Sanchez Elynn Kann, McGuire Courtney, Calhoun Lisa M, Hainsworth Gwyn, Speizer Ilene S
Carolina Population Center, University of North Carolina-Chapel Hill, Chapel Hill, USA.
The Bill & Melinda Gates Foundation, Seattle, USA.
Contracept Reprod Med. 2021 Feb 16;6(1):8. doi: 10.1186/s40834-020-00146-1.
Despite calls to increase contraceptive use among adolescents and youth, large gaps still exist, creating an unmet need for family planning. Past research has focused on barriers to seeking a method. There is less understanding of the types of methods young women want and who and what influences these decisions. This study examines what method characteristics young Nigerian women prioritize when choosing a method to inform future family planning programming.
In 2018, eight focus group discussions (FGD) were conducted in the Nigerian cities of Ilorin and Jos with 83 young women ages 15-24. Participants were identified by community contacts and separated into groups by religion and marital status. The discussion guide utilized a vignette structure to understand the participants' perceptions on contraceptive behavior and attitudes and misconceptions surrounding different types of methods. The FGDs were undertaken and analyzed by collaborative teams from the University of Ibadan and the University of North Carolina-Chapel Hill. A thematic analysis of the transcripts was performed using Atlas.ti, including two rounds of coding, and multiple reviews by the research team.
The method characteristics associated with young women's contraceptive decisions include: side effects, reliability, length of coverage, privacy, cost, and accessibility. Side effects, reliability, and privacy were described as negatively linked to short-acting methods whereas easy accessibility and low cost were positive characteristics of these methods. Long-acting methods were generally viewed as positive. Participants' focus on side effects commonly resulted from concerns about the impact on future fertility. The characteristics prioritized by individuals change throughout their adolescence and as their marital status changes. Providers, peers, parents, and partners were all found to have an influence over method choice in different ways. The role of these influencers also changes over the adolescent years.
This study demonstrates that programs should prioritize expanding method choice to increase the number of available options to ensure all young women can access a method that fits their desired method characteristics. Programming should ensure that medically accurate information is widely distributed to harness providers, peers, parents and partners as a resource for information about specific methods.
尽管呼吁增加青少年和青年使用避孕药具的比例，但差距仍然很大，造成了未满足的计划生育需求。过去的研究主要集中在寻求避孕方法的障碍上。对于年轻女性想要的避孕方法类型以及谁和什么因素影响这些决定的了解较少。本研究调查了尼日利亚年轻女性在选择避孕方法时优先考虑的方法特征，以为未来的计划生育规划提供参考。
2018年，在尼日利亚的伊洛林和乔斯市对83名15至24岁的年轻女性进行了八次焦点小组讨论。参与者由社区联系人确定，并按宗教和婚姻状况分组。讨论指南采用了一个小案例结构，以了解参与者对避孕行为、态度以及围绕不同类型避孕方法的误解的看法。焦点小组讨论由伊巴丹大学和北卡罗来纳大学教堂山分校的合作团队进行并分析。使用Atlas.ti对转录本进行了主题分析，包括两轮编码，并由研究团队进行多次审核。
与年轻女性避孕决定相关的方法特征包括：副作用、可靠性、覆盖时长、隐私性、成本和可及性。副作用、可靠性和隐私性被描述为与短效方法呈负相关，而易于获取和低成本是这些方法的积极特征。长效方法通常被视为积极的。参与者对副作用的关注通常源于对未来生育能力影响的担忧。个人优先考虑的特征会随着青春期的发展以及婚姻状况的变化而改变。发现提供者、同龄人、父母和伴侣都以不同方式对方法选择产生影响。这些影响者的作用在青少年时期也会发生变化。
本研究表明，项目应优先扩大避孕方法的选择范围，以增加可用选项的数量，确保所有年轻女性都能获得符合其期望方法特征的避孕方法。规划应确保广泛传播医学上准确的信息，以利用提供者、同龄人、父母和伴侣作为特定方法信息的资源。
