Adongo P B, Phillips J F, Kajihara B, Fayorsey C, Debpuur C, Binka F N
Navrongo Health Research Centre, Ministry of Health, Upper East Region, Ghana.
Soc Sci Med. 1997 Dec;45(12):1789-804. doi: 10.1016/s0277-9536(97)00110-x.
This study presents a focus group investigation of reasons why women in a rural, Sahelian community are reluctant to adopt family planning even when convenient services are made freely available. First, women opting to practice contraception must do so at considerable risk of social ostracism or familial conflict. Implementing individual preference is something that must be done without the support of others. Second, few women view personal decisions about contraceptives as theirs to make. Women and children are the property of the corporate family-kin and community militate against reproductive control. Third, although children are highly valued for a variety of economic, social, and cultural reasons, mortality risks remain extremely high. Low fertility imposes the unacceptable risk that a woman will have no surviving children at the end of her reproductive life. Taken together, these findings attest to the inadequacy of service strategies focused on the contribution of distribution, individual agency, or personal choice. Outreach should also build a sense of community legitimacy for the program, collective health action, and traditional leadership support for family planning behavior.
本研究针对萨赫勒地区一个农村社区的女性即便能免费获得便捷的计划生育服务却仍不愿采用该服务的原因展开了焦点小组调查。首先，选择实施避孕措施的女性必须承担遭受社会排斥或家庭冲突的巨大风险。在没有他人支持的情况下，实施个人意愿是一件必须要做的事。其次，很少有女性认为关于避孕措施的个人决定应由自己做出。女性和儿童是整个家庭的财产，亲属和社区反对生育控制。第三，尽管出于各种经济、社会和文化原因，孩子备受重视，但死亡风险仍然极高。低生育率带来了不可接受的风险，即女性在生育期结束时可能没有存活的子女。综合来看，这些发现证明了仅关注服务分发、个人能动性或个人选择的服务策略是不够的。外展工作还应营造社区对该项目的认同感、集体健康行动以及传统领导层对计划生育行为的支持。
