BARRIERS TO USE CONTRACEPTIVE METHODS AMONG POST ABORTION CLIENTS IN SARGODHA, PAKISTAN: A QUALITATIVE STUDY

Abstract


 
 
 World Health Organization (WHO) recommends at least 6 months interpregnancy interval after an abortion. Pakistan has a low contraceptive prevalence rate and a high unmet need for contraception. Post-abortion women are the potential clients for contraception but national data reveal low uptake of the contraceptive methods by these clients. This study aimed to explore the barriers to adopting contraception among post-abortion clients in the district of Sargodha, Pakistan. A qualitative research design was used. Study participants were recruited from three private and three public sector hospitals in the district of Sargodha, Pakistan. The study was conducted from July 2018 to November 2018. Ninety-nine in-depth interviews (IDIs) of post-abortion women were conducted using an unstructured interview guide within the period of one month after abortion. Detailed field notes were made. Interviews continued until thematic saturation had reached. The content was organized into a matrix based on themes and sub-themes. A descriptive thematic analysis using both inductive and deductive coding was conducted. Reasons for not adopting contraceptive methods were explored Although many clients expressed a desire to limit fertility, some barriers were found to be hindering the uptake of contraception. Major barriers expressed by clients were the unwillingness of the husband, the resistance of other family members and real or perceived fear of side effects of contraceptive methods. Lack of adequate knowledge about fertility and contraception was another factor which contributed to the decision not to adopt contraception. Socio-cultural norms to have large family sizes were also reported by some clients. Other barriers include religious beliefs, focus on other health issues, financial unaffordability, infrequent intercourse and plan for tubal ligation. The study concluded that without addressing the barriers post-abortion contraceptive uptake is unlikely to improve. Identification of barriers is the first step to addressing the existing unmet need for contraception.