Fears, Misconceptions, and Side Effects of Modern Contraception in Kenya: Preliminary Findings

Transcription

1 Fears, Misconceptions, and Side Effects of Modern Contraception in Kenya: Preliminary Findings G EETA N A N D A J A N E A LAII C A T A L INA R A M IREZ C-Change End-of-Project Meeting September 19, 2012

2 FP Methods What s Important to You? I was thinking something low maintenance.

3 What We Know 26% percent is the total unmet need for family planning among currently married women in Kenya 30.7 percent of women cited fear of side effects or health concerns as the main reasons for not intending to use contraception in the future Source: Kenya DHS 2009

4 Research Objectives 1. To document fears and misconceptions about family planning methods among men and women 2. To explore characteristics, decision-making factors, and processes among men and women who currently use FP methods

5 Study Sites: Kisii South (Nyanza) and Kilifi (Coast)

6 Study Design and Methods Objective 1: In-depth interviews (n=44) and focus group discussions (n=33) Users and non-users Men and women Objective 2: In-depth interviews (n=71) Users only Men and women

7 Objective 1 F E A R S, M I S C O N C E P T I O N S, A N D S I D E E F F E C T S

8 Fears and Misconceptions Related to FP infertility contraceptive failure method expulsion or shift cancerous growths birth defects

9 Fears and Misconceptions, in Context I am told that one was inserted, but while having sex her husband pushed it aside and she can get pregnant when the coil is inside and that coil can settle on the baby s head and when it gets inside the head it affects the brain and therefore the baby could be born with mental disorders. Female FGD Participant

10 Side Effects Related to FP weight changes menstrual changes localized pain changes in libido high BP & shortness of breath dizziness & headache

11 Side Effects, in Context I could not walk. When I would travel up a hill, there was too much breath. I had to finish climbing a hill, sit and rest, and then talk. I would fetch a jar of water from the river, and on getting to a hill I would be unable to carry it further and would have to leave it for my husband. He was very angry because of having to fetch the water. Female Injectable User

12 Main Source of Information about FP Health Concerns and Side Effects 56 percent of men and women indicated that PEERS were their main source of information about FP health concerns/side effects It is not like CHWs come and tell us they have side effects It is those who have used them CHWs are told to come and teach people about FP. They teach, Give birth to the number of children one can take care of but not that they teach they have side effects, no. It s just those who use. Female FGD Participant

13 Perceived Outcomes of Fears, Misconceptions, and Side Effects Fears and misconceptions Side effects inability to fulfill reproductive role in family financial & emotional burden on relationship inability to work or fulfill household duties decreased sexual activity Economic and emotional strain, abandonment by sexual partner, community stigma Changes in normal functioning, disruptions in sexual relationships

14 Fears, Misconceptions, Side Effects, and FP Uptake FEARS & MISCONCEPTIONS INFLUENCE DECISION TO USE FP SIDE EFFECTS INFLUENCE FP METHOD CHOICE AND SWITCHING

15 Objective 2 O V E R C O M I N G F E A R S A N D M I S C O N C E P T I O N S : L E S S O N S F R O M S U C C E S S F U L U S E R S

16 a

17 Analysis Framework

18 Environmental and Community Factors long-term relationship with health care community perceived norms about family size changing economic environment continuous access to information & services

19 Individual and Interpersonal Factors knowledge of possible side effects knowledge of how current FP method works motivation to prevent unintended pregnancy access to multiple information sources communication with partner about FP

20 Access to Multiple Information Sources We were told the pill is so bad it has batteries; I thought that it can go and heap in my stomach. I then decided to use the injection because I had not heard so many negative things about it. After the injection I started bleeding.. so I stopped using it. So after talking with the doctors I went for the pills, and first I put a pill in water but it all dissolved and I did not see a battery inside. From then on I chewed the pill so that it cannot stay in my stomach Female Pill User

21 Motivation to Prevent Unintended Pregnancy and Communication with Partner We sat and discussed the other day, and I told him that we are even lacking food for the children we have now. It is good we go to the seminar and get in-depth information. so that we can be able to have a good life. Female IUD User

22 Opportunities for SBCC

23 Opportunities for SBCC Information Motivation Ability to Act Norms address specific fears and misconceptions promote sustainable relationship with health providers communicate broad benefits of family planning engage men in FP uptake and advocacy Communitylevel efforts to dispel comm. taboo promote changing norms

24 Next Steps Research dissemination meeting scheduled in Nairobi next month Findings will be shared with Division of Reproductive Health, Ministry of Public Health and Sanitation

25 Acknowledgments Division of Reproductive Health Targets Research International