Turned Away and at Risk: Denial of Family Planning Services to Women in Malawi

Abstract

Family planning (FP) has been a development priority since the mid-s, yet barriers to access persist globally, including women being turned away from facilities without a method. This study aimed to assess the extent of, and reasons for, FP turnaway in three districts of Malawi. In , data collectors screened women exiting  health facilities and surveyed those who had been denied a method. Follow-up surveys were conducted via telephone with turned away clients at six and  weeks postvisit. Of the , women who were screened,  were new or restarting users. Of these, % (/) reported having been turned away from the health facility without an FP method. Women cited  different reasons for turnaway; the top three were unavailability of method (%), unavailability of a provider (%), or a requirement to return on the scheduled FP day (%). The multiple reasons cited for leaving the health facility without an FP method indicate that reducing turnaway will not be achieved easily. The top reasons for turnaway are related to health systems or management issues within health facilities. Facilities need additional support for staffing, training on long-acting and permanent methods, and a consistent supply of methods.

Profile of Users of Short- and Long-acting Contraceptive Methods: A Cross-sectional National Study of 12,973 Women

“…This reality may be associated with limitations in the provision of contraceptives by health professionals 16 such as the scarce availability of these methods and insufficient training for the identification of contraceptive needs. 17,18 Regarding the demographic profile, our data show that LARC use was significantly lower in young and unmarried women, which coincides with the study by Maruwo et al 19 This could suggest that the absence of a partner is an important factor in the choice of contraceptive, since not maintaining a stable relationship could promote the eventual use of methods so that LARCs would not be the first choice. In fact, this research shows that, among the SARCs, condoms are one of the most selected.…”

Determining the factors affecting attitudes towards family planning among university students

“…It was mainly related with the structure and management of health facility. 15 According to studies conducted in the Sub-saharan Africa, women face obstacles such as absence of desired method in health facilities, getting an appointment for FP and then being rejected, refusal without explanation, not getting FP service without a pregnancy test and absence of pregnancy tests, being unable to decide on the method, absence of medical books, long waiting in the organization and difficult and expensive access to the organization. 15,16 Cultural characteristics of society affect individuals.…”

“…15 According to studies conducted in the Sub-saharan Africa, women face obstacles such as absence of desired method in health facilities, getting an appointment for FP and then being rejected, refusal without explanation, not getting FP service without a pregnancy test and absence of pregnancy tests, being unable to decide on the method, absence of medical books, long waiting in the organization and difficult and expensive access to the organization. 15,16 Cultural characteristics of society affect individuals. In a study conducted in Van province in the Eastern Anatolia Region in Turkiye, reasons why individuals did not use family planning methods were because they believed it was a sin, the family elders did not want it, the patriarchal structure was dominant and they believed that the methods caused infertility or cancer.…”