卢旺达夫妻联合使用避孕药具的障碍与益处研究
An examination of the barriers to and benefits from collaborative couple contraceptive use in Rwanda.
作者信息
Schwandt Hilary, Boulware Angel, Corey Julia, Herrera Ana, Hudler Ethan, Imbabazi Claudette, King Ilia, Linus Jessica, Manzi Innocent, Merritt Madelyn, Mezier Lyn, Miller Abigail, Morris Haley, Musemakweli Dieudonne, Musekura Uwase, Mutuyimana Divine, Ntakarutimana Chimene, Patel Nirali, Scanteianu Adriana, Shemeza Biganette-Evidente, Stapleton Madi, Sterling-Donaldson Gi'anna, Umutoni Chantal, Uwera Lyse, Zeiler Madeleine, Feinberg Seth
机构信息
Western Washington University, 516 High Street, MS9118, Bellingham, WA, 98225, USA.
Spelman College, 350 Spelman Ln SW, Atlanta, GA, 30314, USA.
出版信息
Reprod Health. 2021 Apr 19;18(1):82. doi: 10.1186/s12978-021-01135-6.
BACKGROUND
Supportive male involvement is strongly correlated with contraceptive use. In Rwanda, where the contraceptive prevalence rate among married women increased from 17 to 52% from 2005 to 2010, and stagnated at 53% in 2015, understanding the role of male partners in collaborative couple contraceptive use can help inform programs designed to further increase the use of contraception in Rwanda.
METHODS
This study utilized qualitative methods in 2018, specifically 32 in-depth interviewers with mostly current users of modern contraceptive methods and eight focus group discussions with family planning providers-both family planning nurses and community health workers (CHWs). Respondents were from Musanze and Nyamasheke Districts, the districts with the highest and lowest modern contraceptive use, respectively, to explore the role of couple collaboration in family planning use in Rwanda. Data were analyzed using the thematic content approach in Atlas.ti (8).
RESULTS
Findings demonstrate that some men are opposed to use of male methods of contraception, and some are opposed to any contraceptive use, which can lead to covert use. Women and providers prefer collaborative couple contraceptive use-as a result, providers advocate for and encourage male partner participation in contraceptive use. Women are most often burdened with seeking out information, initiating discussions, and sharing information discovered about contraceptive use with partners. Decision-making about contraceptive use, once discussed, can be collaborative and motivated by financial considerations. When couple contraceptive use is collaborative, benefits range from marital harmony to husband's support of sustained use through reminders about appointments, joint counseling, and support in managing side effects.
CONCLUSION
Family planning providers at the community and clinic levels encourage collaborative contraceptive use among couples and some Rwandan couples communicate well about family planning use. Despite the positives, women are expected to source family planning information, share that information with their male partners, seek out family planning services, and use family planning. If more Rwandan male partners accepted use, used male methods of contraception, and participated even more in the work it takes to use family planning, the potential for sustained, and even enhanced, contraceptive use in Rwanda could be realized.
背景
男性的支持性参与与避孕措施的使用密切相关。在卢旺达，已婚妇女的避孕普及率从2005年的17%增至2010年的52%，并于2015年停滞在53%。了解男性伴侣在夫妻共同避孕使用中的作用有助于为旨在进一步提高卢旺达避孕措施使用率的项目提供信息。
方法
本研究于2018年采用定性方法，具体为对32名现代避孕方法的当前使用者进行深入访谈，并与计划生育提供者（包括计划生育护士和社区卫生工作者）进行8次焦点小组讨论。受访者分别来自现代避孕使用率最高和最低的穆桑泽区和尼亚马舍克区，以探讨夫妻协作在卢旺达计划生育使用中的作用。使用Atlas.ti（8）中的主题内容分析法对数据进行分析。
结果
研究结果表明，一些男性反对使用男性避孕方法，一些男性反对任何避孕措施的使用，这可能导致秘密使用。女性和提供者更倾向于夫妻共同避孕——因此，提供者提倡并鼓励男性伴侣参与避孕措施的使用。女性通常承担着寻找信息、发起讨论以及与伴侣分享所发现的避孕信息的负担。一旦进行讨论，避孕措施使用的决策可以是协作性的，并受经济因素驱动。当夫妻共同使用避孕措施时，好处包括婚姻和谐，以及丈夫通过提醒预约、联合咨询和管理副作用方面的支持来支持持续使用。
结论
社区和诊所层面的计划生育提供者鼓励夫妻共同使用避孕措施，一些卢旺达夫妻在计划生育使用方面沟通良好。尽管有积极方面，但女性仍需获取计划生育信息，与男性伴侣分享该信息，寻求计划生育服务并使用计划生育措施。如果更多卢旺达男性伴侣接受使用、采用男性避孕方法并更多地参与到使用计划生育所需的工作中，那么卢旺达持续甚至提高避孕措施使用率的潜力就能够实现。
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