Lee Mina
Independent Health Consultant, Seoul, Republic of Korea and Project officer, National Tuberculosis Association.
Afr J Reprod Health. 2021 Aug;25(4):99-107. doi: 10.29063/ajrh2021/v25i4.11.
The relationship between the rate of modern contraception and unintended pregnancy is complicated in Tanzania. Although the contraception rate has been slightly increased; the unintended pregnancy rate has remained at 22~24% since 1999. In addition, married women in rural areas use less modern contraceptive methods than those in urban areas. Young women are at a higher risk of mistimed and unintended pregnancy compared to older females. Various barriers to using contraceptive methods have been reported, including fear of side effects, lack of knowledge, misconception, accessibility of the methods, and limited health workers' skills. This study was aimed to invest the barriers to using modern contraceptive methods among rural young married. A qualitative study was carried out in Moshi rural district in northeast Tanzania between June 2019 and July 2019. 22 in-depth interviews (9 key informants and 13 young married women aged 19-34) were conducted. Thematic analysis was used and data transcripts were coded. As a result, all participants were familiar with modern contraceptive methods and experienced at least one of them. Fear of side effects and prefer inappropriate birth control methods especially superstitious methods were major barriers to use. Also, rumours and misleading concerns have arisen from peers and village members. Condoms were not used among them, and males and the elderly still perceived family planning negatively. Additionally, although long-term modern contraceptive methods have been increased and preferred, IUCD is inaccessible due to the lack of skilled workers and facilities. In conclusion, community-based reproductive education is required to increase awareness of safe and reliable modern contraceptive methods. And frequent outreach services of the field are essential to provide more contraception's benefits to the village members so that barriers to using contraception and unwanted pregnancy could be reduced in rural Tanzania. In order to do that, more interventions, such as NGOs and strengthened government systems of reproductive health, should be enhanced.
在坦桑尼亚,现代避孕措施的使用率与意外怀孕之间的关系较为复杂。尽管避孕率略有上升,但自1999年以来,意外怀孕率一直维持在22%至24%。此外,农村地区的已婚妇女比城市地区的已婚妇女更少使用现代避孕方法。与年长女性相比,年轻女性发生时机不当和意外怀孕的风险更高。据报道,使用避孕方法存在各种障碍,包括对副作用的恐惧、知识缺乏、误解、避孕方法的可及性以及卫生工作者技能有限。本研究旨在调查农村年轻已婚妇女使用现代避孕方法的障碍。2019年6月至7月,在坦桑尼亚东北部的莫希农村地区开展了一项定性研究。进行了22次深入访谈(9名关键信息提供者和13名年龄在19至34岁之间的年轻已婚妇女)。采用了主题分析法并对数据记录进行了编码。结果显示,所有参与者都熟悉现代避孕方法且至少体验过其中一种。对副作用的恐惧以及偏好不恰当的避孕方法,尤其是迷信方法,是使用避孕措施的主要障碍。此外,来自同伴和村民的谣言及误导性担忧也时有出现。她们中无人使用避孕套,男性和老年人对计划生育仍持负面看法。此外,尽管长效现代避孕方法的使用有所增加且更受青睐,但由于缺乏技术熟练的工作人员和设施,宫内节育器难以获得。总之,需要开展基于社区的生殖健康教育,以提高对安全可靠的现代避孕方法的认识。并且,经常开展实地外展服务对于向村民提供更多避孕益处至关重要,这样才能减少坦桑尼亚农村地区使用避孕措施的障碍和意外怀孕情况。为此,应加强更多干预措施,如非政府组织和强化政府的生殖健康系统。