Reveiz Manuela, Gueye Rahmatoulah, González Capella Thaïs, Fall Marieme, Horanieh Nour, Larson Elizabeth, Cislaghi Beniamino
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
LARTES-IFAN, Research Laboratory on Economic and Social Transformation, Cheikh Anta Diop University, Dakar, Senegal.
Front Glob Womens Health. 2025 Jul 28;6:1527733. doi: 10.3389/fgwh.2025.1527733. eCollection 2025.
Despite the increasing contraceptive, women in Senegal are facing both material and social obstacles to access family planning (FP) services. Decisions regarding contraceptive use involve an interplay of influencers, including the woman, her partner, family members, healthcare providers, and the social norms in place. This study employs social norms theory to explore how these dynamics shape women's contraceptive choices, examining the societal expectations, influential relationships, and strategies women use.
This qualitative study involved 256 participants (130 men and 126 women) from four regions of Senegal (Dakar, Tambacounda, Ziguinchor, and Matam). We employed semi-structured interviews (116) and focus group discussions (16 FGDs with 8-10 participants each) to explore experiences related to family planning access and services. Participants were recruited through purposive sampling. Thematic analysis was performed using NVivo 12 Pro.
Participants highlighted how social norms on marriage, infertility, and childbearing heavily influence women's contraceptive use decisions. Participants also mentioned social norms that directly discouraged contraception use, labeling women who used it as disloyal or unloving. The failure to fulfill normative expectations resulted in various forms of sanctions. Given the normative system, numerous women opted to make decisions regarding childbearing in secrecy. Finally, a system of beliefs that participants held about religion and healthcare providers intersected with contraceptive utilization.
Our findings provide evidence of the importance of integrating social interventions into FP interventions to help reframe social relations. Three policy implications arise: (1) Addressing broader social needs and support mechanisms. (2) Integrating insights from violence against women research and theories on the dynamics of abuse into FP programs. (3) Integrating men further into FP programming to address misconceptions.
Drawing on data from 256 young people, men, and women of reproductive age, we uncovered how women navigate the terrain of social norms within their networks, shaping their choices concerning contraceptive utilization.
尽管避孕药具的使用日益普及，但塞内加尔的妇女在获取计划生育（FP）服务方面仍面临物质和社会障碍。关于避孕措施使用的决策涉及多种影响因素的相互作用，包括女性自身、其伴侣、家庭成员、医疗保健提供者以及现有的社会规范。本研究运用社会规范理论来探讨这些动态因素如何塑造女性的避孕选择，考察社会期望、影响关系以及女性所采用的策略。
这项定性研究涉及来自塞内加尔四个地区（达喀尔、坦巴昆达、济金绍尔和马塔姆）的256名参与者（130名男性和126名女性）。我们采用半结构化访谈（116次）和焦点小组讨论（16次焦点小组讨论，每组8 - 10名参与者）来探究与计划生育获取和服务相关的经历。参与者通过目的抽样法招募。使用NVivo 12 Pro进行主题分析。
参与者强调了关于婚姻、不孕和生育的社会规范如何严重影响女性的避孕使用决策。参与者还提到了直接阻碍避孕措施使用的社会规范，将使用避孕措施的女性标签为不忠诚或不慈爱的。未能满足规范期望会导致各种形式的制裁。鉴于这种规范体系，许多女性选择秘密做出生育决策。最后，参与者对宗教和医疗保健提供者持有的一套信念与避孕措施的使用相互交织。
我们的研究结果证明了将社会干预措施纳入计划生育干预措施以帮助重塑社会关系的重要性。由此产生了三项政策建议：（1）满足更广泛的社会需求并建立支持机制。（2）将针对妇女暴力行为的研究见解以及虐待动态理论纳入计划生育项目。（3）让男性更多地参与计划生育项目以消除误解。
基于256名育龄青年、男性和女性的数据，我们揭示了女性如何在其社交网络中应对社会规范领域，从而塑造她们关于避孕措施使用的选择。
