Fears, Misconceptions, and Side Effects of Modern Contraception in Kenya: Preliminary Findings

G E E T A N A N DA J AN E A LAII

C A TA LIN A R A MIRE Z

C-Change End-of-Project Meeting September 19, 2012

FP Methods…What’s Important to You?

“…I was thinking something low maintenance.”

What We Know

30.7 percent of women cited

fear of side effects or

health concerns as the

main reasons for not

intending to use

contraception in the future

26% percent is the total

unmet need for

family planning among

currently married

women in Kenya

Source: Kenya DHS 2009

Research Objectives

1. To document fears and misconceptions about family planning methods among men and women

2. To explore characteristics, decision-making factors, and processes among men and women who currently use FP methods

Study Sites: Kisii South (Nyanza) and Kilifi (Coast)

Study Design and Methods

Objective 1:

In-depth interviews (n=44) and focus group discussions (n=33)

Users and non-users

Men and women

Objective 2:

In-depth interviews (n=71)

Users only

Men and women

F E A R S , M I S C O N C E P T I O N S , A N D S I D E E F F E C T S

Objective 1

Fears and Misconceptions Related to FP

infertility contraceptive

failure

method

expulsion

or shift

birth defects cancerous

growths

Fears and Misconceptions, in Context

“I am told that one was inserted, but while having sex her husband pushed it aside and she can get pregnant…when the coil is inside and that coil can settle on the baby’s head…and when it gets inside the head it affects the brain and therefore the baby could be born with mental disorders.”

Female FGD Participant

Side Effects Related to FP

weight

changes

menstrual

changes

localized

pain

dizziness &

headache

changes

in libido

high BP &

shortness

of breath

Side Effects, in Context

“I could not walk. When I would travel up a hill, there was too much breath. I had to finish climbing a hill, sit and rest, and then talk. I would fetch a jar of water from the river, and on getting to a hill I would be unable to carry it further and would have to leave it for my husband. He was very angry because of having to fetch the water.”

Female Injectable User

Main Source of Information about FP Health Concerns and Side Effects

“It is not like CHWs come and tell us they have side effects…It is those who have used them…CHWs are told to come and teach people about FP. They teach, ‘Give birth to the number of children one can take care of’—but not that they teach they have side effects, no. It’s just those who use.”

Female FGD Participant

56 percent of men and

women indicated that

PEERS were their

main source of

information about FP

health concerns/side

effects

Perceived Outcomes of Fears, Misconceptions, and Side Effects

inability to

work or fulfill

household duties

decreased sexual

activity

Fears and misconceptions Side effects

inability to fulfill

reproductive role

in family

financial &

emotional

burden on

relationship

Economic and emotional strain,

abandonment by sexual partner,

community stigma

Changes in normal functioning,

disruptions in sexual relationships

Fears, Misconceptions, Side Effects, and FP Uptake

INFLUENCE DECISION

TO USE FP

INFLUENCE FP

METHOD CHOICE

AND SWITCHING

FEARS &

MISCONCEPTIONS

SIDE EFFECTS

O V E R C O M I N G F E A R S A N D M I S C O N C E P T I O N S :

L E S S O N S F R O M S U C C E S S F U L U S E R S

Objective 2

a

Analysis Framework

Environmental and Community Factors

changing economic

environment

perceived

norms about

family size

long-term relationship with

health care community

continuous

access to

information

& services

access to multiple

information sources

communication with partner

about FP

motivation to prevent

unintended pregnancy

Individual and Interpersonal Factors

knowledge

of possible

side effects

knowledge

of how current

FP method

works

“We were told the pill is so bad it has batteries; I thought that it can go and heap in my stomach. I then decided to use the injection because I had not heard so many negative things about it. After the injection I started bleeding.. so I stopped using it. So after talking with the doctors I went for the pills, and first I put a pill in water but it all dissolved and I did not see a battery inside. From then on I chewed the pill so that it cannot stay in my stomach” Female Pill User

Access to Multiple Information Sources

Motivation to Prevent Unintended Pregnancy and Communication with Partner

“ We sat and discussed the other day, and I told him that we are even lacking food for the children we have now. It is good we go to the seminar and get in-depth information. … so that we can … be able to have a good life.”

Female IUD User

Opportunities for SBCC

Opportunities for SBCC

Information

address specific fears and

misconceptions

promote sustainable

relationship with health providers

Motivation

communicate broad benefits of family planning

Ability to Act

engage men in FP uptake and

advocacy

Norms

Community-level efforts to dispel comm.

taboo

promote changing norms

Next Steps

Research dissemination meeting scheduled in Nairobi next month

Findings will be shared with Division of Reproductive Health, Ministry of Public Health and Sanitation

Acknowledgments

Targets Research International

Division of Reproductive

Health