Understanding perceived access barriers to contraception through an African feminist lens: a qualitative study in Uganda

Abstract

Background There are many barriers that impact a woman’s access to contraception in rural sub-Saharan Africa, such as financial constraints, supply shortages, stigma, and misconceptions. Through and African Feminist lens, this study examines how these perceived barriers intersect with each other, and how they negatively impact women’s access to family planning and their perceived value of contraceptives in Luweero, Uganda. Methods This qualitative study analyzed data collected from healthcare workers at one private clinic and one public clinic that offer family planning services in four focus group discussions in Luweero, Central Region, Uganda. Two focus group discussions were held in each clinic. Eligible participants spoke English, were at least 18 years of age, and had at least 3 years of experience as a healthcare worker in Luweero. Among the participants were nurses, midwives, family planning counsellors, and village health workers, both male and female. Coded transcripts were analyzed using a reflexive methodology through an African Feminist lens. Results Most of the responses indicated that financial constraints experienced either by the clinic or the women significantly impact access to family planning. Certain social barriers were discussed, and the participants explained that barriers such as stigma, misconceptions, lack of knowledge, religiosity and cultural values impact women’s motivation or ability to access contraceptive methods. Side effects also have a significant role to play in women’s ability or motivation to navigate through these perceived social barriers. Conclusions Participants determined that increased funding for transportation for village health teams, consistent funding for free contraception, and expanded sensitization efforts that particularly target men would be some of the most impactful methods they can adapt to address some of these barriers.

Use of digital media for family planning information by women and their social networks in Kenya: A qualitative study in peri-urban Nairobi

“…This discordance, between women's comfort in discussing FP online with other women and men's discomfort discussing FP experiences with other men, influences the dynamics between women and their partners when making decisions about FP use. This finding highlights the importance of including FP information in digital media spaces that are targeted toward men and of adopting appropriate strategies to engage men in FP conversations to reduce barriers women face in accessing FP information and methods (Potasse and Yaya, 2021 ).…”

Barriers to contraceptive use in humanitarian settings: Experiences of South Sudan refugee women living in Adjumani district, Uganda; An exploratory design using qualitative method

“…Reprisal following contraceptive use is one of the ways in which men can restrict the uptake of certain health care services by women for example sexual reproductive health desires [29]; [34]. Such reprisals may involve neglecting women by leaving them without any social support thereby making them vulnerable considering their socio-economic status in the community [37]. Most families have fallen apart due to disagreements on contraceptive use, impacting negatively on the lives of children and the women themselves due to intimate partner violence [38].…”

“…Limited knowledge about contraceptive methods have been found as barrier for decision making in general [30]; [34]; [37]. The population under study come from a community where sensitization on family planning was never a government priority.…”

Women’s rights in Africa – Progress. Problems! Prospects?

“…This includes a lack of autonomy of women to make informed decisions about whether to become pregnant in the first place or to seek medical care, a lack of access to contraception [13], as well as a lack of education including access to comprehensive sexuality education. It is also related to broader issues such as inadequate infrastructure to ensure women's enjoyment of health rights in reality, such as insufficient roads and transportation systems for reaching health clinics, as well as a lack of access to water and sanitation, which is critical for maintaining good health, including during pregnancy.…”