副作用的担忧及其对加纳农村地区妇女采用现代计划生育方法的影响：一项混合方法研究。
Side effect concerns and their impact on women's uptake of modern family planning methods in rural Ghana: a mixed methods study.
机构信息
Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708, USA.
Millennium Promise Ghana, 14 Bathur St, East Legon, Accra, Ghana.
出版信息
BMC Womens Health. 2020 Mar 20;20(1):57. doi: 10.1186/s12905-020-0885-0.
BACKGROUND
Despite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine the use of modern family planning, in particular hormonal methods, in one district in rural Ghana, and to understand the role that side effects play in women's decisions to start or continue use.
METHODS
This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18-49 years old in the Amansie West District of Ghana between May and July 2018. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects.
RESULTS
The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n = 135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Side effects mentioned include menstrual changes (heavier bleeding, amenorrhea or oligomenorrhea), infertility and childbirth complications.
CONCLUSION
As programs have improved women's ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women's needs in low-income countries.
背景
尽管加纳有现代避孕方法，并记录了计划生育的未满足需求，但由于预期的副作用，许多女性仍选择不使用现代避孕方法。本研究的目的是调查加纳农村地区一个地区现代计划生育（特别是激素方法）的使用情况，并了解副作用在妇女开始或继续使用避孕药具的决定中所起的作用。
方法
本探索性混合方法研究包括 2018 年 5 月至 7 月在加纳阿芒西西部区对 18-49 岁的妇女进行的 281 次调查和 33 次深入访谈。调查评估了避孕方法的使用情况以及使用的潜在预测因素。深入访谈调查了接受和继续使用避孕方法的背景，特别关注感知和经历的副作用的作用。
结果
在希望避免怀孕的有性生活的妇女中，未满足现代计划生育需求的比例为 68.9%（n=135）。在比较有和没有现代计划生育需求的妇女时，没有发现任何因素有显著差异。定性访谈显示，对副作用有严重担忧，这些副作用源于以前的方法经验和/或关于短期影响以及计划生育使用的长期后果的传闻。提到的副作用包括月经变化（出血量更大、闭经或月经稀少）、不孕和分娩并发症。
结论
随着计划生育项目提高了妇女获得现代计划生育的能力，解决患者在接受方面的障碍，特别是有关副作用的信息和对长期使用的误解至关重要。通过全面咨询避孕选择，包括有关副作用的准确信息，以及开发满足低收入国家妇女需求的新避孕技术，可以减少意外怀孕。
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