Factors influencing young Malians' reluctance to use hormonal contraceptives

Stud Fam Plann. 2003 Sep;34(3):186-99. doi: 10.1111/j.1728-4465.2003.00186.x.


During a qualitative evaluation of three peer-education programs in urban Mali, young people stated that they were wary of using either the pill or injectable contraceptives because they believed that these methods would make them sterile. Unmarried women's contraceptive decisionmaking was not primarily driven by a current need to limit fertility, but rather by a future need to maximize it in order to gain status through childbearing in their marital households. Further interviews explored notions of conception, menstruation, and the perceived action of hormonal methods on the reproductive system. Findings revealed that menstrual disruption (in the form of amenorrhea or prolonged bleeding) appeared to have dire repercussions, including accusations of witchcraft and immoral behavior that could result in a woman's being divorced or in her husband's acquiring an additional wife. The social consequences of side effects were perceived to be more important than their biological manifestations, and together with the fear of sterility, resulted in a preference for the condom.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / ethnology*
  • Adolescent Behavior / psychology
  • Adult
  • Amenorrhea / psychology
  • Attitude of Health Personnel
  • Condoms / statistics & numerical data
  • Contraception / methods*
  • Contraception / psychology
  • Contraception Behavior / ethnology*
  • Contraception Behavior / psychology
  • Contraceptive Agents, Female / therapeutic use
  • Contraceptives, Oral, Hormonal / therapeutic use
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infertility / psychology
  • Injections
  • Interviews as Topic
  • Male
  • Mali
  • Medroxyprogesterone Acetate / therapeutic use
  • Menstruation / psychology


  • Contraceptive Agents, Female
  • Contraceptives, Oral, Hormonal
  • Medroxyprogesterone Acetate