Factors influencing contraceptive use or non-use among Aboriginal and Torres Strait Islander people: a systematic review and narrative synthesis

Abstract

Background The Australian population has an unmet need for contraception. However, evidence suggests contraceptive patterns of Aboriginal and Torres Strait Islander populations are unique. To tailor contraceptive services and meet the contraceptive needs of Aboriginal and Torres Strait Islander people, it is important to understand the contributing factors to contraceptive use and non-use. Methods This study aimed to systematically review and narratively synthesise the evidence exploring the factors influencing contraceptive use among Aboriginal and Torres Strait Islander people. A systematic literature search was initially run in September 2016 and was updated again in April and August of 2018. A qualitative narrative synthesis was conducted from 2018 to 2019. Factors influencing contraceptive use or non-use were explored using a Social Ecological Model. Results The review identified 17 studies meeting the inclusion criteria published between 1972 and 2018. Most of the included studies were qualitative (n = 11), with the remaining studies being mixed methods (n = 3) or quantitative (n = 3). The majority focused on either a localised geographic area or specific Aboriginal or Torres Strait Islander community (n = 11). One study specifically focused on factors influencing contraceptive use, albeit among postpartum women. The remaining studies discussed factors influencing contraceptive use within the context of risky behaviour, sexual transmitted infections, or contraceptive practices more generally. Factors unique to individual communities included community attitudes (e.g. importance of not being too young to have a baby), specific cultural norms (e.g. subincising the penis as part of transition to manhood), and access to culturally appropriate health services. Other factors, including contraceptive characteristics (e.g. discomfort of condoms) and reproductive coercion (e.g. partner wants a baby), were similar to those found in the broader population of Australia and internationally. Most studies were lacking in quality, warranting more methodologically sound studies in the future to further assess the factors contributing to contraceptive use or non-use among Aboriginal and Torres Strait Islander people. Conclusions Identifying community specific facilitators, as well as understanding the more broadly applicable factors contributing to contraceptive use or non-use, is essential if wanting to offer appropriate contraceptive services within an Aboriginal or Torres Strait Islander community.

Factors Associated With the Use of Iud Contraceptives at the Pendopo Empat Lawang Public Health Center, Indonesia

“…Based on the study there are several factors that can influence mothers to use contraceptives, namely lack of knowledge and acceptance of wrong information related to the types of contraception available (Cohen et al 2017) (Coombe et al 2020) Another factor is the mother's shame to use existing contraceptives (Coombe et al 2020). This is in line with other studies which say that contraceptive use is influenced by several factors ranging from the individual, family, community level originating from the social environment and also the economic level (Chowdhury and Chakraborty 2017).…”

“…The high maternal mortality rate in Indonesia makes the government have a special strategy in reducing AKI, one of which is safe motherhood, which consists of four pillars, namely antenatal care, clean and safe delivery, essential obstetric services, and family planning (Edy 2018) . Family planning programs have an important role in reducing the risk of maternal death through delaying gestational age, spacing pregnancies, and preventing pregnancy (Coombe et al 2020) .…”

Supply‐Side Versus Demand‐Side Unmet Need: Implications for Family Planning Programs

“…2015; Coombe et al. 2020). Rather than having a single reason for contraceptive nonuse that fits neatly into the demand‐side or supply‐side buckets, it is likely that many women actually have a complex rationale for contraceptive nonuse that straddles both categories.…”

“…An agenda for future research would include following up with women who did not answer this question, using in-depth cognitive interviewing to better understand reasons for nonresponse. Additionally, many respondents to the DHS give only one reason for not using a method during the quantitative survey, in contrast to a wealth of evidence showing that reasons for contraceptive nonuse are manifold and rarely exist in isolation ( Brown and Guthrie 2010 ; Iuliano et al 2006 ; Cheung and Free 2005 ; Borrero et al 2015 ; Wu et al 2008 ; Adebowale and Palamuleni 2014 ; Ochako et al 2015 ; Coombe et al 2020 ). Rather than having a single reason for contraceptive nonuse that fits neatly into the demand-side or supply-side buckets, it is likely that many women actually have a complex rationale for contraceptive nonuse that straddles both categories.…”

Does locality have more impact than ethnicity on contraceptive use?

“…Numerous studies have reported that age , an education level (Blackstone, Nwaozuru, & Iwelunmor, 2017;, and social economic status Najafi-Sharjabad et al, 2013) affects contraceptive use. In addition, the sociocultural environment including ethnicity (Coombe et al, 2020), religion (Ayorinde et al, 2021;Hoga, Rodolpho, Sato, Nunes, & Borges, 2014;Olakunde et al, 2019), and habitat (Joshi et al, 2021) causes variations in contraceptive use rates. Therefore, understanding people's sociocultural backgrounds, particularly ethnicity and locality, is essential for designing and implementing effective family planning programs.…”