INFLUENCE OF DRUGS AND SUBSTANCE ABUSE ON REPRODUCTIVE HEALTH IN GATANGA SUB COUNTY, MURANG’A COUNTY, KENYA BY JOSEPH MAINA KING’ORI REG.NO. C50/CE/26134/2011 A THESIS SUBMITTED TO THE SCHOOL OF HUMANITIES AND SOCIAL SCIENCES IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF DEGREE OF MASTER OF ARTS (GEOGRAPHY) OF KENYATTA UNIVERSITY. FEBRUARY, 2017 ii DECLARATION This thesis is my original work and has not been presented for a degree in any other University. Signature …………………………….. Date …………………… Joseph Maina Kingori Department of Geography, Kenyatta University CERTIFICATION This thesis has been submitted with our approval as the University supervisors. Signature …………………………….. Date …………………… Prof. Leonard. M. Kisovi Department of Geography, Kenyatta University Signature …………………………….. Date …………………… Dr. Francis O. Onsongo Department of Geography, Kenyatta University iii DEDICATION To my daughter, Stella and son, Owen, as a bench mark to your education aspirations. iv ACKNOWLEDGEMENT First and foremost I give honour and glory to the Almighty God for giving me the strength, health, ability and peace throughout my studies, without which, I could not have accomplished this research. I would like to recognize the continued support and guidance of all my lecturers who took me through the various courses and programs that enabled me to accomplish this research. I am also indebted to my supervisors, Prof. Leonard M. Kisovi and Dr. Francis O. Onsongo, both from the department of Geography, Kenyatta University, for their academic guidance, constructive criticism, supervision, motivation and encouragement. The unconditional sacrifices you made towards the success of this work are highly appreciated. I also extend special recognition to all the chiefs, assistant chiefs and religious leaders without whose cooperation, data collection would not have materialized, and also to all the respondents for accepting to participate in the study. I acknowledge with gratitude the support I received from my darling wife, Margaret, daughter Stella and son Owen for their prayers and encouragement. v TABLE OF CONTENTS DECLARATION ........................................................................................................ ii DEDICATION ........................................................................................................... iii ACKNOWLEDGEMENT ......................................................................................... iv TABLE OF CONTENTS ............................................................................................. v LIST OF TABLES ..................................................................................................... ix LIST OF FIGURES .................................................................................................... xi DEFINITION OF OPERATIONAL TERMS ........................................................... xii ABBREVIATIONS AND ACRONYMS ................................................................ xiv ABSTRACT ............................................................................................................... xv 1.0 INTRODUCTION .................................................................................................. 1 1.1 Background to the study ......................................................................................... 1 1.2 Statement of the problem ....................................................................................... 5 1.3 Research Objectives ............................................................................................... 6 1.3.1 General Objective ................................................................................................ 6 1.3.2 Specific Objectives .............................................................................................. 6 1.4 Research questions ................................................................................................. 7 1.5 Hypotheses of the study ......................................................................................... 7 1.6 Justification and Significance of the study ............................................................. 8 1.7 Scope and limitations of the study ......................................................................... 9 2.0 LITERATURE REVIEW ..................................................................................... 11 2.1 Introduction .......................................................................................................... 11 2.2 The concept of drugs and substance abuse ........................................................... 11 2.3 The Drug-Circle Syndrome .................................................................................. 12 2.4 Global trends of substance abuse ......................................................................... 13 2.5 Substance Abuse Situation in Africa .................................................................... 14 2.6 Substance abuse situation in Kenya ..................................................................... 16 2.7 Factors contributing to substance abuse ............................................................... 18 2.8 Effects of substance abuse on reproductive health ............................................... 19 vi 2.9 Summary of Literature Review ............................................................................ 22 2.10 Theoretical framework ....................................................................................... 23 2.11 Conceptual framework ....................................................................................... 23 3.0 RESEARCH METHODOLOGY ......................................................................... 26 3.1 Introduction .......................................................................................................... 26 3.2 Research design .................................................................................................... 26 3.3 Site of the Area ..................................................................................................... 26 3.4 Study population .................................................................................................. 28 3.5 Sampling techniques and sample size .................................................................. 29 3.5.1 Sample Size Determination ............................................................................... 29 3.5.2 Sampling procedure ........................................................................................... 30 3.6 Research instruments ............................................................................................ 31 3.6.1 Questionnaire .................................................................................................... 31 3.6.2 Interview ............................................................................................................ 32 3.6.3 Focus Group Discussion .................................................................................... 33 3.7 Validity and Reliability ........................................................................................ 34 3.8 Data collection ...................................................................................................... 34 3.9 Variable selection, Data Collection and Data Analysis Method .......................... 36 3.10 Ethical Considerations ........................................................................................ 37 4.0 DATA ANALYSIS, PRESENTATION AND INTERPRETATION .................. 38 4.1 Introduction .......................................................................................................... 38 4.2 Instruments return rate ......................................................................................... 38 4.3 Respondents socio-demographic characteristics .................................................. 39 4.3.1 Distribution of respondents by location ............................................................ 39 4.3.2 Distribution of respondents by sub locations .................................................... 39 4.3.3 Distribution of respondents by gender .............................................................. 41 4.3.4 Distribution of respondents according to age .................................................... 42 4.3.5 Distribution of respondents according to marital status .................................... 43 4.3.6 Distribution of respondents’ marital status by their age groups ........................ 44 4.3.7 Respondents religious preference ...................................................................... 45 vii 4.3.8 Distribution of respondents by educational levels ............................................ 46 4.3.9 Respondents occupation .................................................................................... 47 4.4 Types, sources and drug use ................................................................................. 48 4.4.1 Awareness of drugs and substances .................................................................. 48 4.4.2 Commonly used and abused drugs and substances ........................................... 49 4.4.3 Drug abuse prevalence and extent ..................................................................... 50 4.4.4 Sources of drugs ................................................................................................ 51 4.4.5 Respondents utilization