Background: Despite family planning multiple benefits, women's experiences and
concerns present a formidable barrier to the sustained use of contraceptives. Combined oral
contraceptive pills use has remained low in Kwale County, owing to the various challenges that
women of reproductive age face towards modern use of contraception. Objective: To explore
concerns of women using combined oral contraceptive pills in Kwale County, Kenya. Settings:
The study was carried out in the outpatient family planning clinics of 8 maternal and child
health facilities in sub counties of Kwale county. Subjects: A convenient sample of 300 women
attending selected settings was included in the study subjects. Tools: Four tools were used for
data collection. Tool I: Socio-demographic and reproductive history structured interview
schedule; Tool II: Concerns of women using combined oral contraceptive pills structured
interview schedule; Tool III: Generalized anxiety disorder (GAD-7) screening tool and Tool
VI: Women's knowledge of combined oral contraceptive use structured interview schedule.
Results: Findings revealed that mean age of women using combined oral contraceptive pills
was 28.71 ± 5.56. Physical concerns were reported by less than two-thirds (60.7%) of study
subjects. More than half (52.3%) had accessibility concerns, while, more than one-third (38.7%)
had sexual concerns, and about one-fifth (19.7%) had socioeconomic concerns. Conclusion:
Fears of side effects or health-related reasons were the dominant physical concern reported 
by women who were using combined oral contraceptive pills. Recommendations: Strengthen
health education and to improve counseling practice for women and couples seeking FP
services,especially on combined oral contraceptive pills.