Barriers to Modern Contraceptive Use in Kinshasa, DRC

PLoS One. 2016 Dec 1;11(12):e0167560. doi: 10.1371/journal.pone.0167560. eCollection 2016.

Abstract

Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.

MeSH terms

  • Adult
  • Contraception / economics
  • Contraception / psychology
  • Contraception / statistics & numerical data*
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Contraceptive Agents / economics
  • Contraceptive Agents / supply & distribution
  • Democratic Republic of the Congo
  • Family Planning Services / education*
  • Family Planning Services / ethics
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Male
  • Spouses / education
  • Spouses / psychology*
  • Surveys and Questionnaires

Substances

  • Contraceptive Agents

Grant support

The study was funded by the Bill and Melinda Gates Foundation (grant #OPP1117997; URL: http://www.gatesfoundation.org/). JTB and MM received the funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.