Perceptions Of Contraception Research Articles

A New Contraception Curriculum in the Internal Medicine Residency Primary Care Clinic.

Nearly half of all pregnancies in the USA are unintended with a relatively higher proportion occurring in military populations, which can have a large impact on military readiness. Military and civilian internal medicine residency programs do not place an emphasis on contraception in the primary care setting. This intervention sought to elucidate the perceptions of contraception in an internal medicine primary care setting in a military residency and improve confidence in contraceptive counseling and prescribing. Residents at a military internal residency program were given an hour-long didactic presentation on contraception that was followed 5 weeks later by the implementation of a pocket card for point of care use with key information from the presentation. Residents became certified in the placement and removal of the etonogestrel implant. Pre- and post-intervention surveys were administered to assess for changes in attitudes and confidence in prescribing and counseling. This project was determined to be a quality improvement project by the IRB board of the home institution. Forty-two of 75 (56%) residents responded initially and 40 of 75 (53%) responded after the intervention. There was a significant improvement in resident attitudes towards the applicability of contraception training in internal medicine (p = 0.03) as well as acquiring the skill of etonogestrel implant placement (p = 0.001). There was a trend towards significance in confidence in prescribing oral contraception (p = 0.053). There was no change in residents' confidence in counseling on oral contraception (p = 0.45). A change in the contraception curriculum led to improved residents' skills in etonogestrel placement, and attitudes regarding the applicability of training in contraception to internal medicine, but did not significantly improve confidence in contraceptive counseling. These results suggest that internal medicine residencies should focus on teaching contraception to improve the attitudes in future internists who will need to address contraception in the military population. Future studies could include assessing physician preparedness for addressing contraception during general medical officer tours.

Impact of men’s perception on family planning demand and uptake in Nigeria

ObjectiveEvidence from the last three Demographic and Health Surveys (DHS) in Nigeria shows slow progress in family planning (FP) uptake, despite programmatic interventions. While socioeconomic and religious barriers continue to exist, psychosocial factors such as negative contraceptive perceptions by male partners may influence both spousal FP demand and use. Therefore, this research investigates the influence of male partners’ contraceptive perceptions on spousal FP demand and use. MethodsWe analysed the couple dataset from the 2013 Nigeria DHS. ResultsOne in five men held the perception that contraceptive use is women’s business whereas two in five men reported that women who use family planning may become promiscuous, especially older men, those with no formal education, Muslims and residents in rural areas and northern region. Results from regression models, controlling for relevant sociodemographic characteristics, show that men’s perception that contraception is women’s business did not significantly influence FP demand. However, their fear that women who use family planning may become promiscuous was associated with lower odds of FP demand (AOR: 0.86; 95% CI: 0.76–0.97) and increased the odds of traditional methods use (AOR: 1.34; 95% CI: 1.01–1.79). ConclusionThe findings direct the need to adopt targeted approach focusing on couples, and reorient policy and program efforts for FP counselling and behavioural changes in men.

Inadequate birth spacing is perceived as riskier than all family planning methods, except sterilization and abortion, in a qualitative study among urban Nigerians

BackgroundFertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians.MethodsA total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach.ResultsThe ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items.ConclusionInadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants’ risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items’ perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing.Trial registration Number:This study is not a randomized control trial so the study has not been registered as such.

Perceptions and adoption of male contraceptives among men in Indonesia

Introduction: The Family Planning program implemented in Indonesia in the 1970s successfully increases the prevalence of contraception, and on the other hand, lowers fertility. Nevertheless, this success is marred by gender inequality. The majority of family planning acceptors are women. Method: The study (1) explores male narratives on male contraceptives and male perceptions of their risks and benefits; (2) identifies the factors affecting male decisions about contraception; and (3) shows how men negotiate and discuss contraception with women – if at all – before making decisions. The study was conducted in Bandar Lampung (Lampung) and Kulon Progo (Special Region of Yogyakarta). A total of 30 participants, consisting of married men who received a vasectomy, married men who used condoms, sexually active unmarried men who used condoms, and married men who did not use contraceptives were interviewed in depth. In addition, focus group discussions (FGD) were conducted involving stakeholders in each region. Results: That men who used contraceptives experienced positive changes after receiving information and support from their peer group. Men who use contraceptives start off with views (myths) similar to those of the surrounding communities. Gender equality perspective was a key factor affecting contraceptive decision-making among men. Discussion: that male perception of male contraceptives, especially vasectomy, is in flux. Negative prior to use, it gradually transforms into positive after men experience the benefits. Male decisions to use contraceptives are determined by their perceptions Keywords: Male contraceptives, gender equality perspective, perceptions of contraceptives, masculinity, Indonesia.

Influences of Ethnicity on Perceptions of Contraceptive Use in Postpartum Women With Unintended Pregnancies [26F

INTRODUCTION: Unintended pregnancies (UIP) account for nearly 50% of pregnancies. Studies suggest that minority women are less compliant and less likely to use contraception. We assessed knowledge and attitudes associated with pre- and postpartum contraception use in women with UIP. METHODS: A 21-question survey was given to 350 full-term women between the ages of 18 and 40 within 48 hours of delivery from August 2014 to August 2016. RESULTS: Of the 195 respondents, 56% were women with UIP. With regards to UIP, 42% were Caucasian (CA), 49% African American (AA), 3% Hispanic and 6% other. The latter two groups were excluded from analysis. CA and AA were similar in education level (61% vs 59% greater than high school), contraception access/insurance coverage (96% vs 96%), use prior to (61% vs 47%) and at the time of conception (14% vs 24%), P-NS. There was no difference in negative perceptions of contraception (CA- 42% and AA-49% P-NS), though weight gain was high in both (CA 72% vs AA 71%, P-NS). AA were less likely to identify benefits of contraception compared to CA (AA 81% vs CA 93%, P < .001), including a reduction in acne (AA 10% vs CA 39% P < .001) and prevention of further UIP (AA 46% vs CA 78%, P < .001). CONCLUSION: Understanding the disbelief among AA that birth control has non-contraceptive benefits in addition to effectively preventing pregnancy, may be the first step in the development of culturally targeted education and further aid in the reduction of disparities in UIP.

Exploring African-American and Latino Teens' Perceptions of Contraception and Access to Reproductive Health Care Services

PurposeReducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens' 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. MethodsAs a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. ResultsParticipants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants' comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. ConclusionsEnsuring that teens' beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties.

Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study

BackgroundUnmet need for family planning points to the gap between women’s reproductive desire to avoid pregnancy and contraceptive behaviour. An estimated 222 million women in low- and middle-income countries have unmet need for modern contraception. Despite its prevalence, there has been little rigorous research during the past fifteen years on reasons for this widespread failure to implement childbearing desires in contraceptive practice. There is demographic survey data on women’s self-reported reasons for non-use, but these data provide limited insight on the full set of possible obstacles to use, and one may doubt the meaningfulness of explanations provided by non-users alone. To rectify this evidence gap, this study will gather extensive information on women’s perceptions of contraception (generic and method-specific) and their past contraceptive experience, and it will allow for more complexity in fertility preferences than is standard in demographic surveys.MethodsA multi-site cohort study will be conducted in urban Kenya, rural Kenya, and rural Bangladesh. In each setting trained fieldworkers will recruit and interview 2600 women, with participants re-interviewed at 12 and 18 months. Data will be collected using a questionnaire whose development was informed by a review of existing literature and instruments from past studies in both developed and developing countries. Dozens of experts in the field were consulted as the instrument was developed. The questionnaire has three main components: a sub-set of Demographic and Health Survey items measuring socio-demographic characteristics, reproductive history, and sexual activity; additional questions on prospective and retrospective fertility preferences designed to capture ambivalence and uncertainty; and two large blocks of items on (i) generic concerns about contraception and (ii) method-specific attributes. The method-specific items encompass eight modern and traditional methods.DiscussionPolicy and programmes intended to reduce unmet need for contraception in developing countries should be informed by clear understanding of the causes of this phenomenon to better reflect the population needs and to more effectively target planning and investments. To this end, this study will field an innovative instrument in Kenya and Bangladesh. The information to be collected will support a rigorous assessment of reasons for unmet need for family planning.

A qualitative analysis of the effect of a community-based primary health care programme on reproductive preferences and contraceptive use among the Kassena-Nankana of northern Ghana.

BackgroundIn 2000, Ghana launched the Community-based Health Planning and Services (CHPS) initiative to improve access to health and family planning services. This initiative was based in part on research, known as the Navrongo Project, conducted in the Kassena-Nankana district (KND) between 1994 to 2003 which demonstrated significant impact on fertility and child mortality. This paper examines current contraceptive perceptions in communities that were exposed to the Project’s service models over the 1994 to 2003 period, and the post-experimental policies of the CHPS era.MethodsQualitative study was conducted in the KND of Ghana from June to September, 2012, by convening 8 male and 8 female FGD panels as well as 8 in-depth interviews of community leaders. Data collection was stratified by original experimental cell of the Navrongo Project to permit appraisal of social effects of contrasting experimental conditions. Inductive content analysis was performed with QSR Nvivo 10 to identify predominant themes.ResultsWhile findings show that exposure to community-based services was associated with enhanced approval of birth spacing and limitation, this view is grounded in perceptions that childhood survival has improved. Nonetheless, concerns were expressed about contraceptive side effects, prominently permanent sterility. Strategies for male outreach and community engagement originally introduced during the Navrongo Project have not been sustained with CHPS scale-up. The apparent atrophy of attention to the needs of men may explain the resistance of some males to the notion of female reproductive autonomy and the practice of some women to adopt contraception in secret. Despite this apparent programmatic dearth of male engagement, there is evidence to suggest that social impact of the original male engagement strategy persists in communities where male mobilization was combined with doorstep provision of family planning care during the Navrongo Project.ConclusionCommunity-based services fostered attitudinal change towards family planning in a traditional sub-Saharan African setting. Sustained exposure to primary health care that have improved the survival of children has made the use of contraception more acceptable. Efforts should be embedded in primary health care programmes that address concerns about child survival while also consigning sustained priority to the information needs of men.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1325-6) contains supplementary material, which is available to authorized users.

Perception and uptake of contraception among health workers in Ile-Ife, South-western Nigeria

Objective: This study was carried out to assess the perception of health workers towards contraceptive methods, determine the proportion of health workers using modern contraceptive methods and identify factors influencing their contraceptive practice.
 Methods: A cross sectional descriptive survey of 300 practicing nurses in the health facilities within Ile-Ife, Nigeria was done using pre-tested, self-administered semi-structured questionnaires.
 Results: Most of the respondents were less than 30years, married, multiparous and had practised for more than 2years. Prevalence of modern contraceptive use was 75.2%. Knowledge of contraceptives was poorest for injectables and oral contraceptive pills (32% each). Twenty six percent of respondents believed that contraception should be limited to women who had completed their families, while 32.4% were either uncertain or disagreed with the safety of contraceptives. The commonest method used was the condom, though contraceptive choice varied with cadre of staff. Desire for another pregnancy was the main reason for discontinuing contraception (51.2%). Older age, religion and marriage positively influenced contraceptive use.
 Conclusion: Knowledge and perception of contraception among nurses in Ile-Ife is relatively poor. Ensuring accurate information on contraception among this target group of health workers is an important step towards achieving success in the national family planning programme.

Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study.

Objective:This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia.Methods:A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students’ demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20.Findings:The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception.Conclusion:Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results.

Contraceptive perceptions among Arab and non-Arab Muslim males

Enormous studies have been conducted on the dynamics of family planning adoption and the quantitative research has focused mainly on the determinants of contraceptive choices where the women have been taken as collateral respondents. The men’s attitudes towards family planning may affect not only their wives intention to use contraception but also the choice of a particular family planning method particularly in the context of staunch Islamic ideology. Therefore, in this article, a qualitative liberal attempt is made to severance the key proponent arguments related to behaviours towards contraception among the Muslim males. Face to face qualitative interview findings reveal the social acceptability of contraceptives in a variety of situations as well as critically explicate the flexible availability of contraceptives which not only increase the degree of confidence in society for rational consequences. Finally, the analytical understanding of the study leads to the development of an emerging theory somewhat called ‘social transition approach’.

Factors associated with the knowledge, practice and perceptions of contraception in rural southern Nigeria

Significant proportion of maternal deaths in Nigeria is due to complications of unsafe abortions, and these abortions are responses to unwanted pregnancies that could have been prevented by effective contraceptive programming. Despite intense programmatic efforts by the Nigerian government and various non-governmental agencies to reverse the trend, there has been little evidence to suggest a systematic improvement in these indicators. A household random survey of 1,528 women aged between 15-49 years was undertaken at Amukpe community in Nigeria, to determine their knowledge, practice and perceptions of contraception. The results showed that 86.2% of the respondents had secondary or less level of education and 19.2% of the respondents were single parents. The level of contraceptive awareness was high (92.3%) and 88% of the respondents became aware of contraception in the last 14 years. Friends/relatives (40.6%), followed by nurses (31.7%) and then doctors (17.3%) were the common sources of contraceptive awareness. The most widely known contraceptive methods were injectables, condoms, POP and OCP. The specific knowledge of emergency contraception was poor. The factors associated with low contraceptive usage were poor level of training and ineffective conveyance of relevant information to clients by health personnel, low literacy levels, extremes of reproductive age and extremes of parity. Others were fear of side effects, lack of knowledge, and lack of spousal consent. Contraceptive usage remain poor despite high level of awareness. Effective educational and counseling interventions are likely to improve providers' and consumers' knowledge and subsequent uptake of contraceptive usage.

Global knowledge/local bodies: Family planning service providers’ interpretations of contraceptive knowledge(s)

Contraceptive technologies and the knowledges that are constructed around them are simultaneously global and local. Family planning methods in the context of international development interventions are interpreted and understood as part of the relationship between meanings that are at once embodied and remote. While quality of care issues have been raised over nearly two decades the interactive relationship between policy/program supply and interpersonal relations in forming identities has not been analyzed. This paper is based on two years of qualitative fieldwork conducted in Tanzania over a period between the mid-1990s and the mid-2000s. It examines Tanzanian service providers perceptions of contraceptives to shed light on questions of level dissemination of population knowledge(s) and shaping of identities. The findings suggest that the family planning program serves in a process of differentiation between two groups of local women: the service providers and their clients. This differentiation subsequently shapes the implementation of the family planning program. (authors)

Perceptions of contraception, non-protection and induced abortion among a sample of urban Swedish teenage girls: Focus group discussions

Objectives To explore the attitudes of teenage girls towards contraception and induced abortion in order to better understand underlying reasons for non-protection.Methods Four focus group discussions with urban teenage girls aged 15–18 years (n = 16).Results Attitudes towards abortion were generally positive despite some degree of misinformation and lack of knowledge about the subject. Knowledge about methods of birth control was accurate. The use of alcohol was often cited as a factor contributing to risk-taking behaviour. Sexual abuse was mentioned as a common phenomenon, and all participants knew someone who had been sexually abused. Participants agreed that sexual partners were reluctant to use condoms and that it was difficult to negotiate with them about this use. The increased rate of abortion was felt to be mainly due to initiation of sexual activity at a younger age. A need for easily available and inexpensive contraception was expressed along with improvement in the quality of sexual education in school.Conclusion Qualitative sexual education with single-sex sessions and gender related messages as a recurrent activity in the school curricula may help to empower young women and promote avoidance of risk-taking during sexual activity thus helping to reduce the incidence of unwanted pregnancies. In addition, access to cheap condoms could provide a stimulus to increased use of condoms.

Perceptions and Uses of Contraceptives: A Case Study of Some Hearing Impaired Individuals in Oyo State

Objectives for using contraceptives are no less important to non- hearing persons than they are to hearing persons. So the need to ascertain, the understanding of contraceptives among hearing disable persons is as interactive just as it is for the hearing population. This study therefore sought to find out what perceptions do hearing impaired persons have about the use of contraceptives. 156 hearing impaired persons were engaged in the study. Their age ranges from 15 to 35 years old. They were among the Yoruba and Ibo tribes (yorubas-135,Ibos-25). 115 of them were married, 4 are divorcees and 37 are yet to marry. Three hypotheses were generated in the study. They were raised to test the participant\'s perceptions of contraceptives along their tribal, educational, and religious divides. They study found out that three of the aforelisted factors have some significant relationship with the perception and use of contraceptives among the study participants. The study among other things recommended that hearing impaired person should be more enlightened about the need to appreciate the importance of contraceptives. African Journal for the Psychological Study of Social Issues Vol.7(2) 2004: 155-166

Adolescent mothers’ knowledge and perceptions of contraceptives in Tshwane, South Africa

This descriptive quantitative survey attempted to identify reasons why adolescent mothers (aged 19 or younger at the birth of their babies) failed to utilise contraceptive, emergency contraceptive and/or termination of pregnancy&#x0D; (TOP) services.&#x0D; &#x0D; Opsomming&#x0D; Hierdie beskrywende kwantitatiewe opname het gepoog om redes te bepaal waarom adolessente moeders (wat 19 jaar oud of jonger was tydens die geboorte van hulle babas) nie gebruik gemaak het van kontrasepsie (voorbehoedmiddels) of noodkontrasepsie, en/of terminasie van swangerskap (“termination of pregnancy - TOP”) dienste nie.&#x0D; &#x0D; *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

'Infertility Makes You Invisible': Gender, Health and the Negotiation of Fertility in Northern Botswana

Contemporary demographic discourse and population policies in southern Africa tend to focus upon the positive value of low, and ever lowering, total fertility rates. In Botswana, statistics suggest a high rate of extramarital fertility and a rapidly increasing HIV infection rate. While these represent visible problems for demographers and policy makers, infertility ‐ a significant problem for many Batswana ‐ remains 'invisible' in much of demographic discourse. This paper suggests that while infertility may be an invisible demographic variable, it is particularly significant in the lives of the people of northern Botswana and it can be a useful lens through which to view cultural constructions of gender and health. For many women in Botswana, infertility, the apparent inability to bear children, is a serious social and physiological concern and one that is intricately tied to local perceptions of contraceptives and witchcraft, for example. In addition, with large scale migration by men to other areas of southern Africa, women find themselves confronted with various economic concerns and the necessity to negotiate childbearing in that context. It is argued that a more social and ethnographic understanding of the importance of fertility can lead to a better understanding of why some population policies are not particularly efficacious. This paper is based upon ethnographic fieldwork in northern Botswana and represents an attempt to synthesise anthropological and demographic approaches to the concept of fertility by examining the often overlooked variable of infertility.

An oral contraceptive perception scale for female adolescents.

This study sought to develop the initial psychometric properties of a female adolescent oral contraceptive perception scale. Based on qualitative data, a 39-item scale of perceived benefits and barriers was developed, reviewed by adolescence experts and adolescents, and voluntarily completed by 407 female adolescents enrolled in family planning clinics. After item analysis, 15 items were deleted. Maximum likelihood factor analysis with varimax rotation yielded two barrier (relationship-oriented and oral contraceptive regimen) and four benefit (relationship-oriented, pregnancy prevention related to self, pregnancy prevention related to others, personal responsibility) factors that accounted for 53% of the variance. The scale had acceptable reliability (alpha coefficients ranged from 0.71 to 0.87). The scale should be beneficial to further research in this area.

Female adolescents' perceptions of benefits of and barriers to using oral contraceptives.

A study was conducted to describe 12 female adolescents' oral contraceptive perceptions that were considered first independently and then after facilitation by a nurse. A self-administered decisional balance sheet elicited 44 descriptions of oral contraceptive perceptions, and a structured interview elicited 31 additional descriptions. The data were content-analyzed for common elements. The majority of participants perceived oral contraceptive benefits related to pregnancy prevention and others' approval and barriers related to side effects and others' disapproval. Participants considered additional oral contraceptive perceptions upon facilitation by a nurse after the opportunity for independent consideration. Facilitation of female adolescents' consideration of oral contraceptive perceptions may be an appropriate nursing intervention.

Contraceptive Perceptions and Method Choice Among Young Single Women in the United States

Data from a national survey of young unmarried women are used to analyze the relationship of perceptions of method characteristics to the acceptability of methods for use and to the actual contraceptive choice. Ordinary least squares (OLS) and logistic regression analyses are employed to assess the effects of perceptions on method acceptability and on actual use. Methods that were seen as having more highly positive attributes were also seen as more acceptable, and were used by a greater proportion of the women in the sample, even though the overwhelming popularity of the pill overshadowed all other methods. It was concluded that perceptual factors can help predict who will use a particular method and that this can be potentially useful to family planning service providers in influencing method choice.