Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria

Abstract Background Myths and misconceptions around modern contraceptives have been associated with low contraceptive uptake in sub-Saharan Africa and Kenya in particular. Addressing persistent contraceptive knowledge gaps can make a significant contribution towards improved contraceptive uptake among young women. This qualitative study therefore sought to explore and understand young people’s knowledge of modern contraception and to identify their key concerns regarding these methods. Methods We used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18–24 per FGD, one FGD had 8 participants. Predefined codes reflecting the discussion guides and emerging issues in the FGDs were used to develop the thematic coding framework. Our analysis followed a pattern of association on the key preset themes focusing on myths and misconceptions around contraceptive use. Results Results are presented under four key themes: awareness of contraception, myths and misconceptions around contraception, males’ contraceptive narratives and young people’s preferred sources of contraceptives. Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions were discussed and included perceptions that modern contraception: jeopardized future fertility, could result in problems conceiving or birth defects, made women promiscuous, was ‘un-African’, and would deny couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. On preferred sources of contraceptives, respondents reported on two main sources, pharmacies and public hospitals, however, they could not agree on which one was suitable for them. Conclusions This study revealed the presence of a mixture of biological and social myths and misconceptions around contraception, with young men also strongly adhering to these misconceptions. The low level of contraceptive knowledge, particularly on contraceptive fears as revealed by the study demonstrate critical gaps in sexual and reproductive health (SRH) knowledge among young people. Improved SRH literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may therefore contribute to increased uptake of SRH services including modern contraceptive methods.

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“I don’t know how to explain it” Narratives on contraceptives among young men and women in Kwale County, Kenya

10.21203/rs.2.21058/v1 ◽

2020 ◽

Author(s):

Jefferson Mwaisaka ◽

Lianne Gonsalves ◽

Mary Thiongo ◽

Michael Waithaka ◽

Hellen Sidha ◽

...

Keyword(s):

Young Women ◽

Young Men ◽

Modern Contraceptive ◽

Group Discussions ◽

Men And Women ◽

Cultural Effects ◽

Future Fertility ◽

And Gender ◽

Prevention Methods ◽

Contraceptive Uptake

Abstract BackgroundMyths and misconceptions around modern contraceptives have been associated with low contraceptive uptake. Nearly all the research on the link between contraceptives’ misconceptions and low contraceptive prevalence comes mostly from women with little focus on men. This qualitative study therefore sought to explore and understand both young men’s and young women’s knowledge of modern contraception and to identify key concerns regarding modern pregnancy prevention methods.MethodsWe used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants.ResultsBoth men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions around contraception were discussed, they included jeopardizing future fertility, prolonged menstrual bleeding, problems conceiving, birth defects, promiscuity, against religion and perceived to be un-African including denying couples their sexual freedom. Compared to female respondents in the study, men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. Results are presented under three key themes namely (i) Awareness of contraception (ii) Myths and misconceptions around contraception and (iii) Males’ contraceptive narratives. Conclusions Improved sexual and reproductive health (SRH) literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may contribute to increased uptake of SRH services including modern contraceptive methods.

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Variations in modern contraceptive uptake and its correlates in South West and North East Nigeria: a comparative analysis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202721 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2852

Author(s):

Funmilola F. Oyinlola ◽

Samson O. Bamiwuye ◽

Stephen A. Adebowale ◽

Opeyemi O. Ekundayo ◽

Benjamin B. Ilesanmi

Keyword(s):

Reproductive Health ◽

Sexual And Reproductive Health ◽

Reproductive Age ◽

Outcome Variable ◽

Modern Contraceptive ◽

Women Of Reproductive Age ◽

North East ◽

South West ◽

Living Children ◽

Contraceptive Uptake

Background: Family planning programs are implemented specifically to address the sexual and reproductive health challenges of women of childbearing age but these interventions are yet to address regional differences in modern contraceptive usage in Nigeria. Hence, this study aimed to examine correlates of modern contraceptive uptake in South West and North Eastern, Nigeria.Methods: A cross-sectional survey data for women aged 15-49 years was extracted from Nigeria demographic and health surveys 2018 (NDHS). Data analyses were based on a weighted sample of 10,907 (North East= 5406 and South West = 5501) women of reproductive age. The outcome variable was modern contraceptive use. The main explanatory variables were age, employment status, religion, Number of living children, education, and marital status. Frequency distribution, Chi-square test, and binary logistic regression were used for data analysis (α=0.05).Results: The result showed the mean age of women of reproductive age in South West and North East to be 32years and 30 years respectively. More women in South West used modern contraceptive than women in North East. About 91.5% and 75.8% of women in North East and South West respectively did not used any modern method. The result showed that, in the South West, number of living children (OR:4.06, CI: 2.794-5.921), education (OR:1.35, CI: 1.045-1.754) and wealth index (OR:1.77, CI: 1.053-2.973) increased the odds of contraceptive uptake, while maternal age (OR:0.52, CI: 0.282-0.965), religion (OR:0.25, CI: 0.184-0.347) and place of residence (OR:0.68, CI: 0.504-0.916) significantly reduced the odds of modern contraceptive uptake in North East.Conclusions: This study concludes that there are regional variations in uptake and predictors of modern contraceptives use in Nigeria. Therefore, sexual and reproductive health interventions that considers the study’s significant variables should be put in place to increase uptake.

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The unmet need for abortion law reforms and modern contraceptive uptake in Nigeria, Kenya, Ghana and Ethiopia: A systematic review

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2022.v6.i1a.1113 ◽

2022 ◽

Vol 6 (1) ◽

pp. 42-47

Author(s):

Otobo DD ◽

Aouta AC ◽

Otsyina EB ◽

Tatere YH

Keyword(s):

Systematic Review ◽

Unmet Need ◽

Modern Contraceptive ◽

Abortion Law ◽

Contraceptive Uptake

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The impact of adding community-based distribution of oral contraceptives and condoms to a cluster randomized primary health care intervention in rural Tanzania

Reproductive Health ◽

10.1186/s12978-019-0836-0 ◽

2019 ◽

Vol 16 (1) ◽

Author(s):

Mallory C. Sheff ◽

Elizabeth F. Jackson ◽

Almamy M. Kanté ◽

Asinath Rusibamayila ◽

James F. Phillips

Keyword(s):

Perceived Risk ◽

Contraceptive Use ◽

Reproductive Age ◽

Modern Contraceptive ◽

Community Based ◽

Oral Contraceptive Pills ◽

Health Care Intervention ◽

Link Type ◽

The Impact ◽

Contraceptive Uptake

Abstract Background Efforts to expand access to family planning in rural Africa often focus on the deployment of community health agents (CHAs). Methods This paper reports on results of the impact of a randomized cluster trial of CHA deployment on contraceptive uptake among 3078 baseline and 2551 endline women of reproductive age residing in 50 intervention and 51 comparison villages in Tanzania. Qualitative data were collected to broaden understanding of method preference, reasons for choice, and factors that explain non-use. Results Regression difference-in-differences results show that doorstep provision of oral contraceptive pills and condoms was associated with a null effect on modern contraceptive uptake [p = 0.822; CI 0.857; 1.229]. Discussions suggest that expanding geographic access without efforts to improve spousal and social support, respect preference for injectable contraceptives, and address perceived risk of side-effects offset the benefits of adopting contraceptives provided by community-based services. Conclusions The results of this study demonstrate that increasing access to services does not necessarily catalyze contraceptive use as method choice and spousal dynamics are key components of demand for contraception. Findings attest to the importance of strategies that respond to the climate of demand. Trial registration Controlled-Trial.comISRCTN96819844. Retrospectively registered on 29.03.2012.

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Factors Associated with Uptake of Contraceptives among HIV Positive Women on Dolutegravir based Anti-Retroviral Treatment at Health Centres of Kampala Capital City Authority. A cross sectional study in Uganda.

10.21203/rs.3.rs-404132/v1 ◽

2021 ◽

Author(s):

Leah Mbabazi ◽

Mariah Sarah Nabaggala ◽

Suzanne Kiwanuka ◽

Juliet Kiguli ◽

Stephen Okoboi ◽

...

Keyword(s):

Family Planning ◽

World Health ◽

Hiv Care ◽

Hiv Positive ◽

Modern Contraceptive ◽

Cross Sectional ◽

Factors Associated ◽

Hiv Positive Women ◽

The Impact ◽

Contraceptive Uptake

Abstract Background In May 2018, the World Health Organisation issued a teratogenicity alert for HIV positive women using dolutegravir (DTG) and emphasised increased integration of sexual and reproductive services into HIV care to meet contraceptive needs of HIV positive women. However, there are scarce data on the impact of this guidance on contraceptive uptake. Objective To investigate the uptake of contraceptives and the factors affecting the uptake of contraceptive services among the HIV positive women of reproductive age who use DTG.Methods A cross-sectional survey was conducted from April 2019 to July 2019, in five government clinics in central Uganda where DTG was offered as the preferred first-line antiretroviral treatment (ART) regimen. We randomly selected 359 non-pregnant women aged 15-49 years using DTG-based regimens. We used interviewer administered questionnaires to collect data on demographics, contraceptive use, social and health system factors. We defined contraceptive uptake as the proportion of women using any method of contraception divided by the total number of women on DTG during the review period. We described patients’ characteristics using descriptive statistics. Factors associated with contraceptive uptake were investigated using Poisson regression at multivariable analysis (STATA 14).Results Of the 359 participants, the mean age was 37(SD=6.8), half 50.7% had attained primary level of education and average monthly income <100,000Ushs. The overall level of Contraceptive uptake was 38.4%, modern contraceptive uptake was 37.6% and 96.4% of the participants had knowledge of contraceptives. The most utilised method was the injectable at 58.4% followed by condoms 15%, IUD 10.7%, pills 6.4%, implants 5.4%, and least used was sterilization at 0.7%. Predictor factors that increased likelihood of contraceptive uptake were; religion of others category AIRR=1.53(95% CI: 1.01, 2.29) and parity 3-4 children AIRR=1.48(95% CI: 1.14, 1.92). Reduced rates were observed for age 40-49 years AIRR=0.45(95% CI: 0.21, 0.94), unemployment AIRR 0.63(95% CI: 0.42, 0.94), not discussing FP with partner AIRR=0.39(95% CI: 0.29, 0.52) and not receiving FP counselling AIRR=2.86 (95% CI: 0.12, 0.73). Non-significant variables were facility, education level, marital status, sexual activity, experienced side effects of FP and knowledge on both contraceptives and DTG.Conclusion This study shows a low-level uptake of contraceptives and injectable was the most used method. It also indicated that FP counselling and partner discussion on FP increased contraceptive uptake. Therefore, more strategies should be put in place to increase male involvement in family planning programs and scale up the integration of family planning services into HIV care and management programs.

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Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya

10.21203/rs.2.21058/v7 ◽

2020 ◽

Author(s):

Jefferson Mwaisaka ◽

Lianne Gonsalves ◽

Mary Thiongo ◽

Michael Waithaka ◽

Hellen Sidha ◽

...

Keyword(s):

Young Women ◽

Young Men ◽

Public Hospitals ◽

Sub Saharan Africa ◽

Modern Contraceptive ◽

Men And Women ◽

Modern Contraception ◽

Contraceptive Knowledge ◽

Future Fertility ◽

Contraceptive Uptake

Abstract BackgroundMyths and misconceptions around modern contraceptives have been associated with low contraceptive uptake in sub-Saharan Africa and Kenya in particular. Addressing persistent contraceptive knowledge gaps can make a significant contribution towards improved contraceptive uptake among young women. This qualitative study therefore sought to explore and understand young people’s knowledge of modern contraception and to identify their key concerns regarding these methods.MethodsWe used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants. Predefined codes reflecting the discussion guides and emerging issues in the FGDs were used to develop the thematic coding framework. Our analysis followed a pattern of association on the key preset themes focusing on myths and misconceptions around contraceptive use.ResultsResults are presented under four key themes: awareness of contraception, myths and misconceptions around contraception, males’ contraceptive narratives and young people’s preferred sources of contraceptives. Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions were discussed and included perceptions that modern contraception: jeopardized future fertility, could result in problems conceiving or birth defects, made women promiscuous, was ‘un-African’, and would deny couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. On preferred sources of contraceptives, respondents reported on two main sources, pharmacies and public hospitals, however, they could not agree on which one was suitable for them.ConclusionsThis study revealed the presence of a mixture of biological and social myths and misconceptions around contraception, with young men also strongly adhering to these misconceptions. The low level of contraceptive knowledge, particularly on contraceptive fears as revealed by the study demonstrate critical gaps in sexual and reproductive health (SRH) knowledge among young people. Improved SRH literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may therefore contribute to increased uptake of SRH services including modern contraceptive methods.

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Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya

10.21203/rs.2.21058/v5 ◽

2020 ◽

Author(s):

Jefferson Mwaisaka ◽

Lianne Gonsalves ◽

Mary Thiongo ◽

Michael Waithaka ◽

Hellen Sidha ◽

...

Keyword(s):

Young Women ◽

Contraceptive Use ◽

Young Men ◽

Sub Saharan Africa ◽

Modern Contraceptive ◽

Men And Women ◽

Modern Contraception ◽

Contraceptive Knowledge ◽

Future Fertility ◽

Contraceptive Uptake

Abstract Background Myths and misconceptions around modern contraceptives have been associated with low contraceptive uptake in sub-Saharan Africa and Kenya in particular. Addressing persistent contraceptive knowledge gaps can make a significant contribution towards improved contraceptive uptake among young women. This qualitative study therefore sought to explore and understand young people’s knowledge of modern contraception and to identify their key concerns regarding these methods. Methods We used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18-24 per FGD, one FGD had 8 participants. Predefined codes reflecting the discussion guides and emerging issues in the FGDs were used to develop the thematic coding framework. Our analysis followed a pattern of association on the key preset themes focusing on myths and misconceptions around contraceptive use. Results Results are presented under three key themes: awareness of contraception, myths and misconceptions around contraception, and males’ contraceptive narratives. Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions were discussed and included perceptions that modern contraception: jeopardized future fertility, prolonged menstrual bleeding, could result in problems conceiving or birth defects, made women promiscuous, was ‘un-African’, and would deny couples their sexual freedom. Compared to female respondents, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. Conclusions This study revealed the presence of a mixture of biological and social myths and misconceptions around contraception, with young men also strongly adhering to these misconceptions. The low level of contraceptive knowledge, particularly on contraceptive fears as revealed by the study demonstrate critical gaps in sexual and reproductive health (SRH) knowledge among young people. Improved SRH literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may therefore contribute to increased uptake of SRH services including modern contraceptive methods.

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