How women and providers perceive male partner resistance to contraceptives in Western Kenya: A qualitative study.

Autor: Britton LE; Columbia University School of Nursing, New York City, NY, USA. Electronic address: Leb2216@cumc.columbia.edu., Tumlinson K; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: ktumlin@email.unc.edu., Williams CR; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. Electronic address: caitlin.williams@unc.edu., Gorrindo P; Dept of Maternal and Child Health, Highland Hospital, Oakland, CA, USA. Electronic address: pm@gorrindo.com., Onyango D; Kisumu County Department of Health, Kisumu, Kenya; Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands., Wambua D; Innovations for Poverty Action-Kenya, Nairobi, Kenya. Electronic address: dwambua@poverty-action.org.
Jazyk: angličtina
Zdroj: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives [Sex Reprod Healthc] 2021 Sep; Vol. 29, pp. 100650. Date of Electronic Publication: 2021 Jul 27.
DOI: 10.1016/j.srhc.2021.100650
Abstrakt: Objective: Almost a fifth of Kenyan women who desire to delay or avoid pregnancy are not using modern contraception. The objective of this study is to describe how Kenyan women, healthcare providers, and health policymakers perceive male partner resistance to function as a barrier to women's experiences attempting to obtain contraceptives.
Methods: We used a qualitative description approach to analyze the transcripts from a mixed-methods parent study in Western Kenya. We conducted conventional content analysis on transcripts from 8 focus group discussions with current and former female contraceptive users (n = 55 participants); in-depth interviews with key informants from the healthcare sector (n = 19); a client journey mapping workshop with female current contraceptive users (n = 9 participants); and a provider journey mapping workshop with public sector providers (n = 12 participants).
Results: Primary themes concerned the perceived nature, perceived impact, and strategies for addressing male partner resistance to contraceptives. Male partner resistance affected women's experiences of contraceptive care in two ways. First, anticipating male partner resistance, providers modified how they delivered care to female patients to avoid conflicts with male partners. Second, covert utilization, women's primary strategy for obtaining desired contraceptives despite male partner resistance, can make women more vulnerable to facility-level barriers to care. Participants recommended educating men about the benefits of contraception in the clinical encounter and community settings.
Conclusion: Male partner resistance to contraceptives, whether experienced or anticipated, can influence how women navigate the health system and how contraceptive care is delivered in Kenya.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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