Norplant use by adolscents: Viewpoints of three stakeholder groups

Abstract

In the months following FDA approval of Norplant, discussions of the controversies surrounding its introduction took place largely in newspaper and magazine articles detailing interviews with legal and health professionals and scientists who developed the device. This qualitative study brings the viewpoints of selected groups of consumers, reproductive health care workers, and local policy makers to the public discussions of Norplant. This article explores one of several themes raised by study participants--Norplant use by adolescents. Eighteen different focused group interviews were conducted in California between November 1991 and November 1992. A total of 146 individuals attended--63 consumers, 44 health care providers, and 39 policy makers. Participants included consumers identified as so-called "targets" of Norplant use, individuals providing reproductive health services, and individuals in policy and decision-making roles. Participants in all the focus groups agreed that Norplant should not be used to accomplish social goals or viewed as the answer to society's pressing social and economic problems. There was no agreement, however, on the issue of Norplant use by adolescents. Study participants argued persuasively on both sides of the question, expressing ambivalence concerning the incidence of teenage pregnancies, the longterm health effects of Norplant use on adolescents, and the threat of increased risk of STDs and HIV/AIDS among adolescents using Norplant. Study findings highlight a critical need for ongoing dialogue among key stakeholder groups to develop an understanding of the diverse values informing the debate. Participants' responses reinforced that decision-making in public health need not only be the jurisdiction of policy makers, elected officials, and others. Ordinary citizens can be part of the task as well by offering insights for practical and ethical solutions to some of our most pressing social issues.