Abstract
BackgroundA number of factors may determine family planning decisions; however, some may be dependent on the social and cultural context. To understand these factors, we conducted a qualitative study with family planning providers and community stakeholders in a diverse, low-income neighborhood of Istanbul, Turkey.MethodsWe used purposeful sampling to recruit 16 respondents (eight family planning service providers and eight community stakeholders) based on their potential role and influence on matters related to sexual and reproductive health issues. Interviews were audio-recorded with participants' permission and subsequently transcribed in Turkish and translated into English for analysis. We applied a multi-stage analytical strategy, following the principles of the constant comparative method to develop a codebook and identify key themes.ResultsResults indicate that family planning decision-making—that is, decision on whether or not to avoid a pregnancy—is largely considered a women’s issue although men do not actively object to family planning or play a passive role in actual use of methods. Many respondents indicated that women generally prefer to use family planning methods that do not have side-effects and are convenient to use. Although women trust healthcare providers and the information that they receive from them, they prefer to obtain contraceptive advice from friends and family members. Additionally, attitude of men toward childbearing, fertility desires, characteristics of providers, and religious beliefs of the couple exert considerable influence on family planning decisions.ConclusionsNumerous factors influence family planning decision-making in Turkey. Women have a strong preference for traditional methods compared to modern contraceptives. Additionally, religious factors play a leading role in the choice of the particular method, such as withdrawal. Besides, there is a lack of men’s involvement in family planning decision-making. Public health interventions should focus on incorporating men into their efforts and understanding how providers can better provide information to women about contraception.
Highlights
A number of factors may determine family planning decisions; some may be dependent on the social and cultural context
There is considerable literature on the decision-making process related to fertility, and various factors have been proposed as predictors of family planning decision-making
Various studies in Turkey have found that many men are motivated to use family planning and would like to share responsibility for family planning decision-making [5, 6]
Summary
A number of factors may determine family planning decisions; some may be dependent on the social and cultural context. Previous studies have analyzed diverse factors that influence family planning decision-making within the family, such as power relations [3] and dominance of male partners [2, 4]. We would like to emphasize that cultural values play an important role in impacting the use of family planning. Among these cultural factors, perhaps religious values top our list. The present study aims at identifying significant contextual factors that are likely to influence use of family planning such as socio-cultural and religious norms
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