The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study

Abstract

Family planning (FP) has been a global health priority for decades, yet barriers persist, including women being turned away from facilities without receiving services. This study assessed the provider role and perspective in client turnaway in three districts of Malawi. In 2019, data collectors surveyed 57 FP providers from 30 health facilities. All reported being comfortable providing FP to married women with children and married adolescents under 18 years old with children, whereas 12% of the providers expressed discomfort providing such services to married adolescents under 18 without children. Sixty percent of the providers required clients desiring FP and wishing to initiate oral contraceptives or injectables to be currently menstruating. Data collectors later conducted in-depth interviews (IDIs) with 8 of the 57 providers about client turnaway. During IDIs, providers’ most frequently mentioned reasons for turnaway was client pregnancy or suspicion of pregnancy. Providers expressed fears that initiating FP with a pregnant woman could cause community mistrust in the efficacy of modern contraception. Provider support for FP waned for nulliparous clients, regardless of age or marital status. To improve FP services in Malawi, providers need continuous education on all available methods of FP, a reduction in stockouts and programs to further sensitize the community to how contraception works. Understanding how Malawi has helped providers overcome social and cultural norms regarding provision of FP to adolescents might help other countries to make improvements.

A Importância Do Acesso À Informação Acerca Do Planejamento Familiar No Município De Araripina-Pe

“…Obstáculos do planejamento familiar efetivo: Conforme Peterson et al, (2022), as barreiras ao planejamento familiar são bem documentadas e categorizadas na literatura, incluindo obstáculos geográficos, financeiro devido ao custo de viajar para instalação, faltar o trabalho, desinformação, medo de efeitos colaterais, barreiras médicas e sociais. Em sequência, Silva et al, (2008) afirma que a informação é de grande importância para prática consciente, saudável e efetiva do PF, como medida de promoção da saúde, entretanto, é preciso saber informar a população, uma vez que a dificuldade de compreensão devido à baixa escolaridade, baixo interesse ou oportunidade de convívio e interação social sobre a temática podem conduzir a uma comunicação inadequada.…”

Providers’ views on hormonal family planning methods for young women: a qualitative study from Dosso, Niger

“…The method’s effectiveness and the safety of the method in terms of a woman’s health have also been found to be influential in decisions around method choice ( Adinma et al , 1998 ; Higgins et al ., 2020 ; Moronkola et al ., 2006 ). Structural and supply side barriers influence method choice through stock outs or limited supplies of FP products ( Zuniga et al ., 2022 ), and provider bias ( Peterson et al ., 2022 ; Solo & Festin, 2019 ). In an analysis of quantitative and qualitative data from Burkina Faso and Uganda, Brunie & colleagues (2019) demonstrate through quantitative analyses that effectiveness, duration of use, side effects, cost, and access are important factors to women when choosing a FP method.…”