slum. We also conducted 20 in-depth interviews with parenting adolescents and young women and 10 key informant interviews with CHVs to assess intervention acceptability and fidelity. Baseline and endline surveys were conducted in both sites to measure knowledge and attitudes towards contraception, current use and method mix, and continuation. We implemented a pre-post design with a pre-intervention (T1) and post-intervention (T2) measurement of the key indicators to demonstrate changes in key outcomes. Quantitative data analysis was done using STATA to provide descriptive statistics and statistical associations/correlations on key variables. Results from the study were disseminated at community-level forums and to a broader audience that included the Ministry of Health and program implementers. We also developed manuscripts for publishing in peer-review journals.

Version

Version Date
2025-09-08
Version Notes
N/A

Coverage

Geographic Coverage
Nairobi slums: Korogocho and Viwandani
Unit of Analysis
acceptability and effectiveness of an individualized contraception counselling by Community Health Volunteers (CHVs) through home visits and mobile SMS in improving the uptake and continuation of contraception among parenting adolescent and young women (ages 15-24) in Nairobi slums
Universe
parenting adolenscent and young women aged 15 - 25

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
Yohannes Dibaba Wado, PhD African Population and Health Research Center (APHRC)
Producers
Name Affiliation Role
Clement Otendo, M.A African Population and Health Research Center (APHRC) Co-investigators
Antony Idowu Ajayi, PhD African Population and Health Research Center (APHRC) Co-investigators
Caroline W. Kabiru, PhD African Population and Health Research Center (APHRC) Co-investigators
Hellen Akinyi, BSC African Population and Health Research Center (APHRC) data documentarist
Other Identifications/Acknowledgments
Name Role
Marie Stopes Kenya (MSK) Project partners

Sampling

Sampling Procedure
Sample size and power calculations were done based on the expected change in the use of modern contraception methods that included Injectable, Implants and IUD. We used data from the 2014 Kenya Demographic and Health Survey (KDHS) to obtain estimates of baseline contraceptive use among sexually active adolescent girls for the sample size calculation. The KDHS survey showed that 20.3% of sexually active adolescents in Kenya used Injectable and LARCs [3]. To our knowledge, there is no intervention study that examined the effects of such intervention on improving contraceptive method choice among adolescents in urban slums and provided an estimate of effect size. To fill that gap, we used data from the 2017 STEP UP survey that showed that about 12.3% of young women of age 15-24 years in Korogocho and Viwandani slums wanted to shift from condoms, pills and traditional methods to Injectable and LARC methods (Implants and IUDs)[31]. Accordingly, the minimum sample size required to detect change in the use of Injectable and LARCs between baseline and endline is calculated in STATA version 15 with the following assumptions:
- P1- Percentage of sexually active adolescents in Kenya using Injectable and LARC methods at baseline (20.3%) based on data from the Kenya DHS.
- P2- Percentage of pregnant and parenting young mothers in the intervention site who use Injectables and LARCs at the end of the intervention (30.6%) assuming a percentage point increase of 12.3%.
- A two-sided level of significance of 5%, and statistical power of 80%.
Based on the above assumptions of effect size and power, we estimated a sample size of 201 young mothers per group for a total of 402 study participants. The intervention sample of 201 young mothers was recruited from Korogocho slum while the comparison sample of 201 young mothers was sampled from Viwandani slum. For recruitment of young mothers for the intervention, wel drew on the young women's lived experiences study to be implemented in the Korogocho informal settlement by APHRC. This is a 9-months study which is being implemented in the intervention community from August 2022 to April 2023. This lived experiences study collected data from about 500 young mothers and served as a sampling frame for this intervention study in Korogocho slum. We recruited a similar number of young mothers from the Viwandani site for the quasi-experimental study through a household listing exercise to identify eligible young mothers for comparison. We adjusted for any possible loss to follow up by providing for at least 20% attrition rate. However, given the no more than one year duration between the baseline and the endline and the younger age of the target participants, we did not foresee marked loss to follow up.
Deviations from the Sample Design
N/A
Response Rate
Baseline: 87.94%
Endline: 96.83%.
Weighting
N/A

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date Cycle
2022-12-22 2023-02-09 Baseline
2023-07-13 2023-08-01 Endline
Mode of data collection
Face-to-face [f2f]
Supervision
During the data collection period, supervisors consulted regularly with the central coordination team on achievements and constraints of the operation. These consultations facilitated any necessary adjustments to the data collection process. In the first week of data collection, a software developer was available to perform onsite support where necessary. Thereafter, remote connection through TeamViewer was used to offer support to troubleshoot any problems that arose involving data capture (and data transmission) using the tablets.

Team leaders worked with their teams at the end of each day to review data captured on the tablets, looking for any errors, such as incorrectly filled forms, missing data, and inconsistencies. Through sit-in interviews, supervisors randomly observed each interviewer at least once per week during the survey implementation.
Type of Research Instrument
The questionnare was written in english and later translated to kiswahili, local language in kenya for easy understanding

Data Processing

Cleaning Operations
Interviews for all surveys was conducted face-to-face, using Open Data Kit (ODK) software on Android smartphones. Completed ODK forms were submitted to a secure cloud server using Wi-Fi or mobile data networks accessible only to the study team. The data was later uploaded to Stata to be cleaned and analyzed.
Other Processing
N/A

Data Appraisal

Estimates of Sampling Error
N/A

Data access

Contact
Name Affiliation Email
African Population and Heath Research Center APHRC datarequest@aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST be anonymized by removing the respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people do not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or inform publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the acknowledgement for our data is:

"This research utilizes data collected through the "Filling Gaps in Evidence to Enhance Sexual and Reproductive Health and Rights Among Vulnerable Populations in the East and Horn of Africa (Baobab)" program. The Baobab Research Program Consortium was funded by the Foreign, Commonwealth & Development Office (FCDO) and implemented by the Population Council Inc., Population Council Kenya, and the African Population and Health Research Center.
We gratefully acknowledge all study participants, health workers, health facility leadership, refugee settlement commandants, and field research assistants for their dedication in supporting and facilitating the data collection process. We also extend our gratitude to the UNHCR Regional Bureau for the East, Horn of Africa, and Great Lakes Region, UNHCR Uganda and its implementing partners, and the Government of Uganda through the Department of Refugees in the Office of the Prime Minister, as well as the Reproductive and Infant Health Department, Ministry of Health, for their invaluable technical support."

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download

Metadata production

Document ID
DDI-KEN-APHRC-GCC-2023-v1.0
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC Documentation of the DDI
Date of Production
2025-09-08
Document version
Version 1.0(SEPTEMBER 2025)