1. Home
  2. Vol 25, No 4 (2021)
  3. Lee

The barriers to using modern contraceptive methods among rural young married women in Moshi Rural District, the Kilimanjaro region, Tanzania

Mina Lee(1),


(1) Independent Health Consultant, Seoul, Republic of Korea and Project officer, National Tuberculosis Association
Corresponding Author

Abstract


The relationship between the rate of modern contraception and unintended pregnancy is complicated in Tanzania. Although the contraception rate has been slightly increased; the unintended pregnancy rate has remained at 22~24% since 1999. In addition, married women in rural areas use less modern contraceptive methods than those in urban areas. Young women are at a higher risk of mistimed and unintended pregnancy compared to older females. Various barriers to using contraceptive methods have been reported, including fear of side effects, lack of knowledge, misconception, accessibility of the methods, and limited health workers' skills. This study was aimed to invest the barriers to using modern contraceptive methods among rural young married. A qualitative study was carried out in Moshi rural district in northeast Tanzania between June 2019 and July 2019. 22 in-depth interviews (9 key informants and 13 young married women aged 19-34) were conducted. Thematic analysis was used and data transcripts were coded. As a result, all participants were familiar with modern contraceptive methods and experienced at least one of them. Fear of side effects and prefer inappropriate birth control methods especially superstitious methods were major barriers to use. Also, rumours and misleading concerns have arisen from peers and village members. Condoms were not used among them, and males and the elderly still perceived family planning negatively. Additionally, although long-term modern contraceptive methods have been increased and preferred, IUCD is inaccessible due to the lack of skilled workers and facilities. In conclusion, community-based reproductive education is required to increase awareness of safe and reliable modern contraceptive methods. And frequent outreach services of the field are essential to provide more contraception’s benefits to the village members so that barriers to using contraception and unwanted pregnancy could be reduced in rural Tanzania. In order to do that, more interventions, such as NGOs and strengthened government systems of reproductive health, should be enhanced. (Afr J Reprod Health 2021; 25[4]: 99-107).

References


Abraha TH, Teferra AS and Gelagay AA. Postpartum

modern contraceptive use in northern Ethiopia: prevalence and associated factors. Epidemiology and Health, 2017; 39:e2017012.

United Nations. World Fertility Report 2015:

https://www.un.org/en/development/desa/population/publications/pdf/fertility/wfr2015/worldFertilityReport2015.pdf. (accessed 19 August 2019).

Tsui AO, Brown W and Li Q. Contraceptive Practice in

SubSaharan Africa. Population and Development Review. 2017; 43(Suppl 1), 166–191.

DHS. Tanzania Demographic and Health Survey and

Malaria Indicator Survey [TDHS], 2015/16. https://dhsprogram.com/pubs/pdf/fr321/fr321.pdf. (accessed 16 August 2019).

United Nations, Department of Economic and Social

Affairs, Population Division. Contraceptive Use by Method 2019: Data Booklet. 2019.

Izugbara C, Wekesah F, Tilahun T, Amo-Adjei J and

Dimbuene ZT. Family Planning in East Africa: Trends and Dynamics. January 2018. [online] African Population and Health Research Center (APHRC) https://aphrc.org/wp-content/uploads/2019/07/Family-Planning-in-East-Africa-Report_January-2018.pdf(2018, accessed 19 August 2019).

Fall CH, Sachdev HS, Osmond C, Restrepo Mendez MC,

Victora C, Martorell R, Stein AD, Sinha S, Tandon N, Adair L, Bas I, Norris S and Richter LM. Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Global Health. 2015; 3(7):e366–e377

Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R,

Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, McGovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F and Viner RM. Our future: a Lancet commission on adolescent health and wellbeing. The Lancet. 2016; 387(10036), 2423–2478.

Castle S and Askew I. Contraceptive Discontinuation:

Reasons, Challenges, And Solutions. Family Planning 2020. http://www.familyplanning2020.org/resources/contraceptivediscontinuation-reasons-challenges-and-solutions. (accessed 19 August 2019).

Khajehpour M & Simbar M, Jannesari S, Ramezani TF

and Alavi MH. Health status of women with intended and unintended pregnancies. Public health. 2012; 127. 10.1016/j.puhe.2012.08.011.

Safari W, Urassa M, Mtenga B, Changalucha J, Beard J,

Church K, Zaba B and Todd J. Contraceptive use and discontinuation among women in rural North-West Tanzania. Contraception and Reproductive Medicine. 2019; 4, 18. https://doi.org/10.1186/s40834-019-0100-6

Ochako R, Mbondo M, Aloo S, Kaimenyi S, Thompson

R, Temmerman M and Kays M. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15, 118. https://doi.org/10.1186/s12889-015-1483-1

Carlson C, Plonczynski DJ and Yao P. The Impact of

Personal Characteristics on Contraceptive Choices and Use Over 5 years. SAGE Open Nursing. 2016 2:2377960816680824.

Sedekia Y, Jones C, Nathan R, Schellenberg J and

Marchant T. Using contraceptives to delay first birth: a qualitative study of individual, community and health provider perceptions in southern Tanzania. BMC Public Health. 2017; 17, 768. https://doi.org/10.1186/s12889-017-4759-9.

Tibaijuka L, Odongo R, Welikhe E, Mukisa W, Kugonza

L, Busingye I, Nabukalu P, Ngonzi J, Asiimwe SB and Bajunirwe F. Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource limited setting. BMC Women’s Health. 2017; 17(25). https://doi.org/10.1186/s12905-017-0382-2 PMID: 28376779

Wafula S, Obare F and Bellows B. Evaluating the Impact

of Promoting Long Acting and Permanent Methods of Contraceptives on Utilization: Results from a Quasi Experimental Study in Kenya. Population Association of America. 2014.

Oyediran KA and Isiugo-abanihe UC. Husband Wife

Communication and Couple’s Fertility Desires among the Yoruba of Nigeria. 2002.

Marchant T, Mushi A, Nathan R, Mukasa O, Abdulla S,

Lengeler C and Armstrong-Schellenberg J RM. Planning a Family: Priorities and Concerns in Rural Tanzania. African Journal of Reproductive Health / La Revue Africaine De La Santé Reproductive. 2004; 8(2), 111-123. doi:10.2307/3583185

Hollos M. The Cultural Construction of Childhood:

Changing Conceptions Among the Pare of Northern Tanzania. Childhood-a Global Journal of Child Research, 9, 167-189. 10.1177/0907568202009002802. 2002.

Davidson A, Slavinski S, Komoto K and Rakeman J.

Suspected female-to-male sexual transmission of Zika Virus—New York City. Morbidity and Mortality Weekly Report. 2016; 65(2), 716–717.

Schuler SR, Rottach E and Mukiri P. Gender norms and

family planning decision-making in Tanzania: a qualitative study. Journal of Public Health in Africa. 2011; 2(2), 25.

Chipeta EK, Chimwaza W and Kalilani-Phiri L.

Contraceptive knowledge, beliefs and attitudes in rural Malawi: Misinformation, misbeliefs and misperceptions. Malawi Medical Journal. 2011; 22(2), 38–41.

Ministry of Health and Social Welfare (MoHSW).

Tanzania Service Provision Assessment Survey (TSPA) 2014–2015.

Anasel MG. Family planning programme

implementation: Differences in Contraceptive Prevalence Rates across Local Government Authorities in Tanzania. https://www.rug.nl/research/portal/files/40480908/Complete_thesis.pdf. (2017, accessed 28 July 2019).

Stephanie B. 'Don't use birth control,' Tanzania's President

tells women in the country. CNN https://edition.cnn.com/2018/09/11/africa/tanzania-birth-control-magufuli-intl/index.html (2018, accessed 25 December 2020).

Ghule M, Raj A, Palaye P, Dasgupta A, Nair S, Saggurti

N, Battala M and Balaiah D. Barriers to use contraceptive methods among rural young married couples in Maharashtra, India: Qualitative findings. Asian Journal of Research in Social Sciences and Humanities, 5(6), 18–33. https://doi.org/10.5958/2249-7315.2015.00132. 2015.

Sweya MN, Msuya SE, Mahande MJ and Manongi R.

Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania. Adolesc Health Med Ther. 2016; 7, 109-115. DOI: 10.2147/AHMT.S108531

Chi PC, Bulage P, Urdal H and Sundby J. Perceptions of

the effects of armed conflict on maternal and reproductive health services and outcomes in Burundi and Northern Uganda: a qualitative study. BMC International Health and Human Rights, 15(7). https://doi.org/10.1186/s12914-015-0045-z. 2015.


Full Text: PDF

Article Metrics

Abstract View : 1533 times
PDF Download : 446 times

Refbacks

  • There are currently no refbacks.