Why Pakistani Women Do Not Use Intrauterine Contraceptive Devices: A Systematic Review of Barriers and Misconceptions

Abstract

This review explores barriers limiting the adoption of Intrauterine Contraceptive Devices (IUCDs) in Pakistan, focusing exclusively on local articles. As Pakistan's high population calls for widespread contraception, we aim to pinpoint obstacles hindering IUCD utilization, irrespective of parity.We conducted a comprehensive search of PubMed, Google Scholar, PakMedinet, and Wiley Online Library for English-language primary studies published between 2000 and 2022, reporting on IUCD utilization in Pakistan.Our analysis reveals multiple barriers impeding IUCD use in Pakistan. These encompass patriarchal social norms, male dominance, low education, socioeconomic status, and unemployment. Post-insertion health concerns, inadequate counseling, government commitment, and awareness were also identified barriers. Provider confidence, client trust, women's autonomy, social constraints, and limited male partner involvement hindered IUCD adoption. A desire for larger families and male offspring, vague religious beliefs, fear, and misconceptions further restricted usage. Accessibility and high service costs also posed challenges.This review highlights prevailing impediments to IUCD adoption in Pakistan, encompassing knowledge gaps, motivation deficits, resistance from husbands and in-laws, cultural and religious beliefs, limited access, and communication barriers. To promote IUCDs as a modern contraceptive method, it is essential to raise awareness among both men and women. Active involvement of religious leaders and community stakeholders is crucial in addressing these social factors hindering IUCD utilization.

Fatores que dificultam o conhecimento e a adesão aos métodos contraceptivos de longa duração

“…Os resultados desta revisão integrativa da literatura fornecem uma análise sobre os fatores que corroboram o insuficiente conhecimento e a falta de adesão de métodos contraceptivos de longa duração (LARCs), identificando, como principal causa, a educação sexual insatisfatória (Kassa et al, 2021;Paul et al, 2020;Getahun et al, 2018;Silva-Filho et al, 2016;Buhling et al, 2014;Xu et al, 2011;Hoopes et al, 2016;Ontiri et al, 2020;McNicholas et al, 2014;Rouncivelli et al, 2021), tido como tabu em diversas sociedades, as quais limitam a capacidade de pensamento crítico das mulheres e sua autonomia. Outros achados relevantes, foram os impactos dos preconceitos religiosos e culturais (Sajjda;Ishaq;Asghar, 2023;Todd et al, 2010;Kahsay et al, 2018), associados aos mitos sobre os efeitos no corpo pelo uso dos métodos contraceptivos de longa duração (Payne;Sundstrom;Demaria, 2016;Potgieter;Kapp;Coetzee, 2018;Builu;Naidoo, 2015).…”