Kabagenyi Allen, Reid Alice, Ntozi James, Atuyambe Lynn
Department Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda; Center for Population and Applied Statistics, College of Business and Management Sciences, Makerere University, P.O. Box 7062, Kampala, Kampala, Uganda.
Department of Geography, University of Cambridge, Downing Pl, Cambridge CB2 3EN, United Kingdom.
Pan Afr Med J. 2016 Oct 17;25:78. doi: 10.11604/pamj.2016.25.78.6613. eCollection 2016.
Family planning is one of the cost-effective strategies in reducing maternal and child morbidity and mortality rates. Yet in Uganda, the contraceptive prevalence rate is only 30% among married women in conjunction with a persistently high fertility rate of 6.2 children per woman. These demographic indicators have contributed to a high population growth rate of over 3.2% annually. This study examines the role of socio-cultural inhibitions in the use of modern contraceptives in rural Uganda.
This was a qualitative study conducted in 2012 among men aged 15-64 and women aged 15-49 in the districts of Mpigi and Bugiri in rural Uganda. Eighteen selected focus group discussions (FGDs), each internally homogeneous, and eight in-depth interviews (IDIs) were conducted among men and women. Data were collected on sociocultural beliefs and practices, barriers to modern contraceptive use and perceptions of and attitudes to contraceptive use. All interviews were tape recoded, translated and transcribed verbatim. All the transcripts were coded, prearranged into categories and later analyzed using a latent content analysis approach, with support of ATLAS.ti qualitative software. Suitable quotations were used to provide in-depth explanations of the findings.
Three themes central in hindering the uptake of modern contraceptives emerged: (i) persistence of socio-cultural beliefs and practices promoting births (such as polygamy, extending family lineage, replacement of the dead, gender-based violence, power relations and twin myths). (ii) Continued reliance on traditional family planning practices and (iii) misconceptions and fears about modern contraception.
Sociocultural expectations and values attached to marriage, women and child bearing remain an impediment to using family planning methods. The study suggests a need to eradicate the cultural beliefs and practices that hinder people from using contraceptives, as well as a need to scale-up family planning services and sensitization at the grassroots.
计划生育是降低孕产妇和儿童发病率及死亡率的具有成本效益的策略之一。然而在乌干达，已婚妇女的避孕普及率仅为30%，同时妇女平均生育率持续高达每名妇女生育6.2个孩子。这些人口指标导致年人口增长率超过3.2%。本研究探讨了社会文化抑制因素在乌干达农村地区现代避孕方法使用中的作用。
这是一项于2012年在乌干达农村的姆皮吉区和布吉里区对15 - 64岁男性及15 - 49岁女性开展的定性研究。分别对男性和女性进行了18次选定的焦点小组讨论（每个小组内部同质）以及8次深入访谈。收集了关于社会文化信仰与习俗、现代避孕方法使用的障碍以及对避孕方法的认知和态度的数据。所有访谈均进行录音、翻译并逐字转录。所有转录文本进行编码，预先分类，随后在ATLAS.ti定性软件的支持下采用潜在内容分析法进行分析。使用恰当的引用来深入解释研究结果。
出现了阻碍现代避孕方法采用的三个核心主题：（i）促进生育的社会文化信仰与习俗持续存在（如一夫多妻制、延续家族血脉、为逝者延续后代、性别暴力、权力关系及双胞胎神话）。（ii）继续依赖传统计划生育做法以及（iii）对现代避孕方法的误解和恐惧。
与婚姻、妇女和生育相关的社会文化期望和价值观仍然是使用计划生育方法的障碍。该研究表明需要消除阻碍人们使用避孕药具的文化信仰和习俗，同时需要扩大基层计划生育服务及宣传。
