Kibonire Ronald Arineitwe, Mphuthi David D
College of Human Sciences, School of Social Sciences, Department of Health Studies, University of South Africa, City of Tshwane, South Africa.
Contracept Reprod Med. 2023 Oct 16;8(1):50. doi: 10.1186/s40834-023-00246-8.
Worldwide, unintended pregnancies remain a critical public health challenge, with 74 million women in low- and middle-income countries getting these pregnancies yearly. The African continent alone contributes about 25% of all unintended pregnancies globally. Even though not all unintended pregnancies are unwanted, they can lead to many health problems for mothers and children, like malnutrition, sickness, neglect, or abuse, as well as maternal and infant morbidities and mortalities. Globally, many women die due to complications related to childbirth, either during or after pregnancy. Contraceptives, especially for long-acting reversible Contraceptive methods (LARCs), are among the best interventions to reduce maternal death. LARCs help the mother delay pregnancy and allow for longer intervals in childbirth spacing. However, utilising LARCs globally and in Uganda remains low because of limited male partner support.The purpose of this phenomenological qualitative research study was to elicit an understanding of the perceptions and beliefs of rural indigenous Ugandan men towards the use of LARCs by rural women. Ultimately the study designed strategies to enhance the uptake of those methods. Purposive sampling was used to identify 65 participants for focus group interviews and 30 for individual interviews comprising married men aged 20 to 49 years. The study was conducted in the Rubanda and Kiboga Districts of Uganda. The researcher used semi-structured questions for individual and focus group interviews.The data analysis was done by transcribing the interviews, sorting the field notes, organising, and storing the data, listening to recordings, and reading field notes and interviews to look for patterns related to the perceptions and belief systems. Using the identified patterns, the researcher coded and categorised the data to build themes emerging on the phenomenon.The study established negative perceptions and belief systems among rural indigenous Ugandan men regarding the use of LARCs by their rural women, which acted as barriers to utilisation. These perceptions included side effects, fears, desires, and cultural and religious beliefs. The study recommends strengthening social and behavioural change communication, strengthening service provision for LARCs, and monitoring and evaluation systems for LARCs. Additionally, policymakers should provide a conducive environment for LARC services provision, and the Ministry of Education and Sports, through health training institutions and universities, should prepare pre-service and in-service healthcare workers to provide LARC services.
在全球范围内,意外怀孕仍然是一项严峻的公共卫生挑战,低收入和中等收入国家每年有7400万妇女遭遇意外怀孕。仅非洲大陆就占全球所有意外怀孕案例的约25%。尽管并非所有意外怀孕都是非意愿性的,但它们可能给母亲和孩子带来许多健康问题,如营养不良、疾病、忽视或虐待,以及孕产妇和婴儿的发病和死亡。在全球范围内,许多妇女因与分娩相关的并发症在孕期或产后死亡。避孕药具,尤其是长效可逆避孕方法(LARCs),是减少孕产妇死亡的最佳干预措施之一。LARCs有助于母亲推迟怀孕,并使分娩间隔时间更长。然而,由于男性伴侣的支持有限,全球和乌干达对LARCs的使用仍然很低。
这项现象学定性研究的目的是了解乌干达农村本土男性对农村妇女使用LARCs的看法和信念。最终,该研究设计了提高这些方法使用率的策略。采用目的抽样法确定了65名参与者进行焦点小组访谈,30名参与者进行个人访谈,参与者均为年龄在20至49岁的已婚男性。该研究在乌干达的鲁班达和基博加地区进行。研究人员在个人访谈和焦点小组访谈中使用了半结构化问题。
数据分析通过转录访谈内容、整理实地记录、组织和存储数据、听取录音以及阅读实地记录和访谈内容来寻找与看法和信念系统相关的模式。利用所确定的模式,研究人员对数据进行编码和分类,以构建该现象中出现的主题。
该研究发现,乌干达农村本土男性对其农村女性使用LARCs存在负面看法和信念系统,这成为了使用的障碍。这些看法包括副作用、恐惧、欲望以及文化和宗教信仰。该研究建议加强社会和行为改变沟通,加强LARCs的服务提供以及LARCs的监测和评估系统。此外,政策制定者应为LARCs服务提供创造有利环境,教育和体育部应通过健康培训机构和大学,让岗前和在职医护人员做好提供LARCs服务的准备。