Department of Community Health, University of Malawi, Lilongwe.
S Afr Fam Pract (2004). 2020 Oct 7;62(1):e1-e8. doi: 10.4102/safp.v62i1.5153.
The importance of modern contraceptive methods in averting unwanted pregnancies has been acknowledged in Malawi. Currently, the country has registered the highest rates of unsafe abortions, unmet needs for contraception and a low contraceptive prevalence rate. Understanding why these rates exist is important. However, women's views and experiences regarding uptake of family planning methods in Malawi have not been explored.
A grounded theory methodology was used. Data were gathered through in-depth interviews with women (n = 18), men (n = 10), healthcare workers (n = 10) and non-participant observations of family planning clinic consultations (n = 10). Data were analysed using constant comparative technique. Methods of open, axial and selective coding enabled subsequent conceptualisations until theoretical saturation occurred.
The core category 'disenabling environment prevents women's family planning needs from being met' provides an understanding of women's, men's and healthcare workers' experiences of contraceptive use and non-use. The disenabling environment contributed to shaping women's family planning experiences. This was supported by three main categories: navigating the processes, disempowerment of women and learning by chance.
Findings from this study illuminate contextual issues into how women, men and healthcare workers experience family planning use and non-use in Malawi. A multifaceted strategy is required to support a woman's family planning needs. At community level, awareness and education of family planning methods is required to actively inform all people in society so that they support a woman's family planning needs. At national level, laws that would empower women with decision-making ought to be developed and enforced.
现代避孕方法在避免意外怀孕方面的重要性在马拉维已得到认可。目前，该国报告的不安全人工流产率、避孕需求未得到满足以及避孕普及率均处于较高水平。了解这些比率存在的原因很重要。然而，马拉维妇女对计划生育方法的接受程度的看法和经验尚未得到探索。
采用扎根理论方法。通过对妇女（n=18）、男子（n=10）、卫生保健工作者（n=10）的深入访谈以及对计划生育诊所咨询的非参与观察（n=10）收集数据。使用恒定比较技术分析数据。开放式、轴向和选择性编码方法使随后的概念化得以实现，直到达到理论饱和度。
核心类别“使能环境阻碍了妇女计划生育需求的满足”提供了对妇女、男子和卫生保健工作者的避孕使用和不使用的经验的理解。使能环境促成了妇女计划生育经历的形成。这得到了三个主要类别的支持：导航过程、妇女的无权和偶然学习。
本研究的结果阐明了在马拉维，妇女、男子和卫生保健工作者体验计划生育使用和不使用的背景问题。需要采取多方面的策略来支持妇女的计划生育需求。在社区层面，需要开展计划生育方法的宣传和教育，以使社会上所有人都能积极了解，从而支持妇女的计划生育需求。在国家层面，应制定和执行赋予妇女决策权的法律。
