Experiences of women, men and healthcare workers accessing family planning services in Malawi: A grounded theory.

Idesi T Chilinda,Dame T Lavender,Alison Cooke

doi:10.4102/safp.v62i1.5153

Idesi T Chilinda, Dame T Lavender + Show 1 more

Open Access

https://doi.org/10.4102/safp.v62i1.5153

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Abstract

BackgroundThe importance of modern contraceptive methods in averting unwanted pregnancies has been acknowledged in Malawi. Currently, the country has registered the highest rates of unsafe abortions, unmet needs for contraception and a low contraceptive prevalence rate. Understanding why these rates exist is important. However, women’s views and experiences regarding uptake of family planning methods in Malawi have not been explored.MethodsA grounded theory methodology was used. Data were gathered through in-depth interviews with women (n = 18), men (n = 10), healthcare workers (n = 10) and non-participant observations of family planning clinic consultations (n = 10). Data were analysed using constant comparative technique. Methods of open, axial and selective coding enabled subsequent conceptualisations until theoretical saturation occurred.ResultsThe core category ‘disenabling environment prevents women’s family planning needs from being met’ provides an understanding of women’s, men’s and healthcare workers’ experiences of contraceptive use and non-use. The disenabling environment contributed to shaping women’s family planning experiences. This was supported by three main categories: navigating the processes, disempowerment of women and learning by chance.ConclusionFindings from this study illuminate contextual issues into how women, men and healthcare workers experience family planning use and non-use in Malawi. A multifaceted strategy is required to support a woman’s family planning needs. At community level, awareness and education of family planning methods is required to actively inform all people in society so that they support a woman’s family planning needs. At national level, laws that would empower women with decision-making ought to be developed and enforced.

Highlights

Contraceptive use in low-resource countries, including sub-Saharan Africa, remains low, with a minimal rise from 23.6% to 28.5% between 2008 and 2015.1 There are rising rates of unmet need for contraception, which have caused concern to the global health community.[2]
All community participants could mention a method of contraception, none of them were using any family planning method at the time of conducting this study
Our study suggests that healthcare workers ought to utilise the pregnancy checklist as proposed by World Health Organization (WHO) to rule out pregnancy during a family planning consultation session before initiating a woman on contraception

Summary

Introduction

Contraceptive use in low-resource countries, including sub-Saharan Africa, remains low, with a minimal rise from 23.6% to 28.5% between 2008 and 2015.1 There are rising rates of unmet need for contraception, which have caused concern to the global health community.[2] Unmet need for contraception is when a woman is fecund and desires to use contraception but does not have access to it.[3] Recent evidence indicates that reducing unmet needs for contraception remains the greatest challenge globally because of continuing unavailability of the service.[4] It has been estimated that married women between the ages of 15–49 years in Malawi have an unmet need for family planning of 59%.5. Women’s views and experiences regarding uptake of family planning methods in Malawi have not been explored

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Discussion

Conclusion