“It is challenging… oh, nobody likes it!”: a qualitative study exploring Mozambican adolescents and young adults’ experiences with contraception

Abstract

BackgroundBy focusing upon formal sex education programmes, the Mozambican government has significantly enhanced the general health of adolescents and young adults. However, when it comes to contraception, little is known about how adolescents and young adults actually behave.MethodsBased upon a qualitative study in two settings in Maputo province – Ndlavela and Boane – this paper explores the knowledge and practices of contraception among adolescents and young adults. A total of four focus group discussions, 16 in-depth interviews, four informal conversations, and observations were equally divided between both study sites.ResultsDiscrepancies between what adolescents and young adults know and what they do quickly became evident. Ambivalent and contradictory practices concerning contraceptive use was the result. As well, young people had numerous interpretations of risk-taking when not using contraceptives. These inconsistencies are influenced by social and medical barriers such as restricted dialogue on sexuality among adolescents and young adults and their parents and peers. Additionally, ideas about indigenous contraceptives, notions of masculinity and femininity, misconceptions and fear of the side effects of contraceptives, make people of all ages wary of modern birth control. Other barriers include imposed contraceptive choice – meaning no choice, overly technical medical language used at clinics and the absence of healthcare workers more attuned to the needs of adolescents and young adults.ConclusionsAdolescents and young adults have numerous – often erroneous – opinions about contraception, leading to inconsistent use as well as vague perceptions of risk-taking. Moreover, social norms and cultural gender roles often contradict and hinder risk-avoiding behaviour. Therefore, in order to improve young people’s health, policymakers must address the reasons behind this ambivalence and inconsistency.

A rapid scoping review of fear of infertility in Africa

“…The countries of origin primarily included Ghana (n = 8) [5,13,29,31,35,[38][39][40], Kenya (n = 4) [5,26,29,41], Uganda (n = 3) [14,19,20], Tanzania (n = 3) [25,28,34], South Africa (n = 3) [24,32,36]; Cameroon (n = 2) [8,43], Mozambique (n = 2) [15,42], Mali (n = 2) [18,33] and Nigeria [6,7]. One research study was also conducted in each of the following countries Madagascar [27], Congo [22], Ethopia [16], Malawi [45], Rwanda [30], The Gambia [10], Zimbabwe [37] and Botswana [44]; and one across Malawi, South Africa, Uganda and Zimbabwe [17].…”

Impact of experiencing specific side-effects on contraceptive switching and discontinuation in Uganda: Results from a longitudinal PMA Survey

“…Tolerability of speci c side-effects may differ for a variety of social, cultural, and economic reasons; how side-effects are interpreted, treated (e.g. availability and accessibility to menstrual hygiene products or treatment for cramping), and the economic and physical consequences when they are experienced are heavily in uenced by context and quality of available services (12,26,27). Findings from high-income countries should not, therefore, be applied to LMIC contexts nor should ndings from one LMIC be rotely applied to another.…”

Impact of Experiencing Specific Side-Effects on Contraceptive Switching and Discontinuation in Uganda: Results from a Longitudinal PMA Survey

“…Additionally, while research has highlighted the role that contraceptive counseling can play in improving tolerability of side effects, most of these studies have been done in high-and middle-income settings (26)(27)(28). Though valuable, these ndings are limited in their generalizability to low-income countries, where tolerability of speci c side effects may differ for a variety of social, cultural, and economic reasons (17,29). Schwarz and colleagues highlight that the experience of side effects and how these side effects are interpreted and tolerated is heavily in uenced by context (17).…”