Barriers to the Use of Modern Contraceptives and Implications for Woman-Controlled Prevention of Sexually Transmitted Infections in Madagascar

Randrianasolo, Bodo; Swezey, Teresa; Damme, Kathleen Van; Khan, Maria R.; Ravelomanana, N.; Rabenja, Ny Lovaniaina; Raharinivo, Mbolatiana S. M.; Bell, April J.; Jamieson, Denise J.; Behets, Frieda

doi:10.1017/s0021932007002672

Cited by 20 publications

(13 citation statements)

References 44 publications

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“…Ignorance and misinformation were leading barriers to contraceptive use. This corroborates several other studies 21,22. Higher awareness would stimulate community members to look for more accurate information on desired methods from health care providers and consequently, promote correct and consistent use of the method.…”

Section: Discussionsupporting

confidence: 89%

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Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria

Asekun-Olarinmoye¹,

Adebimpe²,

Bamidele³

et al. 2013

IJWH

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ObjectivesTo determine the knowledge and attitudes on modern contraceptive use of women living in an inner city area of Osogbo.Materials and methodsThree hundred and fifty nine women of childbearing age were studied utilizing a community-based, descriptive, cross-sectional study design. A multistage random sampling technique was used in recruiting respondents to the study. A four-part questionnaire was applied dually, by interviewers and by respondents’ self administration, and the data was analyzed using the SPSS software version 17.0.ResultsThe mean age of respondents was 28.6 ± 6.65 years. The majority (90.3%) of respondents were aware of modern methods of family planning (FP), 76.0% claimed awareness of where to obtain FP services, and 74.9% knew of at least five methods. However, only 30.6% had ever used contraceptives, while only 13.1% were current users. The most frequently used method was the male condom. The commonly perceived barriers accounting for low use of FP methods were fear of perceived side effects (44.0%), ignorance (32.6%), misinformation (25.1%), superstition (22.0%), and culture (20.3%). Some reasons were proffered for respondents’ nonuse of modern contraception. Predictors of use of modern contraceptives include the awareness of a place of FP service provision, respondents’ approval of the use of contraceptives, higher education status, and being married.ConclusionMost of the barriers reported appeared preventable and removable and may be responsible for the reported low point prevalence of use of contraceptives. It is recommended that community-based behavioral-change communication programs be instituted, aimed at improving the perceptions of women with respect to bridging knowledge gaps about contraceptive methods and to changing deep-seated negative beliefs related to contraceptive use in Nigeria.

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Section: Discussionsupporting

confidence: 89%

“…Globally, unplanned pregnancies and sexually transmitted infections (STIs) persist as significant threats to women’s reproductive health 2. Barriers to the use of modern contraceptives by women might inhibit uptake of novel woman-controlled methods for preventing unwanted pregnancies and STIs/human immunodeficiency virus (HIV).…”

Section: Introductionmentioning

confidence: 99%

Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria

Asekun-Olarinmoye¹,

Adebimpe²,

Bamidele³

et al. 2013

IJWH

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“…A qualitative study conducted by others in our group indicated that, among women seeking care at public health clinics in Antananarivo, negative perceptions of hormonal contraception’s side effects, namely, weight gain, prevented hormonal contraceptive use [21]. Concerns about side effects and inconvenience of contraception have become the most important factors driving unmet need in the developing world [22].…”

Section: Discussionmentioning

confidence: 99%

Unmet need for contraception among sex workers in Madagascar

et al. 2009

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Background The study was conducted to investigate past and future pregnancy preferences and contraceptive need among Malagasy sex workers. Study Design We analyzed data on pregnancy and contraceptive use collected during the baseline visit of a randomized, prospective formative trial which assessed diaphragm and microbicide acceptability among sex workers. To be eligible, women could not be pregnant or planning pregnancy for the next 2 months. Results Women (N=192) from four cities (Antananarivo, Antsiranana, Mahajanga and Toamasina) reported a median of 10 sex acts per week. Fifty-two percent reported a prior unwanted pregnancy, 45% at least one induced abortion and 86% that preventing future pregnancy was moderately to very important. During the last sex act, 24% used a hormonal method, 36% used a male condom, 2% used a traditional method and 38% used no method. Nearly 30% of participants reported that pregnancy prevention was moderately or very important but used no contraception at last sex; these women were categorized as having “unmet need” for contraception. In multivariable binomial regression analyses, factors associated with unmet need included low knowledge of contraceptive effectiveness [age- and site-adjusted prevalence ratio (PR): 2.1; 95% confidence interval (CI): 1.4–3.0] and low self-efficacy to negotiate condom use (age- and site-adjusted PR: 2.0; 95% CI: 1.4–3.0). Conclusions Among these women, prior unwanted pregnancy and induced abortion were common and preventing future pregnancy was important, yet gaps in contraceptive use were substantial. Contraceptive knowledge and self-efficacy should be improved to promote contraceptive use by sex workers.

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“…Studies have shown that perceptions of whether male partners are supportive of contraceptive use can influence whether women use contraception [ 16 – 22 ]. For example, concern about opposition to contraceptive use, mainly from male partners, was identified as a barrier to contraceptive use among women in Madagascar [ 23 ]. Additional research has found that involving men in contraceptive counseling was associated with increased contraceptive use [ 24 – 27 ], though other studies have found negative or no effects [ 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

The association between men’s family planning networks and contraceptive use among their female partners: an egocentric network study in Madagascar

et al. 2021

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Background Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research shows that women’s social networks - their ties with partners, family members, friends, and providers - affect their contraceptive use. Few studies have considered the role of men’s social networks on women’s contraceptive use. Insofar as women’s contraceptive use may be influenced by their male partners, women’s contraceptive use may also be affected by their partner’s social networks. Men may differ by the types of ties they rely on for information and advice about FP. It is unknown whether differences in the composition of men’s FP networks matter for couples’ contraceptive use. This study assessed the association between men’s FP networks and couples’ contraceptive use. Methods This egocentric network study was conducted among married/partnered men (n = 178) in rural Madagascar. Study participants listed who they relied on for FP information and advice, including health providers and social ties. They provided ties’ gender, age, relationship, and perceived support of contraceptive use. The primary outcome was couples’ contraceptive use, and explanatory variables included FP networks and their composition (no FP network, social-only network, provider-only network, and mixed network of social and provider ties). Analyses used generalized linear models specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors. Results Men who had FP networks were 1.9 times more likely to use modern contraception as a couple compared to men with no FP network (95% confidence interval [CI] 1.64–2.52; p ≤ 0.001). Compared to men with no FP network, men were more likely to use modern contraception if they had a social-only network, relative risk (RR) = 2.10 (95% CI, 1.65–2.68; p ≤ 0.001); a provider-only network, RR = 1.80 (95% CI, 1.54–2.11; p ≤ 0.001); or a mixed network, RR = 2.35 (95% CI, 1.97–2.80; p ≤ 0.001). Conclusions Whether men have a FP network, be it provider or social ties, distinguishes if couples are using contraception. Interventions should focus on reaching men not only through providers but also through their social ties to foster communication and support for contraceptive use.

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Barriers to the Use of Modern Contraceptives and Implications for Woman-Controlled Prevention of Sexually Transmitted Infections in Madagascar

Cited by 20 publications

References 44 publications

Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria

Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria

Unmet need for contraception among sex workers in Madagascar

The association between men’s family planning networks and contraceptive use among their female partners: an egocentric network study in Madagascar

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