Associate, Population Council, Avenue 5, Rose Avenue, P.O. Box 17643, Nairobi 00500, Kenya.
Country Representative, Population Council, Dakar, Senegal.
Sex Reprod Health Matters. 2022;29(3):2104680. doi: 10.1080/26410397.2022.2104680.
The introduction of progesterone vaginal ring (PVR) in sub-Saharan Africa calls for insights on the product's role in promoting women's autonomy regarding their reproductive decision-making and behaviour. Such insights could inform the positioning of the method within family planning programmes in the region. In this paper, we explore husbands' experiences with PVR as perceived by their wives and as reported by husbands of a subset of women users in Kenya, Nigeria, and Senegal. We discuss how such experiences might influence women's rights and autonomy regarding their reproductive decisions and contraceptive behaviour. We use a mixed-methods approach drawing on data from quantitative interviews with 174 women and qualitative in-depth interviews with 10 husbands of a subset of the women in the three countries. The findings show that husbands appreciated PVR's attributes relating to user-control (women could insert and remove the method themselves), ease of use, and non-interference with sex and flow of breast milk. Wives' perceptions of their husbands' experiences regarding PVR's non-interference with sex were consistent with the husbands' own reports. In addition, health care providers played important roles in supporting sustainable use of the method through giving information, counselling, and assisting women who experienced ring slippage to manage those challenges. The findings suggest that self-managed health technologies such as PVR could expand women's choices and control over their reproductive decisions. The findings further suggest that sustainable use of such products could require linkages with appropriate health systems structures to address challenges with use if and when they arise.
孕激素阴道环（PVR）在撒哈拉以南非洲的引入需要深入了解该产品在促进女性在生殖决策和行为方面的自主权方面的作用。这些见解可以为该地区的计划生育方案中该方法的定位提供信息。本文探讨了肯尼亚、尼日利亚和塞内加尔的一些女性使用者的丈夫对 PVR 的体验，这些体验是妻子们感知到的，也是丈夫们报告的。我们讨论了这些体验如何影响妇女在生殖决策和避孕行为方面的权利和自主权。我们使用混合方法，借鉴了来自三个国家的 174 名妇女的定量访谈和 10 名妇女的丈夫的定性深入访谈的数据。研究结果表明，丈夫们赞赏 PVR 在用户控制（女性可以自行插入和取出方法）、易用性以及不干扰性行为和母乳流动方面的属性。妻子们对丈夫们关于 PVR 不干扰性行为的体验的看法与丈夫们自己的报告一致。此外，医疗保健提供者通过提供信息、咨询和帮助遇到环滑脱的妇女应对这些挑战，在支持该方法的可持续使用方面发挥了重要作用。研究结果表明，自我管理的健康技术，如 PVR，可以扩大妇女在生殖决策方面的选择和控制权。研究结果进一步表明，如果出现与使用相关的挑战，可持续使用此类产品可能需要与适当的卫生系统结构联系起来，以应对这些挑战。
