a Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA.
Glob Public Health. 2014;9(4):455-68. doi: 10.1080/17441692.2014.890238. Epub 2014 Mar 5.
Contraceptive use is an important determinant of unintended pregnancy, but little is known about the social and structural factors that determine women's contraceptive use in rural Honduras. In this study, we aim to characterise the individual and social determinants of contraceptive use among women in rural Honduras. In 2011 and 2012, we conducted 14 interviews and 2 focus groups with women 18 years and older. In our analysis, we created a family-planning narrative for each participant and coded transcripts around key emergent themes related to these determinants. We found that social determinants--including poverty, gender dynamics and availability of family-planning methods--had a strong influence on contraceptive use among women in our sample. Study participants stated that they were faced with a difficult economic situation compounded by rising prices of basic goods and diminishing job opportunities. Paradoxically, at the same time that the economic situation led women to seek contraception, it also contributed to the structural barriers that limited their ability to obtain their method of choice and maintain continuous contraceptive use. Our findings suggest the need for multi-level efforts to create an enabling and sustainable environment for family planning among women in rural Honduras.
避孕措施的使用是导致意外怀孕的一个重要决定因素,但对于农村洪都拉斯地区影响女性避孕措施使用的社会和结构性因素知之甚少。本研究旨在描述农村洪都拉斯地区女性使用避孕措施的个体和社会决定因素。2011 年和 2012 年,我们对 18 岁及以上的女性进行了 14 次访谈和 2 次焦点小组讨论。在分析中,我们为每位参与者创建了一个计划生育叙事,并围绕与这些决定因素相关的关键新兴主题对记录进行了编码。我们发现,社会决定因素——包括贫困、性别动态和计划生育方法的可及性——对我们样本中的女性使用避孕措施有很大影响。研究参与者表示,她们面临着严峻的经济形势,基本商品价格上涨,就业机会减少。具有讽刺意味的是,经济形势一方面促使女性寻求避孕措施,另一方面也造成了结构性障碍,限制了她们获得选择方法和持续使用避孕措施的能力。研究结果表明,需要采取多层次的努力,为农村洪都拉斯地区的女性创造一个有利和可持续的计划生育环境。