Awareness and use of the female condom
Majority of the respondents reported that they were aware of the female
condoms and that they can access them from the chemists/ pharmacies
50%, health facilities and shops/ supermarkets 38.2% and 11.8
respectively. The source of the female condom was not significant, the
youths never minded where to access them from so long as they get the
device for use when there is need to use the female condom (p=0.207,
χ2 =1.591, df=2, OR=0.958). However, the youths who
were aware of the female condom use were more likely to use the device
than the ones who not aware of it benefits and where to access it from.
This was significantly associated with use of the female condom
(p=0.040, χ2 =4.21, df= 2).
There were more posters for male condom use than for female condom use.
With the availability of the posters and other information and
communication materials for male condoms being easily available, more
youths were conversant with ease use of the male condom than the female
condom. Respondents were able to explain the correct procedure for male
condom use than for female condom use. However, availability of the
female condom posters was significantly associated with the use of the
female condom (p=0.001, χ2 =9.7776, df=2, OR=2.752).
Availability and use of the female condom
Most respondents 98.2% reported that the female condom were not easily
available in the college’s reproductive health clinic while 1.3% said
sometimes the stocks are there and the remaining 0.5% agreed that the
stocks were available in specific points of sale. Availability of the
female condom was significantly associated with use of the device at a p
value (p≤0.001, χ2 =30.839, df= 2, OR=50.382).
Logistic regression was done on where to access the female condom from
and availability of the female condom at that point, it was found out
that most of the time the female condom was out of stock and this
affected its use among the youths. The youths reported that it took time
before replenishing the stocks and also the working hours for the
reproductive health clinic were limited as they spent the opening hours
of the clinic in class. However, there was no statistical significance
between where to access the female condom from and availability of the
condom (p=0.297).In a study by Obembe et al., accessibility of the
female condom, however, the study didn’t indicate significance of where
to access the female condom from.
When the researcher probed more on female condom distribution, the
respondents reported that mostly they are supplied with male condom
dispensers latter than the female condom dispensers within their place
of residence. Availability of the female condom dispensers in accessible
points was significantly associated with use of the female condom
(p=0.003, χ2 =8.573, df=2, OR=8.256) in most of the
places of residence the female condom dispensers were not there 93.3%,
while the remaining portion of participants reported that though the
dispensers were not there, they can access the reproductive health
clinic which is proximal to their place of residence 6.1%. During an
interview with the key informant, it was evident that the institutions
had procured and had in place male condom dispensers within the place of
residence. This promoted use of male condom compared to female condom,
however even the male condom was not consistently used.
During focused group discussion, members reported that whenever they
sought contraceptives in the reproductive health clinics, they are given
other options and the female condom is rarely championed for as reported
by one of the respondent that;
Whenever I go for family planning services am given the option of
injectable method, a jadelle or sure (a male condom), the nurse has
never bothered to demonstrate to me how to use a female condom, may be
they also don’t know how to use them(respondent from Rongo University) .
On the place (position) where the point of distribution for female
condoms was situated, majority of the respondents (67.6%) reported that
the place was not accessible, while 15%%, 17.4% reported that they
were not sure and some can access the point of distribution
respectively. It was found out that whenever there was need for the
female condom use, most of the supermarkets and shops around the
students’ hostels had no stocks. In the reproductive health clinics,
there was no specific place or point to pick the female condom from; the
respondents reported that in case one needed to get one, she had to be
physically given the condom by a health provider. This barred many
youths since they need a place where they can walk in freely any time of
the day and night to pick the female condom and use. Therefore the
places where the female condoms were stored or distributed from weren’t
accessible at all times, especially at night when the youths would like
to use the device. This was significantly associated with use of the
female condom (p=0.040, χ2 = 4.1887, df= 2). Most
youths during focus group discussion reported that the male condom was
easily accessible at all times hence likely to be used more often than
female condom.
During an in-depth interview with the nurse in charge of the
reproductive health clinics in the selected institutions, it was evident
that they too had no stocks for the female condom but enough stocks of
the male condom. It was found out that whenever they sought the device,
many shops, supermarkets and chemist never stocked the female condom.
The place of residence had male condom dispensers and no female condom
dispenser; this made use of the male condom preferred in comparison with
the female condom.
Cost and use of the female condom
The cost of the female condom was considered relatively expensive
compared to a male condom, 37.9% of the youths were not sure if the
female condom was affordable or not while 35% disagreed, 6.8% strongly
disagreed, 20% agreed and 0.3% strongly agreed that the device was
affordable (p≤0.001, χ2 = 25.349, OR=
15.497,SD=0.871), this meant that the female condom was 15.4 times more
likely to be used if it was made affordable. However, during focused
group discussion it was evident that even for those who can afford
weren’t able to use the device due to unavailability of the stock. In
the selected tertiary institutions, the device was not stocked
frequently due procurement issues surrounding the cost of the female
condom.
During sessions of group discussion, it came out clearly that those who
had used the female condom previously they had gotten it from health
workers during campaigns for HIV/Aids prevention where they were taught
on how to use and were given some for use. Later after using the few
devices given, they haven’t used the device again because they scarcely
know where to get the female condom from and cost implications.