Young Women’s Access to and Use of Contraceptives: The Role of Providers’ Restrictions in Urban Senegal

Abstract

Family planning services were introduced in Senegal in the early 1960s at the private Blue Cross Clinic in Dakar, but it was only in 1981 that the government developed an administrative structure capable of directing a national program and began to provide information, education and counseling support and family planning services. Factors contributing to unmet need for family planning in developing countries include lack of contraceptive knowledge; poor quality of and access to family planning services; method cost; women's concerns about side effects; and women's, husbands' or family members' objections to contraceptive use. 4,5 According to a descriptive analysis of Urban Reproductive Health Initiative data, women's beliefs and misconceptions about contraceptives, husbands' objections to contraceptive use and the poor quality of family planning services are the most frequent reasons deterring women in urban Senegal from practicing contraception. 6Youth constitute a key target in reproductive health strategies and, in Senegal, appear to have particularly low levels of contraceptive use. For example, in 2010-2011, only 2% of all 15-19-year-olds and 6% of all 20-24-yearolds reported using a modern method; 2 the proportions among currently married women in those age-groups were slightly higher (5% and 8%, respectively). Access to reproductive health services remains an issue for young women

Provider barriers to family planning access in urban Kenya

“…Our findings on provider imposed eligibility criteria based on age, parity, marital status and consent are similar to studies from Ghana [9], Senegal [8], and Tanzania [7]. As shown in those three contexts, providers in urban Kenya are imposing barriers to use, particularly for younger or unmarried women.…”

“…Speizer et al (2000) conducted a study among Tanzanian service providers and found that many providers restricted access to modern methods such as pills, injectables, and intrauterine devices (IUCDs) based on age, with a minimum age restriction of 14-15 years and a maximum age restriction of 43-44 years [7]. Results from a recent (2014) study in urban Senegal found that approximately half of providers impose minimum age restrictions with a median minimum age of 18 years [8]. In a study conducted in Ghana, Stanback and Twum-Baah (2001) found that providers restricted the provision of injectables to those 30 years and older [9].…”

“…In the Tanzania study, providers had a mean parity restriction of about 2.5 children for pills, condoms, IUCDs, and injectables [7]. Unmarried women also face barriers; in both the Ghana and Tanzania studies, providers required marriage as an eligibility criterion for reversible methods [7,9] or required husband's consent for provision of any of the methods [7] and in the Senegal study more than one-fifth of providers in private facilities were unwilling to provide pills, injectables, or implants to unmarried women [8]. In Tanzania, the authors found that recent in-service training did not reduce provider-imposed barriers [7].…”

A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal

“…[10][11][12] Interestingly, provider attitudes were cited as one of the main barriers to access, yet only nine informants had ever visited a SRH service delivery point, so this barrier may not be based only on experiences, but also on perceptions. These are compounded by the restricting social and gender norms (especially regarding behavioural expectations for women) and lack of access to information about where they can access SRH services.…”

Influence of hormonal contraceptives and the occurrence of stroke: integrative review

“…The use of combined injectables showed no increased risk; however, the only study that addressed this method was conducted more than a decade ago. It is worth mentioning that use of injectable contraceptives has increased in recent years, becoming the hormonal method most used by women in some countries (31)(32) . Likewise, the use of vaginal ring and contraceptive patch has increased as they became more easily available and users became more aware of them (33) .…”