Abstract

<strong>Background:</strong> Government policies have led to an increase in modern contraception use. Rural indigenous populations in countries like Ecuador, however, have relatively lower rates of utilization. Our objectives were to work with the community to identify perceived barriers for contraception use and determine solutions for an indigenous Ecuadorian community. <strong>Methods:</strong> Using a qualitative descriptive study design based on participatory research principles, focus groups and individual semi-structured interviews were conducted with women in the community as well as semi-structured interviews with physicians working at the regional hospital. All sessions were taped, transcribed, translated and analyzed using descriptive thematic analysis. <strong>Results:</strong> Women had basic knowledge about contraception, but also had many fears related to false beliefs about side effects. Women using modern contraception spoke of difficulties getting to a doctor to get a prescription. They had a relationship of trust with their partners although men were perceived to have preponderant decisional powers. Physicians suggested creating a mobile team to provide information about maternal health and to distribute contraceptives directly in the communities. <strong>Conclusions:</strong> There is need for rural communities to have better information and access to contraception. While the Ecuador national contraception policy has made an impact, several practical barriers prevented optimal implementation.

Highlights

  • The United Nations estimated that the world population will reach 9.7 billion by 2050, and 11.2 billion by 2100 (Department of Economic and Social Affairs, United Nations, 2015) creating significant burdens and resource issues

  • Since 2008, the Department of Family Medicine at our institution has engaged in a participatory research partnership with the rural indigenous community of Chilcapamba, Province of Imbabura, Canton of Cotacachi, Ecuador where the research topic is chosen by the community and each summer a Spanish-speaking medical student travels to the community (Dube, 2015; Evans, 2010; Misra et al, 2018)

  • The implementation of this law, has various practical issues as demonstrated by this study that may directly contribute to the poor uptake of modern contraception use by indigenous and rural women of Ecuador

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Summary

Introduction

The United Nations estimated that the world population will reach 9.7 billion by 2050, and 11.2 billion by 2100 (Department of Economic and Social Affairs, United Nations, 2015) creating significant burdens and resource issues. This exponential population growth comes with challenges such as those posed by high rates of maternal and infant mortality. Women using modern contraception spoke of difficulties getting to a doctor to get a prescription. They had a relationship of trust with their partners men were perceived to have preponderant decisional powers. While the Ecuador national contraception policy has made an impact, several practical barriers prevented optimal implementation

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