Hair salons and stylist–client social relationships as facilitators of community-based contraceptive uptake in KwaZulu-Natal, South Africa: a qualitative analysis
| Autor: | Christina Psaros, Jana Jarolimova, Nafisa J Wara, Dani Zionts, Ashley Stuckwisch, Ingrid V. Bassett, Nosipho Dladla, Sabina Govere |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Psychological intervention South Africa Nursing Contraceptive Agents Health care medicine Humans Confidentiality Interpersonal Relations Salon Qualitative Research Poverty business.industry Public health Research Obstetrics and Gynecology Social environment Reproducibility of Results Gynecology and obstetrics Focus group Community delivery Contraception Reproductive Medicine RG1-991 Hair salon Female Psychology business Adolescent girls and young women |
| Zdroj: | Reproductive Health, Vol 18, Iss 1, Pp 1-16 (2021) Reproductive Health |
| ISSN: | 1742-4755 |
| Popis: | Background South Africa faces a high burden of unmet contraceptive need, particularly among adolescent girls and young women. Providing contraception in community-based venues may overcome barriers to contraceptive access. Our objective was to explore the potential impact of the social environment and stylist–client interactions on perceived accessibility of contraceptives within hair salons. Methods We conducted 42 semi-structured, in-depth interviews with salon clients (100% identified as female, 100% identified as Black, median age 27.1 years) and 6 focus groups with 43 stylists (95% identified as female, 98% identified as Black, median age 29.6 years) in and around Umlazi Township, Durban, KwaZulu-Natal to explore perspectives on offering contraceptive services in hair salons. We used an inductive and deductive approach to generate the codebook, identified themes in the data, and then organized findings according to Rogers’ Individual Adoption Model as applied to community-based health prevention programs. Twenty-five percent of transcripts were coded by two independent coders to ensure reliability. Results We identified elements of the salon environment and stylist–client relationships as facilitators of and barriers to acceptability of salon-based contraceptive care. Factors that may facilitate perceived contraceptive accessibility in salons include: the anonymous, young, female-centered nature of salons; high trust and kinship within stylist–client interactions; and mutual investment of time. Stylists may further help clients build comprehension about contraceptives through training. Stylists and clients believe salon-based contraceptive delivery may be more accessible due to contraceptive need facilitating client buy-in for the program, as well as a salon environment in which clients may encourage other clients by voluntarily sharing their own contraceptive decisions. The non-judgmental nature of stylist–client relationships can empower clients to make contraceptive decisions, and stylists seek to support clients’ continued use of contraceptives through various adherence and support strategies. Some stylists and clients identified existing social barriers (e.g. confidentiality concerns) and made recommendations to strengthen potential contraceptive delivery in salons. Conclusion Stylists and clients were highly receptive to contraceptive delivery in salons and identified several social facilitators as well as barriers within this setting. Hair salons are community venues with a social environment that may uniquely mitigate barriers to contraceptive access in South Africa. Plain language summary Women in South Africa experience high rates of unintended pregnancies. Because of high HIV prevalence within the country, women who experience unplanned pregnancies may also be vulnerable to HIV. Studies have detailed the barriers women in South Africa face in accessing contraceptives, including poverty, cultural norms around contraceptive use, lack of confidential spaces, and negative experiences with healthcare workers. In response, we propose the provision of contraceptive and preventive HIV care in salons—places that may be more convenient, accessible, and comfortable for women to acquire contraceptives. In this analysis, we aimed to understand how the salon social environment and client–stylist relationships may lower barriers women face when accessing contraceptives, using a framework for how individuals adopt new interventions. We conducted in-depth interviews with 42 salon clients and six focus group discussions with 43 stylists and used content analysis to explore themes within the data. Overall, participants identified components of the salon environment and stylist–client relationships that may facilitate how clients learn and make decisions about contraceptive use. These included perceptions of: salons being anonymous and centered around young, female clients; and stylists and clients recognizing contraceptive need within the community, being invested in salon services, and building trusted relationships. Although overall buy-in was high, some stylists and clients also identified barriers such as confidentiality concerns, negative views on stylists, and discomfort with discussing contraceptives. Overall, our study identifies hair salons as promising spaces for women in South Africa to seek contraceptive care. |
| Databáze: | OpenAIRE |
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