Barriers and facilitators to contraceptive use among Somali immigrant women in Oslo: A qualitative study

Abstract

Background The European Action Plan for Sexual and Reproductive Health emphasizes the importance of improving access to contraceptive services for disadvantaged groups. However, a prior study showed that the prevalence of abortion is two times higher among refugees compared to non-immigrants in Norway. Similarly, a recent study reported that 50% of Somali women in Oslo had unintended childbirth on one occasion or more. These findings are supported by several studies in Europe that showed immigrant and refugee women have higher rates of unintended pregnancy and abortion than Non-immigrant women, and more than half of immigrants, who seek abortion are not using any form of contraception, raising concerns about their access to utilization of modern contraception. However, none of these studies have explored reasons underlying immigrant women's underutilization of modern contraception. The present study aimed to explore the barriers and facilitators to contraceptive usage among Somali immigrant women in Oslo area. Methods A qualitative study using unstructured in-depth interviews with twenty one Somali women of reproductive age, >18 years, was conducted in Oslo from May-August 2018. The participants were recruited using purposive sampling method. Interviews began with a general question and were followed with some probing questions, and were continued until data saturation was reached. Data were analyzed using thematic analysis. Results Although the majority of the participants were educated, aware of the importance of contraceptive methods and interested in child spacing, systemic and socio-cultural barriers were found to be hindering their access to contraception. Several barriers were identified,

Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study

“…For example, one of the alarming findings of the study was the myths and misconception about FP, where mothers considered FP as sinful. These findings are analogous to the studies conducted in other Muslim developing countries where religion is one of the major barriers to FP usage [ 64 , 65 ]. However, in most of the Muslim countries, Islam supports contraception usage [ 66 ].…”

Unmet needs for contraception: A comparative study among Somali immigrant women in Oslo and their original population in Mogadishu, Somalia

“…Somali immigrants come from a context where contraception is openly rejected by a diverse range of gate keepers, including medical doctors, prominent religious leaders and community elders. The current study and others suggest the need to provide not only family planning, but reproductive health services as a whole within a broader social and cultural dimension that meets the need of Somali women, which entails viewing the contraceptive services within their social and cultural context [26–28].…”

“…Evidences show, in Somalia, a woman’s status is enhanced by her ability to produce numerous children [17]. A qualitative study we conducted both in Oslo and in Mogadishu showed that if a Somali woman does not reproduce children, the husband is likely to abandon her for another, which means reproduction of children is not only family treasure but also a means for women to secure their marriage [28]. In the polygamous life, there is a perception that the woman with the largest number of children can take over the love of the husband.…”

Barriers and Facilitators to Modern Contraception Among Married Women in Conflict Affected Town of Mogadishu, Somalia

“…Therefore, educated women may experience different barriers not mentioned here. Other studies have investigated barriers to modern contraception among Somali communities, both in Somalia (32) and among Somali immigrants in the West, and found similar results (13,29). Our study focused on modern contraception and left traditional methods unaddressed.…”