Educational Intervention Effects on Bilateral Tubal Ligation Knowledge among Women Attending Antenatal and Family Planning Clinics in Bomet County

Abstract

Bilateral Tubal Ligation (BTL) is a highly effective contraceptive method with more than 99% effectiveness at preventing pregnancy. Its uptake remains low in Sub-Saharan Africa, at 1.6%. The Kenya Health and Demographics Survey 2014, indicated that almost half of the married women did not desire further childbearing. The low acceptance of BTL as a method of contraception in this region has been attributed to a lack of knowledge and cultural and religious misconceptions. This study aimed to determine the level of knowledge about BTL at baseline and the impact of an educational intervention among women attending ANC/Family planning clinics at Tenwek and Longisa Hospitals in Bomet County. A quasi-experimental study design was used. Demographic characteristics, knowledge of BTL, perceived risks, and benefits were assessed at baseline and post-intervention. A difference measure was used to assess the impact of the intervention at 95% CI, with a p-value of 0.05 considered significant. The data was analyzed using STATA version 18. The mean age of the participants at baseline and post-intervention was 29.0±5.8 years and 29.2±5.6 years, respectively. Overall, 62% of participants said they would choose BTL, with 52% in the post-intervention arm. When asked if their religion allowed BTL, 80.6% said yes and were supported by their husband (92%), However, 62% said they couldn't have it if their spouse was against it. In general, lower knowledge scores were obtained in the post-intervention arm, implying that the educational intervention provided did not influence participants' knowledge of BTL. There was no statistically significant difference in the participants' knowledge levels at baseline and post-intervention [3.3 (-3.2 to 9.9); p-value=0.3]. Educating families, particularly women of childbearing age, about alternative family planning methods would increase uptake, allowing families to achieve desired family sizes while limiting the impact of unwanted pregnancies and maintaining a healthy population.