Contraception use and unplanned pregnancies in a peri-urban area of eSwatini (Swaziland)

Hultstrand, Jenny Niemeyer; Tydén, Tanja; Jonsson, Maria

doi:10.1016/j.srhc.2019.01.004

Cited by 10 publications

(13 citation statements)

References 23 publications

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“…In a study comparing thirty African countries, unwanted pregnancies were most frequent in Eswatini (Amo-Adjei and Anamaale Tuoyire 2016; Central Statistical Office 2008). In an earlier study, we found that 70% of all pregnancies among the studied population were unplanned (Niemeyer Hultstrand et al 2019). Teenagers and first-time mothers were more likely to have an unplanned pregnancy and women with unplanned pregnancies were less likely to attend the recommended number of antenatal care visits.…”

Section: Unplanned Pregnancy In Eswatinimentioning

confidence: 60%

“…Matsapha is an industrial suburb outside Manzini, the country's largest city. Siphilile's clients in Matsapha constitute a vulnerable group of women as most are unemployed, lack of food is common and the HIV-prevalence at 42% is higher than the national average (Niemeyer Hultstrand et al 2019). A Siphilile office in Lubombo, a rural part of Eswatini, was started in 2016 and employed nine mentor mothers at the time of the study.…”

Section: Study Setting and Participantsmentioning

confidence: 99%

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The perpetuating cycle of unplanned pregnancy: underlying causes and implications in Eswatini

Hultstrand

Abuelgasim

Tydén

et al. 2020

Culture, Health & Sexuality

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Unplanned pregnancies constitute a major health problem globally carrying negative social, economic and health consequences for individuals and families. In this study, we explored the underlying causes and implications of this phenomenon in Eswatini, a country with high rates of unplanned pregnancy. Three focus group discussions were conducted in January 2018 with female health workers called mentor mothers, chosen because they offer a twofold perspective, being both Swati women and health workers in socially and economically disadvantaged settings. Using inductive thematic analysis, we identified five sub-themes and an overarching theme called 'the perpetuating cycle of unplanned pregnancy' in the data. A social-ecological model was used to frame the results, describing how factors at the individual, relationship, societal and community levels interact to influence unplanned pregnancy. In this setting, factors such as perceived low self-esteem as well as poor conditions in the community drove young women to engage in transactional relationships characterised by abuse, gender inequality and unprotected sex, resulting in unplanned pregnancy. These pregnancies led to neglected and abandoned children growing up to become vulnerable, young adults at risk of becoming pregnant unintendedly, thus creating an iterative cycle of unplanned childbearing.

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Section: Unplanned Pregnancy In Eswatinimentioning

confidence: 60%

Section: Study Setting and Participantsmentioning

confidence: 99%

The perpetuating cycle of unplanned pregnancy: underlying causes and implications in Eswatini

Hultstrand

Abuelgasim

Tydén

et al. 2020

Culture, Health & Sexuality

Self Cite

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“…Teenagers were also highlighted as a group in need of more support as non-pregnant teenager are not part of the Siphilile intervention. This was not surprising as teenagers in this setting are less likely to use contraception and have a more than two-folded increased odds of unplanned pregnancy compared to older women [ 15 ]. The MMs suggested the use of teenage clubs as well as training of Mentor Fathers could help increase teenagers’ and men’s knowledge and challenge cultural norms and stigma around contraception.…”

Section: Discussionmentioning

confidence: 99%

“…Lubombo is a rural part of Eswatini, where an office was started in 2016. Siphilile’s clients constitute a disadvantaged group as most women are unemployed, lack of food is common and the HIV-prevalence is 41%, which is higher than the national average [ 15 , 17 ]. Seven out of ten pregnancies are unplanned and teenage pregnancies are common [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

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Evaluating the implementation of the Reproductive Life Plan in disadvantaged communities: A mixed-methods study using the i-PARIHS framework

et al. 2020

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Introduction The Reproductive Life Plan (RLP) is a clinical tool to help clients find strategies to achieve their reproductive goals. Despite much research on the RLP from high-income countries, it has never been studied in low-or middle income countries. Together with health workers called Mentor Mothers (MMs), we used a context-adapted RLP in disadvantaged areas in Eswatini. Our aim was to evaluate the implementation of the RLP in this setting. Methodology MMs participated in focus group discussions (FGDs, n = 3 MMs n = 29) in January 2018 and at follow-up in May 2018 (n = 4, MMs n = 24). FGDs covered challenges in using the RLP, how to adapt it, and later experiences from using it. We used a deductive qualitative thematic analysis with the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, creating themes guided by its four constructs: facilitation, innovation, recipients and context. The MMs also answered a questionnaire to assess the implementation process inspired by normalization process theory. Results The RLP intervention was feasible and acceptable among MMs and fit well with existing practices. The RLP questions were perceived as advantageous since they opened up discussions with clients and enabled reflection. All except one MM (n = 23) agreed or strongly agreed that they valued the effect the RLP has had on their work. Using the RLP, the MMs observed progress in pregnancy planning among their clients and thought it improved the quality of contraceptive counselling. The clients' ability to form and achieve their

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Family planning practices and women’s impression of the reproductive life plan in Eswatini

Engström

Hultstrand

2022

Sexual & Reproductive Healthcare

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Contraception use and unplanned pregnancies in a peri-urban area of eSwatini (Swaziland)

Cited by 10 publications

References 23 publications

The perpetuating cycle of unplanned pregnancy: underlying causes and implications in Eswatini

The perpetuating cycle of unplanned pregnancy: underlying causes and implications in Eswatini

Evaluating the implementation of the Reproductive Life Plan in disadvantaged communities: A mixed-methods study using the i-PARIHS framework

Family planning practices and women’s impression of the reproductive life plan in Eswatini

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