Barriers to Modern Contraceptive Use in Kinshasa, DRC

Muanda, Mbadu; Ndongo, Parfait Gahungu; Taub, Leah D.; Bertrand, Jane T.

doi:10.1371/journal.pone.0167560

Cited by 54 publications

(74 citation statements)

References 12 publications

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“…In addition to communication issues and differing spousal perspectives, cultural norms that support large families were revealed as a major barrier in a qualitative study conducted in Kinshasa with similar objectives. Although cultural norms were identified as contributing to non-use in this study undertaken in DRC rural areas, some women revealed that if their husband supported the use of a modern family planning method, they felt justified in using one, even if their family or friends criticised this decision (Muanda et al 2016). This finding differs from the common impression backed up by other studies that report that deep-rooted cultural beliefs about gender norms help explain non-use in rural areas (Farmer et al 2015).…”

Section: Discussioncontrasting

confidence: 95%

Barriers to modern contraceptive use in rural areas in DRC

Muanda

Ndongo

Messina

et al. 2017

Culture, Health & Sexuality

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Recent research in the Democratic Republic of Congo (DRC) has shown that over a quarter of women have an unmet need for family planning and that modern contraceptive use is three times higher among urban than rural women. This study focuses on the reasons behind the choices of married men and women to use contraception or not. What are the barriers that have led to low levels of modern contraceptive use among women and men in DRC rural areas? The research team conducted 24 focus groups among women (non-users of any method, users of traditional methods and users of modern methods) and husbands (of non-users or users of traditional methods) in six health zones of three geographically dispersed provinces. The key barriers that emerged were poor spousal communication, sociocultural norms (especially the husband's role as primary decision-maker and the desire for a large family), fear of side-effects and a lack of knowledge. Despite these barriers, many women in the study indicated that they were open to adopting a modern family planning method in the future. These findings imply that programming must address mutual comprehension and decision-making among rural men and women alike in order to trigger positive changes in behaviour and perceptions relating to contraceptive use.

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Section: Discussioncontrasting

confidence: 95%

Barriers to modern contraceptive use in rural areas in DRC

Muanda

Ndongo

Messina

et al. 2017

Culture, Health & Sexuality

Self Cite

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“…We discuss several probable explanations that could explain our results. lack of knowledge about types and sources of contraceptives was among the reasons for not using contraceptive methods [42]. Another study conducted in Chad found that a correlation exists between wealth and the knowledge about the family planning service providers.…”

Section: Discussionmentioning

confidence: 99%

“…Women may also not use specific services despite the availability and quality of services if they do not intend to use modern contraception. Strong social norms that support large families are among the reasons cited as barriers to modern contraceptive use in Kinshasa [42]. These norms also might be a strong barrier for some women to use modern contraceptives.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

Babazadeh

Hernandez

Anglewicz

et al. 2020

Preprint

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Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning (FP) services, as well as service availability and quality of family planning services in Kinshasa. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa not to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

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“…Better-educated women were more likely to practice contraception and to use modern methods (Bader, 2015). Data from the countries where the Demographic and Health Surveys have been conducted demonstrate the positive relationship between education and the use of family planning (Muanda, et al, 2016). Ochako, et al, (2017) analyzed the world fertility survey that was collected from 25 countries and found a positive relationship between women's education and the contraceptive method practices, and that education was associated with increased awareness, acceptability and use of contraception.…”

Section: Educationmentioning

confidence: 99%

Socio-economic and Socio-cultural Factors Influencing Contraceptive Uptake among Women of Reproductive Age at Kahe Ward in Moshi, Kilimanjaro - Tanzania

2019

IST Journal

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Family planning services play an important role in managing fertility; utilization of contraceptive in the United States is virtually universal among women of reproductive age: at least one contraceptive method had been used by over 98 percent of all women who had ever had intercourse. In 2010, 90 percent had ever had a partner who used the male condom, 82 percent had ever used the oral contraceptive pill, and 56 percent have had a partner who used withdrawal (Lindh, 2011). Generally, there has been an impressive increase in contraceptive prevalence in the entire world (Miano, 2014). Even in the Least Developed Countries (LDC), the fertility rate declined from 6.55 births per woman in the early 1950s to 4.53 in 2010 (Hukin, 2012). However, at the regional level, the progress in the efficiency of family planning program and in the range of contraceptive method used has been different. In fact, in 2013, investigations by Bhandari, Shrestha, & Thakuri, (2013) revealed that Africa and sub-Saharan Africa had the lowest contraceptive prevalence at 31 percent and 26 per cent, respectively, as compared to 75 percent in Latin America and the Caribbean, and 65 percent in Asia (Baidoo, 2013). Thus, the statistics show that the use of modern methods in Africa and sub-Saharan Africa continues to be about one-third of the levels in the other two developing regions (Boamah, 2012). Differential in contraceptive prevalence is also distinguished at the sub-regional levels within each major area. For example, Northern and Southern Africa regions have much higher prevalence of all methods or of modern methods of contraception compared to any other African region (Heisler & Van Eron, 2012). Comparatively, utilization of modern methods of contraception is very low in Middle and Western Africa, 8 per cent and 11 per cent, respectively, in 2013 (Lemba, 2014). The number of people in need of health and education, among other public goods is large and increasing which in turn requires large amounts of resources, personnel and infrastructure. This is likely to be an impediment towards the realization of the reduction of child mortality, improvement of maternal health, achievement of universal primary education, environmental sustainability and combating HIV/AIDS, malaria and other diseases. Therefore, the countries in Sub Saharan Africa (SSA)

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Barriers to Modern Contraceptive Use in Kinshasa, DRC

Cited by 54 publications

References 12 publications

Barriers to modern contraceptive use in rural areas in DRC

Barriers to modern contraceptive use in rural areas in DRC

The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

Socio-economic and Socio-cultural Factors Influencing Contraceptive Uptake among Women of Reproductive Age at Kahe Ward in Moshi, Kilimanjaro - Tanzania

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