Abstract
BackgroundIn recent decades there have been great improvements in the reproductive health of women in low- and middle-income countries and increases in the use of modern contraceptive methods. Nonetheless, many women are not able to access information, contraceptive technologies and services that could facilitate preventing unintended pregnancies and planning the number and timing of desired pregnancies.In South Africa, the contraceptive prevalence rate is 64.6%. However, this relatively high contraceptive prevalence rate masks problems with quality contraceptive service delivery, equitable access, and women’s ability to correctly and consistently, use contraceptive methods of their choice. This study set out to understand the specific family planning and contraceptive needs and behaviours of women of reproductive age in South Africa, through a lived experience, multisensory approach.MethodsParticipatory qualitative research methods were used including body mapping workshops amongst reproductive aged women recruited from urban and peri urban areas in the Western Cape South Africa. Data including body map images were analysed using a thematic analysis approach.ResultsWomen had limited biomedical knowledge of the female reproductive anatomy, conception, fertility and how contraceptives worked, compounded by a lack of contraceptive counseling and support from health care providers. Women’s preferences for different contraceptive methods were not based on a single, sensory or experiential factor. Rather, they were made up of a composite of sensory, physical, social and emotional experiences underscored by potential for threats to bodily harm.ConclusionsThis study highlighted the need to address communication and knowledge gaps around the female reproductive anatomy, different contraceptive methods and how contraception works to prevent a pregnancy. Women, including younger women, identified sexual and reproductive health knowledge gaps themselves and identified these gaps as important factors that influenced uptake and effective contraceptive use. These knowledge gaps were overwhelmingly linked to poor or absent communication and counseling provided by health care providers. Body mapping techniques could be used in education and communication strategies around sexual and reproductive health programmes in diverse settings.
Highlights
In recent decades there have been great improvements in the reproductive health of women in lowand middle-income countries and increases in the use of modern contraceptive methods
Body mapping is the process of creating life-sized figures using drawing or painting to visually represent aspects of peoples’ lives, their bodies and the world they live in
Women’s poor levels of knowledge of their reproductive system and contraception and family planning were linked to poor or absent communication and counseling provided by the health care services
Summary
In recent decades there have been great improvements in the reproductive health of women in lowand middle-income countries and increases in the use of modern contraceptive methods. Many women are not able to access information, contraceptive technologies and services that could facilitate preventing unintended pregnancies and planning the number and timing of desired pregnancies. In recent decades there have been great improvements in the reproductive health of women and men in low and middle income countries, and increases in the use of modern contraceptive methods [1]. In South Africa, the contraceptive prevalence rate for all women of reproductive age (15–49 years) who are using a modern contraceptive method is 64.6% This relatively high contraceptive prevalence rate masks problems with service delivery; equitable access, and correct, consistent, and continuous use of contraception especially among certain groups such as young or rural women [5, 6].
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