背景:女性在意外妊娠结局和不健康的妊娠间隔的负担中占有不公平的份额。对触发器的理解,影响现代避孕药使用的观念和动机因素与旨在提高公众使用率的努力有关,特别是性活跃的女性。本研究的目的是探索触发因素,影响现代计划生育方法使用的观念和动机因素,包括仓库-醋酸甲羟孕酮皮下(DMPA-SC)。
方法:定性方法,包括;焦点小组讨论(FGD)和深入访谈(IDIs)用于从尼日利亚某些州的育龄妇女和看门人中获取信息;河流,奥贡,Kwara,尼日尔,阿南布拉,Delta,拉各斯,Enugu和Oyo.受访者的类别包括;18-25岁的未婚女性,使用现代计划生育(FP)的年龄在18-24岁之间的妇女,使用现代FP的年龄在25-49岁之间的女性,年龄在26-49岁之间的妇女不使用现代FP,社区领袖,医疗机构联络人,现代FP当前用户的丈夫,非现代FP使用者的丈夫,宗教领袖,州FP协调员和目前使用DMPA-SC的18-49岁女性。最大变异抽样技术用于招募参与者参与FGD和IDI。
结果:受访者报告说,由于该方法的好处等原因,他们有动机使用FP,经济形势,方法的适用性,担心意外怀孕及其便利性。进一步的分析表明,未婚受访者更多地讨论了对意外怀孕的恐惧以及作为关键动机的可及性和可负担性;而工会中的妇女则更多地讨论了经济状况,与未婚人士相比,伴侣的鼓励和FP的好处。此外,受访者报告说,他们的合作伙伴,卫生工作者和朋友影响了他们使用FP的决定。合作伙伴的鼓励,个人经历,可访问性和可用性,对FP及其好处的认识;空间儿童的意愿和成本是FP使用的显著推动者。FP使用的触发因素是;预约卡,来自卫生工作者的电话,提醒(短信,电话报警和合作伙伴\'支持)。
结论:因此,提高利用率需要一个有计划的横向方法,考虑到影响利用率的所有有利因素,包括赋予妇女权力。以客户为中心的计划生育方案,解决社会文化和性别规范,并确保获得混合避孕方法,以提高使用率。这项研究建议通过建立基于社区的意识来改善寻求护理的行为,以解决计划生育使用的神话和误解,建立避孕药具交付小组,以防止可用性和可及性方面的挑战,价值澄清和任务转移等,以处理计划生育利用不足的问题。
BACKGROUND: Women have unfair share in the burden of unintended pregnancy outcome and unhealthy interpregnancy intervals. An understanding of the triggers, ideation and motivational factors influencing utilization of modern contraceptives is relevant for efforts aimed at increasing utilization among the general public, specifically sexually active women. The objective of this
study is to explore the triggers, ideation and motivational factors influencing the use of modern family planning methods including depot-medroxyprogesterone acetate subcutaneous (DMPA-SC).
METHODS: Qualitative methods which include; Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were used to elicit information from women of reproductive age and gate-keepers in selected Nigerian states; Rivers, Ogun, Kwara, Niger, Anambra, Delta, Lagos, Enugu and Oyo. The categories of respondents include; unmarried women aged 18-25 years, women in union aged 18-24 years using modern family planning (FP), women in union aged 25-49 years using modern FP, women in union aged 26-49 years non-users of modern FP, community leaders, health facility focal person, husbands of current users of modern FP, husbands of non-users of modern FP, religious leaders, state FP coordinators and women aged 18-49 years who currently use DMPA-SC. Maximum variation sampling techniques was used to enlist participants to participate in both FGDs and IDIs.
RESULTS: Respondents reported being motivated to use FP for reasons such as benefits of the method, economic situation, suitability of the methods, fear of unwanted pregnancy and its convenience. Further analysis showed that the unmarried respondents discussed more about fear of unwanted pregnancy and accessibility and affordability as a key motivator; while women in union discussed more on economic situations, encouragement from partners and benefits of FP when compared with the unmarried. In addition, respondents reported that their partners, health workers and friends influenced their decisions to use FP. Partners\' encouragement, personal experience, accessibility and availability, awareness of FP and its benefits; willingness to space children and costs were notable enablers of FP use. The triggers for FP use were; appointment cards, phone calls from health workers, reminders (text messages, phone alarms and partners\' support).
CONCLUSIONS: Increasing utilization therefore requires a well-planned horizontal approach that considers all enabling factors influencing utilization including women\'s empowerment. Family planning programmes that are client centered, address socio-cultural and gender norms and ensure access to contraceptive mix methods are recommended to improve utilization rate. This
study recommends improved care-seeking behaviour through community-based awareness creation to address myths and misconceptions of family planning use, establishment of contraceptive delivery teams to prevent challenges of availability and accessibility, value clarification and tasks shifting among others to deal with the issue of inadequate family planning utilization.