Covert use of contraception in three sub-Saharan African countries: a qualitative exploration of motivations and challenges
Covert use of contraception in three sub-Saharan African countries: a qualitative exploration of motivations and challenges
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DOI：
10.1186/s12889-020-08977-y
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发表时间：
2020-06-05
影响因子：
4.5
通讯作者：
Moreau, Caroline
中科院分区：
文献类型：
--
作者：
Kibira, Simon P. S.;Karp, Celia;Moreau, Caroline
背景增加男子参与计划生育和基于权利的倡议，有利于妇女赋权之间的平衡是突出与隐蔽使用避孕的问题。虽然在低收入和中等收入国家，有记录表明妇女在伴侣反对的情况下秘密使用避孕药具，但人们对妇女的决策过程、行动以及谨慎使用避孕药具的潜在后果知之甚少。我们的目的是了解妇女的选择使用避孕隐蔽和他们所面临的挑战，在隐瞒他们的使用在三个撒哈拉以南非洲countries.MethodsWomen年龄在15-49和他们的男性伴侣故意抽样从城市和农村的网站在埃塞俄比亚，北方和南部尼日利亚，乌干达120个深入采访和38个焦点小组讨论。半结构化访谈探讨了围绕性、生育和避孕增强妇女和女孩权能的问题。访谈以当地语言进行，录音并逐字转录成英文。归纳专题分析用于分析数据;隐蔽使用代码进行了审查和矩阵创建的基础上的主题和sub-themes.ResultsFindings包括三个主题领域：隐蔽避孕药具的使用和使用隐蔽的原因的做法;妇女谁使用避孕隐蔽的挑战;和披露或被发现的后果。虽然有些妇女由于关系紧张或由于已知的伴侣反对而秘密地开始使用避孕药具，但其他人并不认为计划生育是男性的责任。虽然秘密使用是经常讨论的，但它也是社会认可的，并被描绘成女性不服从的行为，质疑父权制的社会秩序。秘密使用的进一步挑战包括缺乏财政和社会支持，以及对延迟生育和避孕相关副作用的怀疑。拒绝包括增加怀疑，威胁，或暴力，虽然一些妇女报告说，改善夫妇沟通披露.ConclusionsResults表明，虽然隐蔽使用避孕是常见的，继续隐蔽使用是具有挑战性的，特别是当副作用的表现。秘密使用可能进一步表明妇女采取独立行动，象征着某种程度的赋权。结果强调了解开秘密使用的独特原因和披露的影响的严重性的重要性。
BackgroundThe balance between increasing men's participation in family planning and rights-based initiatives favoring women's empowerment is highlighted with the issue of covert use of contraception. While covert use has been documented in low- and middle-income countries as a way for women to obtain contraception in light of partner opposition, little is known about women's decision-making processes, actions, and potential consequences of discreet contraceptive use. We aimed to understand women's choices to use contraception covertly and the challenges they faced in concealing their use across three sub-Saharan African countries.MethodsWomen aged 15-49 and their male partners were purposively sampled from urban and rural sites in Ethiopia, Northern and Southern Nigeria, and Uganda for 120 in-depth interviews and 38 focus group discussions. Semi-structured interviews explored women's and girls' empowerment surrounding sex, childbearing, and contraception. Interviews were conducted in local languages, audio-recorded, and transcribed verbatim into English. Inductive thematic analysis was used to analyze data; covert use codes were reviewed and matrices were created based on themes and sub-themes.ResultsFindings comprised three thematic areas: the practice of covert contraceptive use and reasons for using covertly; challenges for women who use contraception covertly; and consequences of disclosure or being discovered. While some women initiated using contraception covertly due to tensions within relationships or to keep peace within the home due to known partner opposition, others did not consider family planning to be a male responsibility. Though covert use was commonly discussed, it was also socially sanctioned, and portrayed as an act of female disobedience that questioned the social order of patriarchy. Further challenges of using covertly included lack of financial and social support, and suspicions surrounding delayed fertility and contraceptive-related side effects. Repercussions comprised increased suspicion, threats, or violence, though some women reported improved couple communication with disclosure.ConclusionsResults indicate that while covert use of contraception is common, continued covert use is challenging, especially when side effects manifest. Covert use may further suggest women taking independent action, symbolizing some level of empowerment. Results underscore the importance of disentangling unique reasons for covert use and the severity of repercussions of disclosure.